Overview
Wound dehiscence is a surgical complication where a wound that was previously closed—either with sutures, staples, or glue—reopens partially or completely. It can occur in both superficial skin layers and deeper surgical incisions, sometimes exposing underlying tissues or organs. This condition requires prompt medical attention to prevent infection, delayed healing, or more serious complications like evisceration.
What is Wound Dehiscence?
Wound dehiscence refers to the separation or rupture of a surgical incision after it has been closed. It may involve just the skin or extend deeper into muscle and fascia layers. This usually occurs within the first two weeks post-surgery, a critical time when the wound is still healing and regaining tensile strength. Dehiscence is most common after abdominal or thoracic surgeries, especially in high-risk patients.
Symptoms
Common signs and symptoms of wound dehiscence include:
- Visible opening or gaping of the wound
- Sudden drainage or bleeding from the wound site
- Pain or swelling at the incision area
- Redness or warmth around the wound
- Visible underlying tissue or organs in severe cases (evisceration)
- Fever or chills if infection has set in
- Delayed healing or non-closure of the wound
Any sudden change in a post-surgical wound’s appearance warrants medical evaluation.
Causes
Wound dehiscence can result from multiple factors, including:
- Increased pressure on the wound site (e.g., coughing, vomiting, heavy lifting)
- Infection at the incision site
- Poor surgical technique or weak sutures
- Inadequate post-operative care or wound support
- Underlying chronic conditions (e.g., diabetes, obesity)
- Malnutrition or protein deficiency
- Smoking, which impairs oxygen delivery and healing
- Use of corticosteroids or immunosuppressants
Risk Factors
Individuals more likely to develop wound dehiscence include:
- Elderly patients
- Obese individuals
- Patients with poorly controlled diabetes
- People with compromised immune systems
- Patients with history of radiation or chemotherapy
- Smokers
- Those undergoing abdominal or emergency surgery
- Patients with chronic coughing or respiratory conditions
Complications
If untreated, wound dehiscence can lead to serious complications:
- Surgical site infection (SSI)
- Evisceration, where internal organs protrude through the open wound
- Sepsis, a life-threatening systemic infection
- Poor cosmetic healing or large scar formation
- Delayed recovery and extended hospital stays
- Need for repeat surgery or wound revision
- Chronic wound formation or failure to heal
Prevention
Preventing wound dehiscence involves both surgical technique and post-operative care:
During surgery:
- Proper suturing technique and tension control
- Use of wound reinforcement materials when needed
- Ensuring hemostasis and aseptic conditions
Post-operative care:
- Follow wound care instructions meticulously
- Avoid heavy lifting, coughing, or straining
- Maintain good blood glucose control in diabetic patients
- Nutritional support to aid tissue repair
- Avoid smoking and alcohol
- Use of abdominal binders or wound support garments after abdominal surgeries
- Early detection and treatment of wound infection
Treatment Options in Korea
South Korea offers advanced surgical and wound care for conditions like wound dehiscence. Treatment depends on the severity of the wound and underlying causes:
- Wound cleaning and debridement to remove dead tissue
- Antibiotics if infection is present
- Re-suturing or surgical revision of the wound
- Vacuum-assisted closure (VAC) therapy to enhance healing
- Hyperbaric oxygen therapy in select chronic or infected cases
- Nutritional and metabolic support
- Wound care clinics offering specialized dressings and follow-up
Top hospitals like Seoul National University Hospital, Asan Medical Center, and Samsung Medical Center offer multidisciplinary wound care teams including surgeons, infectious disease specialists, and wound nurses to ensure optimal recovery and cosmetic outcomes.
