The Postoperative Wound Dehiscence arises as a result of tissue disruption during surgery. The wound whose edges are close to each other and are small heals due to rapid growth (1). The edges of the Postoperative Wound Dehiscence stick together and thin scar forms, if there are no complications, this is the fastest way to heal wounds.
When the wound is extensive, there is a large tissue defect, the wound heals more slowly by granulation. In the bottom of the wound, blood vessels grow that cause the formation of granulation tissue.
It is a substrate for regenerating the next layers of skin and epidermis. The resulting scar is more extensive and visible, often with a different color than healthy skin. Each postoperative Postoperative Wound Dehiscence requires special care.
Also, patients should be aware of the careful handling of the wound and be advised on how to care for proper healing.
Scab is a Biological Dressing:
The patient should know that the Postoperative Wound Dehiscence will heal for about two weeks. Around this time, the first scar forms, the scab falls off and the seams are removed. Healing of the wound under the scab occurs when the clot form at the beginning dries. The scab is a biological dressing under which the granulation and regeneration process takes place (2)
Therefore, patients should not scratch, dry with ointments, or tear off. Pain, itching, or pulling lasts about a week to two. You need to be able to distinguish between pathological pain, which can be a sign of a developing inflammatory process, and pain associate with damage to the skin and tissues.
Initially high postoperative pain, as the days go by after surgery decreases, can be seen by monitoring the amount of painkillers taken by patients. The pain associates with inflammation increases as the inflammation progresses.
Hematoma and Bruising:
The patient should know that hematoma and bruising may form around the Postoperative Wound Dehiscence if there is interference with muscle and subcutaneous tissue, its absorption is time consuming and not very aesthetic.
Most often it is “spilled”, ie it occupies a large space (3). The bruise changes color as it is absorbed, it is initially purple, green, and finally turns yellow and disappears.
The change of colors indicates its absorption and there is nothing to worry about. However, when the hematoma collects in one place, which begins to hurt or harden, it may need to be surgically evacuated. Hematomas – bruises often arise during surgery on the limbs, rarely when surgery on the trunk.
Major operations Especially about Postoperative Wound Dehiscence:
Initially, the Postoperative Wound Dehiscence is painful, slightly swollen, and red, and as it heals, these symptoms disappear. After major operations, the wounds, especially in areas where the drains have been removed, bleed slightly.
Blood appears on the dressing, later a yellow-green, but odorless liquid appears. Especially where the drains are removed, the dressing may be more permeate.
Exercise, rehabilitation, and uprighting of the patient may cause a temporary increase in soiling of the dressing, due to the work of muscles and gravity, which accelerate the evacuation of the hematoma.
Inflammation on Postoperative Wound Dehiscence :
Inflammation is an undesirable condition, it may indicate bacterial contamination of the wound. In contrast to the normal state, the pain, as I wrote above, instead of giving way increases.
The patient may complain of Postoperative Wound Dehiscence pulsating, warming, and redness of the wound, but also of systemic fever. The edges of the wound may separate and the fluid that comes out of it has an unpleasant smell and a turbid yellow color.
To prevent bacterial infections, patients undergo antibacterial prophylaxis. Unfortunately, once the infection has healed the wound is longer and often requires a hospital stay. Antibiotic therapies are continuing, the wound can be surgically cleaned, and special bacteriostatic or antibiotic meshes may be used locally.
Dressing of Postoperative Wound Dehiscence :
On the first day after surgery, it does not change, even a very bloodshot dressing. Next layers are added to the dressing, which was place in the operating room, so as to ensure patient comfort, do not dirty the bedding, and that the wound through the wet dressing does not come into contact with the environment.
This is to create a scab, hemostasis, and to prevent infection of the fresh Postoperative Wound Dehiscence and wound edges. In any other case, a wet or dirty dressing needs to be changed in an aseptic manner.
The patient should know that while taking a bath, the dressing and wound must be protected against wetting. And if he fails, the dressing should be change to dry. The Wound Dehiscence should be gently washed with 0.9% saline or a non-alcoholic disinfectant. If the dressing peels off, it must also be changed so that it is always tight.