Provider Prepared’s Weekly Pearl of Wound Wisdom #18 Dehisced

Occasionally, despite careful layered closure of any wound, wound dehiscence can occur. Reasons for dehiscence include: high tension in the wound, atrophic skin, lack of patient compliance with wound care instructions, medications that inhibit wound healing, poor circulation, lack of deep absorbable sutures, wound infection.
Wounds that dehisce typically should heal by secondary intention. The wound should have a thin layer of petrolatum, or as appropriate antibiotic ointment, applied with a nonadherent dressing. The dressing should be changed daily.
Ritchie, SI et al. Skin surgery: Prevention and treatment of complications UpToDate, December 2017.

Dehisced wounds should be carefully examined for infection. With any signs of infection topical and systemic antibiotic treatment should be used as clinically appropriate.

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Provider Prepared
Nathan Whittaker, MD