From the Guidelines
For a 2-week-old bleeding dehisced surgical wound, seek immediate medical attention as this requires professional evaluation. In the meantime, apply gentle pressure with a clean gauze pad to control bleeding, and keep the wound clean by rinsing with sterile saline solution 1. Cover the wound with a sterile, non-stick dressing and change it daily or when soiled. Do not apply any over-the-counter ointments or medications unless specifically directed by your healthcare provider. Monitor for signs of infection such as increasing redness, warmth, swelling, foul odor, or fever. Wound dehiscence (separation of the wound edges) at this stage is concerning and may require surgical re-closure, specialized wound care, or negative pressure wound therapy 1. The bleeding indicates active tissue disruption and possible complications that need professional assessment. Proper nutrition with adequate protein intake and staying well-hydrated can support healing, but this does not replace the need for prompt medical care 1. Avoid activities that put strain on the wound area to prevent further separation. Consideration of negative pressure wound therapy may be beneficial in promoting wound healing, as suggested by recent guidelines 1. It is essential to follow the guidance of a healthcare professional for the management of a dehisced surgical wound, as the treatment approach may vary depending on the individual case and the presence of any underlying conditions 1.
From the Research
Caring for a 2-Week Old Bleeding Dehisced Surgical Wound
- The management of a dehisced incision is a common home care challenge that must be understood, as most surgical wounds heal uneventfully 2.
- There are various methods to manage a dehisced wound, including negative pressure wound therapy (NPWT) which may reduce the rate of surgical site infections (SSIs) 3.
- NPWT with instillation and dwell time (NPWTi-d) has been shown to reduce the number of dressing changes, promote faster wound bed cleansing, and achieve better exudate management compared to traditional dressings 4.
- The treatment of surgical wound dehiscence may involve surgical exploration, antibiotic therapy, and topical treatment, which can vary based on the evaluation of the lesion and the experience of the healthcare team 5.
- Advanced wound care approaches, including NPWT and closed-incision negative-pressure therapy, can provide adjunctive postoperative support and facilitate wound healing, but their use should be assessed on a case-by-case basis 6.
Key Considerations
- The use of NPWT may reduce the risk of SSIs, but the evidence is of low certainty due to risk of bias and imprecision 3.
- The management of wound dehiscence requires a step-by-step approach, including wound bed preparation, dressing changes, and possibly the use of NPWTi-d 4.
- Healthcare providers should be aware of the risk factors associated with surgical site occurrences, such as patient characteristics, surgical type, and postoperative care, to reduce the incidence of complications 6.
Treatment Options
- NPWT with instillation and dwell time (NPWTi-d) can be an effective treatment option for wound dehiscence, especially in patients with complex wounds 4.
- Advanced wound dressings and closed-incision negative-pressure therapy can provide adjunctive postoperative support and facilitate wound healing 6.
- Topical treatment, surgical exploration, and antibiotic therapy may be necessary to control cutaneous infection and promote wound healing 5.