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(Surgical Wound Dehiscence; Operative Wound Dehiscence)
- Infection at the wound
- Pressure on sutures
- Sutures too tight
- Injury to the wound area
- Weak tissue or muscle at the wound area
- Incorrect suture technique used to close operative area
- Poor closure technique at the time of surgery
- Use of high-dose or long-term corticosteroids
- Severe vitamin C deficiency—scurvy
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- Being overweight
- Increasing age
- Poor nutrition
- Malignant growth
- Presence of prior scar or radiation at the incision site
- Non-compliance with post-operative instructions (such as early excessive exercise or lifting heavy objects)
- Surgical error
- Increased pressure within the abdomen, which can occur with fluid accumulation ascites, inflamed bowel, or severe coughing, straining, or vomiting
- Long-term use of corticosteroid medications
- Other medical conditions, such as diabetes, kidney disease, cancer, immune problems, chemotherapy, or radiation therapy
- Wound and tissue cultures to determine if there is an infection
- Blood tests to determine if there is an infection
- Antibiotics if an infection is present or possible
- Frequent changes in wound dressing to prevent infection—when appropriate
- Wound exposure to air to accelerate healing and prevent infection, and allow growth of new tissue from below—when appropriate
- Remove contaminated and/or dead tissue
- Resuture the wound
- Place a temporary or permanent piece of mesh to bridge the gap in the wound
- When appropriate, have antibiotic therapy prior to surgery
- When appropriate, have antibiotic therapy after surgery
- When using wound dressing, maintain light pressure on wound
- Keep wound area clean
- Comply with post-operative instructions
American College of Surgeons http://www.facs.org
Centers for Disease Control and Prevention http://www.cdc.gov
Canadian Association of Wound Care http://www.cawc.net
The Canadian Society of Plastic Surgeons http://www.plasticsurgery.ca
Bennett R. Fundamentals of Cutaneous Surgery. St. Louis, MO: CV Mosby; 1988: 498.
DeCherney AH, Nathan L. Current Obstetric & Gynecologic Diagnosis & Treatment. 9th ed. New York, NY: McGraw-Hill; 2003.
Dorland WN. Dorland's Illustrated Medical Dictionary. Philadelphia, PA: WB Saunders, Harcourt Health Sciences; 2005.
Porter RS. The Merck Manual of Medical Information Home Edition. 2nd ed. Whitehouse Station, NJ: Merck Research Laboratories; 2004.
Schwartz S, Brunicardi F, et al. Schwartz’s Principles of Surgery. 8th ed. New York, NY: McGraw-Hill; 2007.
Surgical site infection. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated August 14, 2014. Accessed September 30, 2014.
Surgical site infection—prevention. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated September 29, 2014. Accessed September 30, 2014.
- Reviewer: Marcin Chwistek, MD
- Review Date: 08/2014
- Update Date: 09/30/2013