dehiscence

dehiscence

 [de-his´ens]

1. a splitting open.

2. wound dehiscence.

dehiscence of uterus rupture of the uterus following cesarean section, especially separation of the uterine scar prior to or during a subsequent labor.

wound dehiscence separation of the layers of a surgical wound; it may be partial or only superficial, or complete with separation of all layers and total disruption. Complete dehiscence of an abdominal wound usually leads to evisceration.

Patient Care. Patients most at risk for wound dehiscence are those who are obese, malnourished, or dehydrated or have abdominal distention, a malignancy, or multiple trauma to the abdomen. Infected wounds are also prone to dehiscence. Those patients who smoke or have a chronic cough are also at risk. Careful monitoring of patients with a predisposition to delayed healing is essential for prevention or mitigation of wound separation, especially between the fifth and twelfth postoperative days, when dehiscence most often occurs. In about half the cases of dehiscence there is a noticeable increase in serosanguineous drainage on the wound dressing before separation of the outer layers becomes apparent. Patients also may report the feeling that something has “given way” in the wound.

If evisceration has not occurred, the wound may be splinted with reinforced dressings, sterile towels, or a binder. This could prevent further separation and allow time to notify the surgeon. The patient should be instructed to lie quietly and, if it is an abdominal wound, to try to avoid increasing intra-abdominal pressure by coughing or straining in any way.

Should splinting an abdominal wound fail to prevent further separation and a spilling of the viscera through the opening, emergency surgery is imperative. Until the patient goes to surgery, the protruding intestines should be covered to prevent drying. Some authorities recommend that only dry sterile towels be used while others prefer covering the entire wound with a sterile towel moistened with povidone-iodine (Betadine). Warming the solution to body temperature can help avoid shock to the intestines, but is not necessary if there is not time to do this.

 The sutures are unable to keep the wound closed and the edges are no longer approximated. Dehiscence can lead to wound evisceration. From Ignatavicius and Workman, 2002.

de·his·cence

(dē-his'ents),

A bursting open, splitting, or gaping along natural or sutured lines.

[L. dehisco, to split apart or open]

dehiscence

/de·his·cence/ (de-his´ins) a splitting open.

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wound dehiscence  separation of the layers of a surgical wound.

de·his·cence

(dĭ-hĭs′əns)

n.

A bursting open or splitting along natural or sutured lines.

dehiscence

[dihis′əns]

Etymology: L, dehiscere, to gape

the separation of a surgical incision or rupture of a wound closure, typically an abdominal incision.

dehiscence

Surgery The pulling apart of apposed or sutured margins

de·his·cence

(dē-his'ĕns)

A bursting open, splitting, or gaping along natural or sutured lines.

[L. dehisco, to split apart or open]

dehiscence

suture line failure secondary to wound infection, tissue necrosis or foreign body; wound healing fails to proceed to completion at the normal rate; treatment includes meticulous wound cleansing and debridement, antibiosis as necessary, and regular redressing until wound healing is complete

de·his·cence

(dē-his'ĕns)

A bursting open, splitting, or gaping along natural or sutured lines.

[L. dehisco, to split apart or open]

dehiscence (dēhis´əns),

n a fissural defect in the facial alveolar plate extending from the gingival margin apically.

dehiscent mandibular canal,

n a condition caused by bone resorption that leaves the mandibular canal without a covering or roof of bone.

dehiscence

a splitting open, as in a surgical wound.