Wound dehiscence
A surgical wound rupturing along the incision line.
After surgery, an incision can reopen, a condition called wound dehiscence. This complication is more likely in older patients, those with diabetes, obesity, or collagen disorders like Ehlers–Danlos syndrome, and can be triggered by poor stitching technique or post-surgical injury to the wound.
Did You Know?
- Signs of dehiscence can include bleeding, pain, inflammation, fever, or the wound opening spontaneously.
- An internal surgical wound dehiscence can occur internally, as a consequence of hysterectomy, at the site of the vaginal cuff.
Cause
Wound dehiscence often starts with a sub-acute infection, which happens when sterile technique is not fully maintained. Coated sutures like Vicryl are designed to dissolve at a rate that matches normal healing, but bacteria can speed up that breakdown. If no other metabolic issues are slowing recovery, a sub-acute infection is likely, and wound cultures should be taken. Dehiscence may also occur when the wound is not adequately undermined during surgery, when the patient lifts or strains causing too much tension on the edges, or when the wound is on a high-mobility or high-tension area like the back, shoulders, or legs. People with Ehlers-Danlos syndrome are also prone to this condition. Other risk factors include obesity, smoking or any nicotine use, previous scarring, surgical mistakes, cancer, long-term corticosteroid use, and increased abdominal pressure.
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