What is wound dehiscence?

Dehiscence is a partial or total separation of wound edges that had been closed, due to a failure of proper wound healing. It typically occurs 5 to 8 days after surgery.

Dehiscence is the clinical word for a wound coming apart after it was closed. It means a partial or total separation of previously approximated wound edges, due to a failure of proper wound healing.

Approximated means the edges had been brought together by stitches, clips, staples, glue or tape. Separation means they have come apart again, either along part of the closure or along all of it.

It typically occurs 5 to 8 days after surgery, when healing is still in the early stages. The causes are similar to the causes of poor wound healing in general: ischemia, infection, increased abdominal pressure, diabetes, malnutrition, smoking and obesity.

In superficial dehiscence, the wound edges begin to separate, with increased bleeding or drainage at the site. A clinician should investigate the wound for worrisome signs, including infection or necrosis. Here’s why this matters: prompt identification is important for preventing worsening dehiscence, infection and other complications. Complete dehiscence after abdominal surgery also has a serious complication, called evisceration.

In plainer language: sometimes an incision breaks open. This may happen along the entire cut or just part of it, and your surgeon may decide not to close it again with sutures. If that happens, the wound heals from the inside to the outside, and a dressing keeps the skin from closing before the tissue underneath fills in.

The reason to know the word at all is that it will appear in notes, letters and discharge instructions, and it is easier to ask about something you can name.

What to watch for

Contact your provider right away if you have a wound that has come open or the stitches or staples have come out too soon.

In superficial dehiscence, the wound edges begin to separate, with increased bleeding or drainage at the site. Prompt identification matters for preventing worsening dehiscence, infection and other complications. Early separation is the stage worth reporting, not the obvious one.

Also report these changes: more redness or pain, swelling or bleeding, a wound that is larger or deeper, a wound that looks dried out or dark, and drainage that increases or becomes thick, tan, green or yellow, or smells bad.

Wound Wizard is general education and cannot assess your wound. Your surgeon is the right person to ask.

What we look at

  • Examining how far the wound has separated
  • Investigating for infection or dead tissue
  • Deciding whether to close it again or let it heal open
  • Identifying what contributed to it

Sources

  1. Wound Dehiscence — StatPearls, National Library of Medicine https://www.ncbi.nlm.nih.gov/books/NBK551712/
  2. Surgical wound care - open — MedlinePlus, U.S. National Library of Medicine https://medlineplus.gov/ency/patientinstructions/000040.htm