Post-operative Wound Dehiscence

Partial or complete separation of the layers of a surgical wound.

• Increased intra-abdominal pressure (e.g., coughing, vomiting)
• Mechanical stress on the wound
• Surgical factors (e.g., tension on the wound, inappropriate suture material or technique)
• Infection at the wound site
• Malnutrition
• Steroid use
• Radiation therapy
• Underlying diseases (e.g., diabetes, vascular disorders)
• Smoking

• Discharge of serosanguinous fluid from the wound.
• Visible separation of wound edges.
• Underlying tissues/organs may become exposed.
• Pain or discomfort around the wound site.
• Signs of infection (redness, warmth, swelling, purulent discharge).

• Protect the wound to prevent further separation and contamination.
• If minor, secondary healing may be sufficient with dressings and wound care.
• Significant dehiscence may require surgical intervention (e.g., wound closure, debridement).
• Systemic antibiotics if there’s evidence of infection.
• Nutritional support to promote wound healing.
• Manage underlying conditions that may impede healing (e.g., hyperglycaemia in diabetics).

• Meticulous surgical technique.
• Use appropriate sutures and closure techniques.
• Address and manage risk factors pre-operatively (e.g., improving nutritional status, optimizing blood glucose levels).
• Post-operative wound care and education (e.g., advising patients to avoid activities that increase intra-abdominal pressure).
• Early mobilisation post-surgery can help reduce the risk.
• Proper post-operative pain management (to minimise coughing due to pain).

• Infection
• Evisceration (protrusion of internal organs, typically intestines, through the wound)
• Formation of wound abscess or fistula
• Prolonged wound healing
• Scarring
• Increased hospital stay and associated costs