Wound dehiscence: Difference between revisions
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'''Wound dehiscence''' is a [[complication (medicine)|surgical complication]] in which a [[wound]] breaks open along [[surgical suture]]. Risk factors are age, diabetes, obesity, poor knotting or grabbing of stitches, and trauma to the wound after surgery.<ref name = EBSCO>{{cite web | url = http://www.upmc.com/healthatoz/pages/healthlibrary.aspx?chunkiid=99918 | title = Wound Dehiscence (Surgical Wound Dehiscence; Operative Wound Dehiscence) | publisher = [[EBSCO Industries]] | date = 2010-09-01 | accessdate = 2011-06-24 }}</ref> |
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{{sources|date=June 2011}} |
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'''Wound dehiscence''' is the premature "bursting" open of a [[wound]] along surgical suture. It is a surgical complication that results from poor wound healing. Risk factors are age, diabetes, obesity, poor knotting or grabbing of stitches, and trauma to the wound after surgery.<ref>[http://cancerweb.ncl.ac.uk/cgi-bin/omd?wound+dehiscence], "Definition of dehiscence: Cancer Web"</ref><ref>[http://www.upmc.com/HealthManagement/ManagingYourHealth/HealthReference/Diseases/?chunkiid=99918], "Definition of dehiscence: UPMC"</ref> Sometimes a pink (serosanguinous) fluid may leak out. |
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A possible cause of wound dehiscence includes inadequate scar formation, which in turn can be caused by any of the following: |
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*[[Ehlers-Danlos syndrome]]. People with this genetic disorder are unable to make normal collagen, which is essential in scar formation. |
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*[[Scurvy]]. Scurvy is a disease caused by Vitamin C (ascorbic acid) deficiency. Vitamin C is required to create strong cross links between collagen fibers. An inability to make these cross links leads to weak scar tissue. |
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*Poor blood supply to the wound. Inflammation, and subsequent delivery of nutrients is vital for wound healing. Some individuals, such as diabetics, have poor blood supply in certain parts of their body. |
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*The use of medications. Medications such as anti-inflammatory agents such as steroids inhibit proper wound healing. |
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*Physical stress. Often, wound dehiscence occurs from physical stress on the wound. Physical stress can be caused by the [[Valsalva maneuver]] or by other physical forces, such as by flexure of a nearby joint. |
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*Bacterial weakening of the tissue. |
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==Symptoms== |
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Furthermore, the size, location, and type of the wound impacts its probability of rupture. |
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Symptoms of dehiscence can include bleeding, pain, [[inflammation]], [[fever]], or the wound opening spontaneously.<ref name = EBSCO/> |
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==Cause== |
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Wound dehiscence can be caused by inadequate undermining (cutting the skin away from the underlying tissues) of the wound during surgery, excessive tension on the wound edges caused by lifting or straining, or the wound being located on a highly mobile or high tension area such as the back, shoulders or legs.<ref name = Textbook>{{cite book | last = Rusciani | first = L | coauthors = Robins P | year = 2008 | publisher = PICCIN | title = Textbook of dermatologic surgery | isbn= 8829918989 | pages = [http://books.google.ca/books?id=js2L1nPMJMwC&pg=PA183#v=onepage&q&f=false 183] }}</ref> Individuals with [[Ehlers–Danlos syndrome]] also commonly experience wound dehiscence.<ref>{{cite book | last =Cassidy | first = SB | coauthors = Allanson JE | title = Management of genetic syndromes | pages = 220 | publisher = Wiley-Liss | year = 2005| isbn = 0471308706 }}</ref> Risk factors can include any of the above as well as obesity, smoking, previous scarring, surgical error, [[cancer]], chronic use of [[corticosteroid]]s and increased abdominal pressure.<ref name = EBSCO/> |
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==Prevention== |
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Dehiscence can be prevented through adequate undermining to reduce stress on the wound edges, avoiding heavy lifting and [[hematoma]]s, and speeding healing through adequate nutrition, controlled [[diabetes]] and avoiding certiain medications such as [[prednisone]]. Sterile strips may also be used to cover the sutures for up to a week.<ref name = Textbook/> Antibiotics and cleaning the wound may also help.<ref name = EBSCO/> |
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==Treatment== |
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Once wound dehiscence occurs, it can be treated by allowing [[Granulation tissue|granulation]], re-cutting and suturing the edges and providing [[Preventive medicine#Prophylaxis|prophylactic]] [[Antibacterial|antibiotics]].<ref name = Textbook/> Exposure to the air, [[debridement]] and if indicated, frequent [[dressing (medical)|dressing]] changes may also help.<ref name = EBSCO/> |
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== Notes == |
== Notes == |
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Revision as of 18:03, 24 June 2011
Wound dehiscence is a surgical complication in which a wound breaks open along surgical suture. Risk factors are age, diabetes, obesity, poor knotting or grabbing of stitches, and trauma to the wound after surgery.[1]
Symptoms
Symptoms of dehiscence can include bleeding, pain, inflammation, fever, or the wound opening spontaneously.[1]
Cause
Wound dehiscence can be caused by inadequate undermining (cutting the skin away from the underlying tissues) of the wound during surgery, excessive tension on the wound edges caused by lifting or straining, or the wound being located on a highly mobile or high tension area such as the back, shoulders or legs.[2] Individuals with Ehlers–Danlos syndrome also commonly experience wound dehiscence.[3] Risk factors can include any of the above as well as obesity, smoking, previous scarring, surgical error, cancer, chronic use of corticosteroids and increased abdominal pressure.[1]
Prevention
Dehiscence can be prevented through adequate undermining to reduce stress on the wound edges, avoiding heavy lifting and hematomas, and speeding healing through adequate nutrition, controlled diabetes and avoiding certiain medications such as prednisone. Sterile strips may also be used to cover the sutures for up to a week.[2] Antibiotics and cleaning the wound may also help.[1]
Treatment
Once wound dehiscence occurs, it can be treated by allowing granulation, re-cutting and suturing the edges and providing prophylactic antibiotics.[2] Exposure to the air, debridement and if indicated, frequent dressing changes may also help.[1]
Notes
- ^ a b c d e "Wound Dehiscence (Surgical Wound Dehiscence; Operative Wound Dehiscence)". EBSCO Industries. 2010-09-01. Retrieved 2011-06-24.
- ^ a b c Rusciani, L (2008). Textbook of dermatologic surgery. PICCIN. pp. 183. ISBN 8829918989.
{{cite book}}: Unknown parameter|coauthors=ignored (|author=suggested) (help) - ^ Cassidy, SB (2005). Management of genetic syndromes. Wiley-Liss. p. 220. ISBN 0471308706.
{{cite book}}: Unknown parameter|coauthors=ignored (|author=suggested) (help)
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