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.