dehiscence


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dehiscence

 [de-his´ens]
1. a splitting open.
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.
wound dehiscence  separation of the layers of a surgical wound.

dehiscence

(dĭ-hĭs′əns)
n.
1. Botany The spontaneous opening at maturity of a plant structure, such as a fruit, anther, or sporangium, to release its contents.
2. Medicine A rupture or splitting open, as of a surgical wound, or of an organ or structure to discharge its contents.

de·his′cent adj.

dehiscence

[dihis′əns]
Etymology: L, dehiscere, to gape
the separation of a surgical incision or rupture of a wound closure, typically an abdominal incision.
enlarge picture
Wound dehiscence

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

Splitting open or separating. Often used of an operation wound which has failed to heal normally and which breaks down under internal pressure.

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.
References in periodicals archive ?
There are many benefits to NPWT for the management of superficial and deep wound dehiscence in the ob.
Moreover, cofactors such as the intensity and chronicity of coughing, lifting and other activities as well as the effects of breast mass would need to be taken into account to ensure an accurate interpretation of risk factors for dehiscence.
Several prevention strategies have been investigated for patients undergoing median sternotomy aimed at reducing the incidence of sternal instability, dehiscence, and/or mediastinitis.
Correll and Johnston (1970) describe dehiscence accurately but do not mention rainfall as a mechanism for fruit dispersal.
44%) isolated on-pump coronary artery bypass surgery (CABG) cases that developed dehiscence were analyzed with Student's t test, Mann Whitney U test, Chi-square test and Fisher's Exact test according to the type of sternal closure: figure-of-eight or simple wire technique.
Patient Safety Inpatient Quality Indicators Death among surgical patients with Abdominal aortic aneurysm (AAA) treatable serious complications mortality rate with volume Iatrogenic pneumothorax, adult Postoperative wound dehiscence Hip facture mortality rate Accidental puncture or laceration Complication/patient safety for Composite mortality rates selected indicators (composite) for selected surgical procedures: esophageal resection, pancreatic resection, AAA repair, CABG, craniotomy, hip replacement, PTCA, carotid endarterectomy Composite mortality rates for selected medical conditions: AMI, CHF, stroke, GI hemorrhage, Hip fracture, pneumonia
During the debriefing, Pam explains, the student stated that he knew he should reposition the patient but he was concerned that the patient was experiencing a wound dehiscence.
Three cases of complete uterine rupture, and six cases of uterine scar dehiscence were reported.
The acute form of BPF is typically related to stump dehiscence and necessitates early re-operation.
Also recorded were cases of wound infection, wound dehiscence, arm oedema and shoulder movement.
This is referred to as dehiscence, and occurs with an audible pop.