How do you fix dehiscence? A guide to treatment and care

October 2, 2025 •

5 min read

Wound dehiscence, the reopening of a surgical incision, occurs in 5% to 33% of patients following surgery. If you are wondering, how do you fix dehiscence, the treatment approach is multifaceted and depends on the severity, from conservative wound care to surgical intervention.

Quick Summary

Fixing dehiscence involves a medical assessment to determine the severity and the best course of action, which could range from conservative wound care with specialized dressings for minor cases to surgical re-closure or debridement for more serious situations, while managing underlying risk factors like infection and nutrition is crucial for successful healing.

Key Points

Assessment is Critical: The first step to fix dehiscence is a medical assessment to determine if it is superficial or deep and if infection is present.
Conservative vs. Surgical Treatment: Minor, superficial dehiscence can be treated with specialized dressings and wound care, while deep dehiscence often requires surgical re-closure.
Infection Management: Antibiotics are a key component of treatment if the wound becomes infected, a common cause of dehiscence.
Advanced Therapies: Negative Pressure Wound Therapy (Wound Vac) can be used to promote faster healing in more complex wounds by drawing out fluids and stimulating tissue growth.
Preventative Measures: Risk factors like smoking, poor nutrition, and excessive strain can be managed proactively to minimize the chance of dehiscence from occurring.
Immediate Care for Emergencies: In cases of evisceration (protruding organs), cover the wound with a sterile, saline dressing and seek emergency medical care immediately.

Understanding the Problem: What Is Wound Dehiscence?

Dehiscence is the medical term for a surgical wound that reopens after being closed with stitches or staples. This complication is most common within the first one to two weeks following a procedure, a critical period when the incision is still in the early stages of healing. It can range in severity from a partial separation of the superficial skin layers to a complete opening involving all layers of tissue and muscle. A key distinction is between superficial dehiscence, affecting only the outer layers, and deep dehiscence, which can lead to a more dangerous complication called evisceration, where internal organs protrude through the wound. The specific causes can include infection, excessive tension on the wound from coughing or physical strain, poor nutrition, and underlying medical conditions such as diabetes or obesity.

Assessing the Severity: When Is It a Medical Emergency?

For most patients, the sight of a separating wound can be alarming, but not all instances of dehiscence require emergency surgery. The first step is always to have a healthcare provider assess the wound to determine its depth and the presence of infection. Deep dehiscence, particularly with evisceration, is a serious medical emergency that requires immediate surgical intervention. For more superficial or minor separations, a conservative approach is often taken.

Medical and Non-Surgical Treatment Options

The treatment for dehiscence is highly individualized, based on the wound's size, location, and the patient's overall health. Most cases, especially superficial ones, can be effectively managed without returning to the operating room.

Wound Care and Dressing: Maintaining a clean, moist environment is critical for encouraging natural healing. This involves regular cleansing with saline solution and covering the wound with a suitable dressing. A healthcare provider will determine the best dressing, which may include non-adherent, absorbent, or specialized silver-infused options to manage drainage and prevent infection.
Negative Pressure Wound Therapy (NPWT): Also known as a wound vacuum, this advanced therapy uses a special dressing and a pump to create negative pressure over the wound. This helps draw out fluid, reduce swelling, and promote the growth of healthy new tissue from the bottom up, accelerating the healing process. NPWT is particularly useful for larger or more complex wounds that are healing by secondary intention (healing from the inside out).
Antibiotics: If the wound shows signs of infection—such as increased redness, swelling, warmth, fever, or pus—antibiotic therapy will be administered. This may be given orally for localized infections or intravenously for more severe cases.
Debridement: In cases where dead or infected tissue (necrotic tissue) is present, a doctor may perform debridement. This procedure removes the unhealthy tissue, allowing the wound to heal properly and preventing the spread of infection.

Surgical Intervention for Severe Cases

For severe or deep dehiscence, surgical repair is often the only option to close the wound and prevent further complications, such as evisceration.

Resuturing or Surgical Revision

If the underlying tissue is healthy and there is no infection, the surgeon may re-close the wound with new sutures. For more significant tissue loss or damage, a surgical revision might be necessary, which can involve techniques like placing a mesh to help support and close the wound.

