A dehisced wound is a surgical wound that has opened up during the healing process. In some cases, wound dehiscence can be a medical emergency requiring immediate surgery to repair the wound. For less severe cases, it may be treated with careful bandaging and monitoring to check for signs of further dehiscence or infection. While people recover from surgery in the hospital, nurses check their healing wounds regularly for signs of complications like spontaneous ruptures and once they arrive home, people should keep an eye on their surgical wounds. If there are any signs of dehiscence, the surgeon should be called immediately.
There are a number of factors known to lead to spontaneous ruptures of surgical wounds. Abdominal surgeries are far more likely to end with a dehisced wound and these wounds can come with serious complications like evisceration, where the contents of the abdomen protrude out of the wound when it splits open. People with medical conditions like connective tissue disorders and diabetes are at increased risk of developing a dehisced wound. Sometimes, this surgical complication is the result of placing sutures incorrectly.
A major concern with spontaneous reopening of surgical wounds is the potential for infection. If a wound opens up, bacteria and other organisms can work their way into the surgical site and cause complications for the patient. The wound may also become inflamed and chronically irritated, making it difficult for the injury to heal or causing severe scarring when the wound does close. It is also possible for a dehisced wound to widen beyond the original boundaries of the surgical site as a result of tension on the edges of the wound.
In a mild case, the surgical wound opens slightly, but does not rupture all along its length or all the way to the base of the incision. The surgeon should be called to examine the wound. Typically the wound is irrigated to remove any bacteria present and then it will be bandaged to protect it. More serious open wounds may be treated with a vacuum bandage to keep the wound closed and allow the edges to start knitting together.
In deep dehisced wounds or wounds where evisceration has occurred, the patient needs surgery. The bound will be covered with moist bandage material and the patient will be prepared for surgery. If a patient is too unstable for surgery, supportive care will be provided while hospital personnel work on stabilizing the patient for the operating room.