What causes fascial dehiscence?
Fascial dehiscence is classically described in the context of a breakdown in fascial tissue integrity. Factors such as the patient’s age and nutritional status, along with a history of smoking, obesity, chronic steroid use, diabetes, and other chronic illnesses may predispose to compromised fascial tissue (1).
What are signs of dehiscence?
What are the signs and symptoms of wound dehiscence?
- A feeling that the wound is ripping apart or giving way.
- Leaking pink or yellow fluid from the wound.
- Signs of infection at the wound site, such as yellow or green pus, swelling, redness, or warmth.
How is fascial dehiscence diagnosed?
New or markedly increased wound drainage or a new abdominal wall bulging are indicators of dehiscence of the fascia. The clinician should ask the patient about obstructive symptoms, including nausea, vomiting, or obstipation.
What is fascial defect?
Muscle herniation, also known as a myofascial defect, is the protrusion of a muscle through the surrounding fascia. The most common location of muscle herniation is in the leg. Because this injury is tricky to diagnose and rarely reported, there is little data in the literature upon which to draw(1-3).
How is wound dehiscence treated?
Treatment may include:
- Antibiotics if an infection is present or possible.
- Changing wound dressing often to prevent infection.
- Open would to air—will speed up healing, prevent infection, and allow growth of new tissue from below.
- Negative pressure wound therapy—a dressing that is to a pump that can speed healing.
How do you fix a wound dehiscence?
What is fascial dehiscence?
Dehiscence is the separation of the fascial closure of the reoperated abdominal wound with the exposure of intraabdominal contents to the external environment. Dehiscence is secondary to technical failure of sutures, shear forces from tension, or fascial necrosis from infection and/or ischemia (2).
Can muscle fascia be repaired?
Fascia doesn’t typically heal in its original configuration. Instead of restoring to its previous flat and smooth texture, fascia may heal into a jumbled clump. Called fascial adhesion, fascia can literally stick to existing muscle or developing scar tissue.
How to tell if you have fascial dehiscence?
New or markedly increased wound drainage or a new abdominal wall bulging are indicators of dehiscence of the fascia. The clinician should ask the patient about obstructive symptoms, including nausea, vomiting, or obstipation.
What are the risks of fascial dehiscence surgery?
Fascial dehiscence places patients at risk of hernias and their associated short- and long-term complications, including obstruction and strangulation. Additionally, progression to evisceration represents a true surgical emergency. [1] [2] [3] [4] Fascial dehiscence is a complication of both elective and emergent surgeries.
What is the difference between superficial and full thickness dehiscence?
Superficial dehiscence – the skin wound alone fails, with the rectus sheath remaining intact Often occurs secondary to local infection, poorly controlled diabetes mellitus, or poor nutritional status Full thickness dehiscence – the rectus sheath fails to heal and bursts, with protrusion of abdominal content (often termed a “burst abdomen”)
Which is a sign of deep dehiscence in a wound?
A classic sign of deep / full thickness dehiscence (where the skin can be intact) is new bulging of the wound and seepage of pink serous or blood-stained fluid from the wound. A sudden increase in wound discharge should be considered as deep dehiscence until proven otherwise*.