Immediate Surgical Management for Evisceration

Evisceration is an emergency requiring immediate surgical attention. The exposed organs must be covered with sterile, saline-soaked gauze and the patient must be taken to the operating room for an urgent procedure to reduce the organs back into the abdomen and close the wound.

Prevention is Key: Reducing Your Risk

Preventing dehiscence is always better than treating it after it has occurred. Patient education and adherence to post-operative instructions are crucial.

Patient Education and Behavior

Avoid Strain: Limit strenuous activities, including heavy lifting, and use a pillow or folded towel to splint the incision when coughing or sneezing to minimize tension on the wound.
Manage Underlying Conditions: Effectively managing chronic conditions like diabetes is essential, as high blood sugar can impair wound healing.
Improve Nutrition: A diet rich in protein, vitamins (especially Vitamin C), and minerals (like zinc) is vital for tissue repair.
Quit Smoking: Smoking dramatically hinders blood flow and impairs healing, significantly increasing the risk of dehiscence.


Table: Superficial vs. Deep Dehiscence Management	Feature	Superficial Dehiscence	Deep Dehiscence (Medical Emergency)
Involved Layers	Outer layers of skin only	All layers, including fascia and muscle
Key Risk	Localized infection	Evisceration (protrusion of organs)
Primary Treatment	Conservative wound care, dressings	Immediate surgical repair
Secondary Healing	Often heals by secondary intention	Requires surgical re-closure
Support Method	Abdominal binder (for abdominal wounds)	Requires more extensive internal support

The Role of Specialized Wound Care

Sometimes, treating a dehisced wound is beyond the scope of a primary care physician. In these cases, a patient may be referred to a wound clinic or a specialist, such as a plastic surgeon or infectious disease specialist, depending on the nature of the wound. These specialized teams have access to more advanced treatments and can monitor complex wounds more closely.

Living with a Dehisced Wound: The Healing Process

Healing from a dehisced wound takes time and patience. The process, known as healing by secondary intention, involves the wound gradually filling with granulation tissue from the bottom up. The timeline for this can vary significantly, taking several weeks to months, especially for larger wounds. During this time, proper wound care, nutritional support, and adherence to medical advice are crucial to ensure a successful recovery and minimize the risk of complications.

To learn more about advanced wound care options, the Wound Care Education Institute offers valuable resources and training for healthcare professionals and patients alike: Wound Care Education Institute.

Conclusion: A Multi-Pronged Approach

In conclusion, addressing wound dehiscence is not a one-size-fits-all solution but rather a multi-pronged approach that depends on the wound's specific characteristics and severity. While minor cases can often be treated conservatively with diligent wound care and management of risk factors, severe dehiscence requires prompt medical and possibly surgical intervention. Crucially, a patient's involvement in their own care through proper nutrition, activity restrictions, and awareness of warning signs plays a significant role in achieving a positive outcome and a full recovery.

Frequently Asked Questions

Wound dehiscence is when a surgical incision or wound that has been stitched or stapled closed reopens or separates. This can happen partially, affecting only the outer skin layers, or completely, exposing deeper tissues.

Yes, minor, superficial dehiscence can sometimes heal on its own through a process called secondary intention, where the wound heals from the inside out. However, this requires careful management and should always be overseen by a healthcare provider.

If you suspect dehiscence, especially if you see internal tissues or experience excessive bleeding, you should seek immediate medical attention. For minor separations, cover the wound with a sterile dressing and contact your doctor for an assessment.

The healing time for a dehisced wound varies depending on its size, location, and the patient's overall health. Minor wounds may heal in weeks, while larger or more complex ones could take several months with careful wound management.

Several factors can increase the risk of dehiscence, including wound infection, diabetes, obesity, malnutrition, smoking, and putting excessive tension or strain on the incision site from lifting or coughing.

Negative Pressure Wound Therapy (NPWT), or a wound vac, is a treatment that uses a pump to apply negative pressure to the wound site. This helps to remove excess fluid, reduce swelling, and accelerate tissue growth to promote healing.

You can take several steps to reduce your risk. These include following all post-operative instructions, avoiding heavy lifting or straining, eating a diet rich in protein and vitamins, quitting smoking, and managing underlying health conditions.