From the Guidelines
To heal a small dehiscence of a surgical wound, the patient should prioritize thorough cleaning of the wound, wrapping it in a sterile wet dressing, and maintaining a clean environment to promote optimal healing conditions. According to the guidelines for acute care 1, the primary focus should be on:
- Thorough cleaning of the wound to prevent infection
- Wrapping of the wound in a sterile wet dressing to maintain a moist environment conducive to healing
- Monitoring for signs of infection, such as increased redness, warmth, swelling, pus, foul odor, or fever
- Adhering to prescribed antibiotic regimens, such as clindamycin and gentamicin in cases of allergy to beta-lactam antibiotics 1 It is essential to change the dressing daily or whenever it becomes wet or soiled to maintain a clean environment. Additionally, patients should avoid strenuous activities that could strain the wound area and focus on maintaining good nutrition with adequate protein intake to support healing. Smoking should be avoided, as it impairs wound healing. Patients should contact their healthcare provider if they notice any signs of infection, worsening of the dehiscence, bleeding, or fever above 100.4°F (38°C). By following these instructions and prioritizing wound care, patients can create an optimal environment for their body's natural healing processes to close the gap through granulation tissue formation and eventual re-epithelialization 1.
From the Research
Patient Instructions for Healing a Small Dehiscence of a Surgical Wound
To promote healing and prevent further complications, patients with a small dehiscence of a surgical wound should follow these instructions:
- Keep the wound clean and moist to promote granulation tissue and reduce bioburden 2
- Use saline irrigation to remove debris and foreign material from the wound, but note that saline alone may not be sufficient to reduce bacterial contamination completely 3, 4
- Consider using a topical antibiotic irrigant, such as a triple antibiotic solution (neomycin, polymyxin, and bacitracin), to reduce bacterial contamination 3, 4
- However, be aware that the use of bacitracin as an irrigant should probably be avoided in patients previously exposed to that agent due to the increasing incidence of allergy to this agent 5
- Maintain a moist wound environment, reduce pain, and promote granulation tissue to support the healing process 2
- Ensure adequate nutrition and reduce tension on the abdomen to prevent incisional infections and promote wound healing 2
- Antiseptics, such as octenidine dihydrochloride and polyhexanide, may be effective in reducing bioburden in chronic wounds, but their use should be balanced with tolerability and addressing other factors regarding the patient's general health or the wound's physical environment 6