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Incision dehiscence refers to a surgical wound that has reopened. It is one of the possible complications of surgery, and this condition can range from mild to severe. Even if the patient notices a very small opening in the surgical wound, he should immediately report it to his surgeon for proper treatment. Depending on the severity of the incision dehiscence, this complication may lead to an infection or the protrusion of internal organs, which requires emergency medical care.
The causes of incision dehiscence are widely varied, and certain underlying factors may increase the risk for some patients. Those who are malnourished, smoke cigarettes, or take steroid drugs are thought to be at a greater risk of improper wound healing. Being diabetic or having rheumatoid arthritis may also increase the risk of incision dehiscence, because these conditions interfere with the normal healing process. People who are obese may suffer from a reopened surgical wound more frequently, because the newly formed skin must hold together more fatty tissues.
In most cases, incision dehiscence occurs when excessive pressure is exerted on the surgical area. For example, patients who are constipated may strain during bowel movements, exerting pressure that can cause the incision to split open. Vomiting can also exert too much pressure, as can coughing or sneezing. Patients should always avoid lifting heavy objects or engaging in strenuous activities following a surgery, because this can also cause the incision to split open, despite the sutures.
When the skin around the incision splits open, causing only minor bleeding, the patient should affix a clean bandage. He should then call his physician and get medical care as soon as possible to prevent an infection. The threat of infection is present even if only one suture split and the rest of the incision is intact.
If the muscle and other deep tissues also split open and the internal organs begin to protrude through the wound, this is called evisceration, and it occurs only rarely. Those who have this severe degree of incision dehiscence must call for an ambulance immediately. They must then wet a sterile bandage or a clean sheet and cover the opening. Sterile saline solution or bottled water is preferable for wetting the bandage. Patients should never attempt to reposition the internal organs, or to push them back through the incision.
Evisceration will require additional surgery to properly reposition the organs. In most cases of mild incision dehiscence, that does not include evisceration, the doctor will clean the incision and close it with sutures. Depending on the needs of the patient, he may also administer antibiotics for infection and mild pain relievers.