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What Is Dehiscence?

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  • Written By: Mary McMahon
  • Edited By: O. Wallace
  • Last Modified Date: 13 August 2014
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Dehiscence is a term which refers to the spontaneous creation of an opening. It can take several forms in both botany and medicine. Most commonly, however, people use this term to refer to a potentially fatal complication of surgery called wound dehiscence, in which a surgical wound reopens after surgery. This can be very dangerous to the patient, and is one reason why surgical sites are so very closely monitored, to ensure that any signs of wound dehiscence are identified early.

In the case of wound dehiscence, the phenomenon is associated with a number of things. Abdominal surgery can be a risk factor, as can diabetes, general ill health, and other factors which complicate healing. If a surgery is performed on a site where surgery has been performed before, the risk can increase, and surgery as a result of severe trauma can also be a risk factor, as the surgeon may not be able to control the incision as much as he or she desires. Especially large incisions are also a risk factor.

Wound dehiscence can happen as late as a week after surgery. Signs that the patient may be at risk can include a slow healing time, increased discharge around the wound, severe bruising around the wound, and the lack of tissue granulation around the wound during the healing process. These signs can indicate that the patient should be monitored closely so that signs of splitting and separation along the incision will be quickly spotted.

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If a patient experiences surgical dehiscence, it can be fatal. It increases the risk of peritonitis and infection, can result in evisceration, and may present other problems, depending on the patient and the location of the wound. It needs to be treated promptly by a surgeon who can repair the rupture. The risk of wound dehiscence is one reason why patients may be asked to remain in a hospital during the early stages of the healing process if they have had traumatic surgery or if they are at risk of developing dehiscence.

The medical community also uses this term to refer to a very rare balance disorder called Superior Canal Dehiscence Syndrome (SCDS). In this condition, an opening to the inner ear appears spontaneously, disrupting the patient's balance and creating a sense of vertigo. The treatment for this condition is surgery to repair the opening. Since the condition is often caused by severe head trauma, the patient may also be monitored for signs of neurological complications.

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Discuss this Article

sweetPeas
Post 5

At least there are definite signs to alert the doctor or patient that something needs to be done about their surgical wound. Dehiscence can be serious and even fatal.

A wound area that is healing slowly, discharge and bruising are signs that the wound site should be attended to immediately.

I have never heard of dehiscence happening, but I'm glad I know about it now, just in case.

lovealot
Post 4

I wonder how often dehiscence wounds occur after surgery. I'm glad to hear that patients who are at high risk for this situation are kept in the hospital for longer than the average surgical patient.

It sounds like a condition that would be difficult to fix. I think that any surgery in the abdominal area could be a problem. And surgery after a traumatic accident could cause real problems.

I hope this condition isn't too common. It's pretty scary.

allenJo
Post 3

@MrMoody - I can think of no bigger wound – and one with more potential for complication- than a Caesarean section.

I know that women who go this route have done so because they usually have no choice; some condition has arisen where they will not be able to deliver the baby through traditional birth.

In a few cases, some women choose to have a Caesarian because of its convenience, but those who do so should weigh the risks in my opinion.

For example, with a wound created from a Caesarian operation a woman risks infection, extra blood loss and even damage to other internal organs. If the organs are damaged in any way then she will need additional surgery (creating even more wound sites) to repair the organs.

I think a Caesarian is a bigger risk than eye surgery, any day.

hamje32
Post 2

@MrMoody - I think you’re describing what’s called a flap in these surgical eye treatments. Despite appearances, these are serious cases and not merely cases of superficial dehiscence.

Sometimes what causes the flap to occur is an injury to the eye shortly after surgery. In situations like this the patient can return to the eye care doctor to have the flap repositioned. This is what happened to a friend of mine and she is fine.

Within a week or so the eye returns to normal sight. These things happened in the early days of laser eye surgery, and personally I don’t think you should be too worried about it happening to you if you go this route. They’ve got this thing down to a science nowadays.

MrMoody
Post 1

While any surgery creates the potential for a dehiscence wound, I think that the most dangerous kind of surgery in this regard would be eye surgery.

I can’t imagine what it would be like to have a delicate surgical procedure performed on the eye, only to have the suture open up again after a few weeks. That would be a terrifying predicament in my opinion, and is one of the reasons I have avoided things like laser eye treatments.

I have heard of situations where these things didn’t work out well, and the patient had to go back to the doctor for a second stitch or another surgical procedure. I’ll stick with my glasses for now.

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