A surgical incision opening, medically termed dehiscence, occurs when a wound that was previously closed after surgery reopens. This can expose underlying tissues and, in some instances, even internal organs. It is a known complication of surgery, and understanding the appropriate steps to take is important for management and recovery.
Immediate First Steps
If your surgical incision opens, remaining calm is the first step. Avoid attempting to push any exposed tissue or organs back into the wound. Instead, gently cover the wound with a clean, sterile dressing or a clean cloth.
Apply gentle, direct pressure to control any bleeding. If possible, lie down to reduce pressure on the affected area. Note details about the opening, such as its size, depth, and any associated symptoms like new or increased pain or bleeding. This information will be valuable when seeking medical attention.
When to Seek Professional Medical Care
Any incision opening warrants medical evaluation, but urgency varies by symptoms. Contact your surgeon or healthcare provider immediately if the opening is small, if there is persistent drainage, mild redness, increasing pain, or if you are unsure about the severity. Even a minor separation, like a single broken suture, should be reported to your medical team.
Certain signs indicate a medical emergency requiring immediate attention, such as calling emergency services or going to the nearest emergency room. These include a large opening, significant uncontrolled bleeding, or exposed internal organs. Signs of infection combined with systemic symptoms, such as fever, spreading redness, pus, or a foul odor, also necessitate urgent care.
Medical Management of an Open Incision
Upon seeking medical care, healthcare professionals will perform a thorough assessment. This includes examining the wound’s size, depth, and checking for infection, along with reviewing your medical history and vital signs. The wound will likely be cleaned, and any dead tissue or foreign material may be removed.
Treatment options for closing the wound vary based on its characteristics and the presence of infection. Re-suturing might be an option if the wound is suitable and not infected. Other approaches include negative pressure wound therapy or packing the wound with dressings. Sometimes, the wound may be allowed to heal by secondary intention, meaning it closes naturally from the bottom up. If infection is present or suspected, antibiotics will be prescribed, and pain management provided as needed. Following initial treatment, you will receive specific instructions for follow-up care to support proper healing.
Preventing Incision Opening
Preventing an incision from opening involves diligent adherence to post-operative instructions and promoting optimal healing conditions. Following all activity restrictions, such as limits on lifting, is important to avoid placing undue stress on the healing wound. Supporting the incision during activities that increase abdominal pressure, like coughing or sneezing, can also help protect it.
Maintaining good wound hygiene by keeping the incision clean and dry and changing dressings as advised by your healthcare provider is important for preventing infection. A balanced diet rich in protein, vitamins, and minerals supports tissue repair and overall healing. Staying adequately hydrated is also important for the healing process. Managing underlying health conditions, such as diabetes, is also helpful, as these can impair wound healing. Promptly reporting any concerning signs or symptoms to your doctor ensures early intervention and can prevent further complications.