prevent postoperative wound dehiscence

Postoperative wound dehiscence is a serious complication that can occur during surgical recovery. It not only delays healing but also increases the risk of infection. Proper management of wound dehiscence requires scientific methods and meticulous care. Here are 10 practical tips for managing postoperative wound dehiscence.

How to determine if a wound is dehiscent?

Wound dehiscence typically manifests as suture separation or separation of wound edges, possibly accompanied by drainage or bleeding. Mild dehiscence may involve only the superficial skin layer, while more severe dehiscence may also involve separation of deeper tissues. Sometimes, yellowish fatty tissue or reddish muscle tissue may be exposed within the wound . Patients may experience increased localized pain or a tearing sensation.

How to deal with the initial cracking ?

If you notice a wound dehiscence, immediately cover it with sterile gauze, avoiding direct contact with the wound interior. Keep the wound clean and dry to avoid contamination. Do not attempt to push back or tape the wound edges, as this may cause further damage. See a doctor for evaluation and treatment . Before seeking medical attention, try to lie flat to reduce tension on the wound.

What methods are needed in the later stage of cracking ?

Depending on the degree of dehiscence, doctors may adopt different treatment methods. For wounds with minor dehiscence and no signs of infection, secondary suturing or the use of a wound skin closure device may be performed. Wound skin closure is an important treatment method, which includes methods such as suturing, staplers, medical tape or tissue adhesives. If the wound is infected or has tissue necrosis, debridement and removal of necrotic tissue are required before considering delayed closure. For wounds that are not suitable for immediate closure, negative pressure wound therapy technology may be used to promote the growth of granulation tissue. Larger defects may require flap transplantation or skin grafting.

How to properly care for wounds?

Maintaining wound cleanliness is crucial. Irrigate the wound daily with normal saline to remove secretions and necrotic tissue. Use appropriate dressings as directed by your doctor. For wounds with excessive exudate, choose highly absorbent dressings such as silicone gel foam . Silver-containing dressings can be used for wounds at high risk of infection. When changing dressings, ensure aseptic technique, wash hands, and wear gloves to avoid cross-infection.

How to avoid increasing wound tension?

Reducing abdominal pressure is important. Avoid lifting heavy objects, coughing violently, or straining during bowel movements. When getting up, first roll onto your side and then use your arms to support yourself, avoiding sit-ups. Using an abdominal binder or girdle can provide external support, but only under a doctor's supervision. Maintain adequate rest and avoid standing or walking for extended periods. Use pillows to elevate the wound area during sleep to reduce tension.

What signs indicate that immediate medical attention is needed?

Profuse, bright red bleeding from the wound that doesn't stop with pressure. Increased purulent discharge with a foul odor. A fever exceeding 38°C. Expanding redness and swelling around the wound, and increased pain. Nausea, vomiting, or changes in consciousness. These may be signs of a serious infection or complication requiring immediate medical attention.

How to prevent the wound from reopening?

To avoid secondary injury, avoid strenuous exercise too early. Manage chronic conditions like diabetes and keep your blood sugar stable. Avoid smoking, as nicotine can affect blood circulation and delay healing.

What adjunctive treatments are used?

Negative pressure wound therapy can promote the growth of granulation tissue and shorten healing time. Hyperbaric oxygen therapy increases tissue oxygen content and enhances the bactericidal ability of white blood cells. Growth factor preparations stimulate cell proliferation and angiogenesis. New dressings such as hydrocolloid dressings and foam dressings provide a suitable healing environment.

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Editor: kiki Jia