HomeHealthcare Education SupportPostoperative Wound Dehiscence - Symptoms, Treatment, Risk Factors

Postoperative Wound Dehiscence – Symptoms, Treatment, Risk Factors

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.

What is postoperative wound dehiscence?

The wound is considered “dehisced” when an incision splits after surgery. This indicates that it divided along a natural axis. The split can occur only in the upper layers of the skin, or the entire wound can reopen.

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.

Wound dehiscence symptoms:

Even when wounds appear to be healed, they can split open. You may notice the following when your wound starts to fall apart:

  1. A sensation that the wound is ripping or giving way.
  2. Wound dehiscence may cause Bleeding, Pain, Swelling, Redness, Fever, Broken sutures, and Open wound
  3. The wound is leaking pink or yellow fluid.
  4. Infection symptoms include yellow or green pus, edema, redness, or warmth at the incision site.

Postoperative Wound Dehiscence Causes:

Depending on the type of surgery, the cause may differ. The following are some common causes:

  • At the wound site, there is weakened tissue or muscle.
  • At the time of surgery, the suturing was incorrect.
  • Corticosteroids in high doses or for a long time
  • Infection at the wound
  • Pressure on sutures
  • Sutures are too tight
  • New injury to the area
  • Pressure on sutures
  • Sutures are too tight

Risk Factors:

The following factors may increase your risk of wound dehiscence:

  1. Increasing age
  2. Being overweight
  3. Poor nutrition
  4. Diabetes
  5. Smoking
  6. Having a scar or having been exposed to radiation at the spot
  7. Failure to adhere to post-surgery care instructions (such as too much exercise too early or exercise or lifting heavy objects)
  8. Fluid buildup, inflammation, or intense coughing, straining, or vomiting can all cause increased pressure in the stomach.
  9. Use of corticosteroid medications for a long time
  10. Diabetes, kidney illness, cancer, immunological disorders, chemotherapy, or radiation therapy are examples of various medical conditions.

Diagnosis:

The wound will be examined by the surgeon. If there are indicators of infection, you should perform the following:

  1. A sample of the wound’s fluids will be examined for infection.
  2. Blood tests are used to look for indicators that the body is battling an infection.

Additional tests may be required only if the wound is deep or not healing properly. The surgeon may want to examine the extent of the damage. This can be accomplished by using X-ray, Ultrasound, and CT scan.

Wound dehiscence treatment antibiotics:

Some commonly prescribed antibiotics include: amoxicillin-clavulanate (Augmentin, Augmentin-Duo) cephalexin (Keflex) doxycycline (Doryx).

Treatment may include:

  1. If an infection is present or probable, antibiotics should be used.
  2. In order to avoid infection, wound dressings should be changed often.
  3. Opening the wound to the air will hasten healing, avoid infection, and allow new tissue to grow from underneath.
  4. Negative pressure wound therapy is a dressing connected to a pump that can help speed up the healing process.
  5. One or more of the following conditions may necessitate surgery:
  6. Damaged, diseased, and/or dead tissue should be removed.
  7. Suture the wound using fresh sutures.
  8. To assist close the wound, place a piece of mesh over it.

Wound dehiscence nursing interventions:

Dehiscence and evisceration are life-threatening emergencies; do not leave the client alone; call for assistance and cover the wound with a clean, sterile cloth or sterile saline wet bandage. Reinserting the organs should not be attempted under any circumstances.

Nurses use their pathophysiology expertise to keep track of problems. Nurses, for example, use their understanding of the etiology, risk factors, signs and symptoms, and complications of numerous diseases and disorders to help patients.

As these fundamental principles are implemented to the client’s care, the nurse is also aware of the numerous complications that may arise, as well as their risk factors, indicators, and symptoms, in order to prevent them.

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.

What is postoperative wound dehiscence?

The wound is considered “dehisced” when an incision splits after surgery. This indicates that it divided along a natural axis. The split can occur only in the upper layers of the skin, or the entire wound can reopen.

What does wound dehiscence look like?

What does wound dehiscence look like
What does wound dehiscence look like

A dehisced wound might be totally open, with the tissue beneath exposed, or partially open, with only the top portion of the skin split open. The wound may be red around the edges, have drainage, or be bleeding or seeping, with only a little trickle of blood dripping from it.

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.

What is the difference in postoperative wound dehiscence and evisceration:

  1. Dehiscence occurs as a result of suture failure, shear pressures from tension, or fascial necrosis caused by infection and/or ischemia.
  2. Evisceration is the uncontrolled exteriorization of intraabdominal contents outside of the abdominal cavity through a dehisced surgical wound.

Major operations Especially about Postoperative Wound Dehiscence:

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 :

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.

Resources

SignSymptom
SignSymptomhttps://signsymptom.com
Written by Dr. Ozair (CEO of SignSymptom.com) as physician writers are physicians who write creatively in fields outside their practice of medicine.

Most Popular