Table of ContentsView AllTable of ContentsDefinitionCausesSymptomsEviscerationTreatmentPrevention
Table of ContentsView All
View All
Table of Contents
Definition
Causes
Symptoms
Evisceration
Treatment
Prevention
Dehiscenceis asurgical complicationin which the edges of a wound no longer meet. It’s also known as wound separation. A wound that separates after surgery won’t close neatly and will be weaker after healing. It is also at greater risk of becoming infected.
In rare instances, a wound that doesn’t close properly can result inevisceration, which occurs when internal organs (most often organs in the abdomen), push out through the wound.
This article explains how and why wound separation happens, possible complications, ways to prevent it, and treatment options.
1:47Click Play to Learn All About Wound Dehiscence
1:47
Click Play to Learn All About Wound Dehiscence
Dehiscence: Definition
During an operation, your surgeon makes an incision or cut. Depending on thetype of surgery, this can be a fraction of an inch or spread across several inches.
As the cut heals, the wound fills in with new tissue, called “granulation” or “granulating tissue.” If stress or other factors cause the edges of a wound to separate before the new skin has time to strengthen, the wound won’t close. The granulating tissue will tear open or won’t come together at all.A wound is at the greatest risk of dehiscence in the first two weeks after surgery when the skin is still very fragile.
What to Know About How Wounds Are Closed
Wound Dehiscence Causes
When the edges of a wound separate, it’s usually because of problems with sutures or staples that are supposed to hold the skin together. Issues that come up can include:
While the type of suture material—sutures, staples, or surgical glue—and surgical technique may cause separation, those factors are less important than a person’s pre-existing health issues.
Underlying Health Issues
Your risk of wound dehiscence increases if you have certain types of medical conditions.
Understanding the Possible Risks and Complications of Surgery
Dehiscence Symptoms
This photo contains content that some people may find graphic or disturbing.See Photojax10289 / Getty Images
This photo contains content that some people may find graphic or disturbing.See Photo
This photo contains content that some people may find graphic or disturbing.
jax10289 / Getty Images
Wound dehiscence most commonly occurs six to eight days after surgery.
Signs and symptoms of dehiscence can include:
With dehiscence, the wound is completely or partially open so you can see the raw tissue underneath. Often, the skin around the edges is red and inflamed. Pus or other liquid may be draining from the opening along with blood.
Pus in a Wound After Surgery
Evisceration of a Surgical Wound
Evisceration is a rare but severe surgical complication where thesurgical incisionopens (dehiscence) and the abdominal organs then protrude or come out of the incision (evisceration). Evisceration is an emergency and should be treated as such.
Evisceration can range from less severe, with the organs visible and slightly extending outside of the incision to very severe. For instance, intestines may spill out of an abdominal incision.
Treatment for Dehiscence and Evisceration
Although rates of dehiscence are low, once it occurs, the possibility of further complications or death is high.Thus, any break in a post-surgical incision should be reported to your surgeon at once, before it becomes a potentially life-threatening medical emergency.
Managing Dehiscence
While waiting to see your healthcare provider, continue to cover your incision with a clean bandage (if you were originally instructed to have the wound covered).
Your healthcare provider may use a number of different strategies to treat wound dehiscence. These may include:
Signs of an Infection After Surgery
The length of time it takes dehiscence to heal depends on the size of the wound, its location, and the level of repair needed. In some cases, it may take about three months to fully heal, particularly if there was an infection.
Treating Evisceration
About 20% to 45% of cases of dehiscence become evisceration. The risk of death is much higher once an evisceration develops.
Evisceration is always a medical emergency. If you see tissue or organs protruding from a surgical wound, call 911 or go to the nearest hospital emergency room.
It’s important to keep the wound moist.To care for it on your way to seek medical attention or while waiting for EMS, cover the opening and organs with a moist, sterile bandage or sheet.
Wound evisceration is treated with emergency surgery.
Evisceration WarningDo not, under any circumstances, try to push organs or tissue back into the wound.
Evisceration Warning
Do not, under any circumstances, try to push organs or tissue back into the wound.
In high-risk situations or special circumstances, surgeons may use an advanced technique to close a wound. Known as a “pie-crust” incision, this method makes a number of small cuts in the surrounding skin similar to the holes in a pie crust. The multiple cuts are perpendicular to the wound line. They allow the skin to come together more easily and heal better with less scarring.
Regardless of the method used to close the wound, it’s important to take steps to reduce the chances of dehiscence or evisceration. These are some techniques you can use:
Protein and Wound HealingEating a diet rich in lean protein before surgery and during recovery may help promote healthy healing so you can avoid dehiscence.Proteins are the building blocks for tissue growth, cell renewal, and cell repair, so they’re essential during healing.
Protein and Wound Healing
Eating a diet rich in lean protein before surgery and during recovery may help promote healthy healing so you can avoid dehiscence.Proteins are the building blocks for tissue growth, cell renewal, and cell repair, so they’re essential during healing.
Summary
If the wound separates significantly, your internal organs and tissue could push out of the incision. This is known as evisceration. Get to an emergency room immediately if this happens.
10 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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