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

(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

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.

de·his·cence

(dē-his'ĕns)
A bursting open, splitting, or gaping along natural or sutured lines.
[L. dehisco, to split apart or open]
References in periodicals archive ?
Wound dehiscence was present in 35% in interrupted-X and 22.5% in Professor Hughes technique at 6 weeks but the difference was not statistically significant.
The association of intra-abdominal infection and abdominal wound dehiscence. Am Surg 1998; 64:660-5.
The postoperative wound site dehiscence that can be seen in PSD patients occurs because the region is a humid and narrow area and the wound sides that are brought together in a strained way during the surgery may split again after the sutures are removed while performing daily activities, such as sitting down and using the toilet.
According to the records, four patients in the sternal simple wire group developed sternal dehiscence, infection, and mediastinitis that required sternal re-wiring.
The presence of dehiscence was a matter of concern both esthetically, functionally, and oral hygiene.
As in other reported cases of otic capsule dehiscence, VEMPs were preserved [7].
Finally, good postoperative care is quite important to get the best results from pediatric dermatologic procedures, avoiding infections, and poor healing including dehiscence.
We divided the animals based on the position of the dehiscence and its size.
According to the examination above, the patient was diagnosed of CII/2 subdivision malocclusion with retroinclined upper incisors, undersized lateral incisors, dehiscence defect in the maxillary anterior alveolar bone, and deep overbite.
Vaginal cuff dehiscence with or without bowel evisceration has been reported as early as 3 days [7] and as late as 30 years postoperatively [8].
Data collected included patient age and gender, indication for keratoplasty, surgical procedures, duration between keratoplasty and WD, causative events for WD, size of dehiscence, treatment procedures, and vision outcomes after surgical repair.