- Main signs of dehiscence
- What can cause dehiscence
- How the treatment is done
- Possible complications
- How to prevent the development of dehiscence
The dehiscence of the surgical suture is a serious complication in which the edges of the wound, which are joined by a suture, end up opening and moving away, increasing the risk of infection and hindering healing.
Although it is relatively rare, the risk of dehiscence is greater during the first 2 weeks and after abdominal surgery, as the healing process is still in its early stages.
As it is a serious complication, whenever there is a suspicion that the surgical wound may be open, it is very important to immediately go to the hospital to be evaluated by a doctor or nurse, starting treatment if necessary.
Main signs of dehiscence
The most evident sign of dehiscence is the partial or total opening of the surgical wound, however, when the wound is in a place of difficult observation, other signs that should be observed, and that should always be evaluated by a health professional, include:
- Swelling in place; Severe pain; Pus output; Feeling of excessive heat in the wound.
In cases where the wound cannot be seen, you can ask someone else to look at the place or use a mirror, for example.
See the main care that should be taken after surgery to avoid complications.
What can cause dehiscence
The main cause of wound dehiscence is the increase in pressure on the surgical wound site, which can happen when exaggerated physical efforts are made in the first weeks or when you have very frequent coughing, or even sneezing, and the site is not adequately protected., for example.
In addition, overweight people also have a higher risk of dehiscence, especially after abdominal surgery, since excess weight and fat make it difficult for the edges of the wound to stick together.
Other factors that can further increase the risk of dehiscence include being a smoker, having a kidney disease, diabetes or even a disease that causes immunosuppression, as these are conditions that hinder healing.
How the treatment is done
The treatment of a dehiscence must always be started in the hospital by a doctor or nurse, who must assess the wound and decide the best form of treatment.
In most cases, treatment is done with an antibiotic to eliminate a possible infection of the wound and use of analgesics to relieve pain. In addition, the wound dressing must be done by a nurse, as it is important to adapt the type of material used, as well as maintaining an aseptic technique.
Only in the most severe cases may it be necessary to have surgery again to clean and close the wound again.
Possible complications
When treatment for dehiscence is not started early there is a high risk of evisceration, which is when the organs under the skin pass out of the wound. This is an emergency situation that must be treated immediately at the hospital, as there is a very increased risk of a generalized infection and even organ failure.
In addition, after a dehiscence it is very possible that the scar will become uglier and more visible, since the healing process will take longer and occupy a larger area of the skin.
How to prevent the development of dehiscence
Although wound dehiscence is a rare complication that can happen in almost all surgeries, especially those performed on the abdomen, such as cesarean section.
However, there are some precautions that reduce this risk, such as:
- Apply pressure on the wound: especially when it is necessary to make a movement that causes increased pressure in the place, such as coughing, sneezing, laughing or vomiting, for example; Avoid constipation: this is a very important tip in the postoperative period of abdominal surgeries, since the accumulation of feces increases the pressure in the belly, affecting the wound. Thus, you should drink at least 2 liters of water a day and eat foods rich in fiber, such as fruits and vegetables; Avoid making efforts: mainly during the first 2 weeks, or according to the doctor's instructions; Avoid wetting the wound site during the first 2 weeks: it increases the risk of infections that end up weakening the skin.
In addition, it is advisable to make the appropriate treatment of the wound with a nurse at a health center, for example, since it allows a regular assessment of the site as well as the use of the most appropriate materials.
