Definition: Partial or complete separation of the layers of a surgical wound. Etiology: 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. Clinical Features: 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). Management: 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., hyperglycemia in diabetics). Prevention: 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). Complications: 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.
