From the Guidelines
Debriding and reclosing an incisional wound dehiscence after running with sutures is not recommended without proper medical evaluation. This situation requires assessment by a healthcare provider, ideally the surgeon who performed the original procedure, to evaluate the wound bed, surrounding tissue viability, and rule out infection 1. Fresh wound dehiscence may benefit from surgical reclosure, but this should be done in a sterile clinical environment. Self-closure attempts risk introducing infection, improper wound approximation, and poor cosmetic outcomes.
Instead, the wound should be kept clean with gentle saline rinses, and a non-adherent dressing should be applied to maintain moisture. It is essential to seek prompt medical attention to address the underlying cause of the dehiscence, which might include excessive tension from physical activity, poor tissue healing, infection, or technical issues with the original closure. Running may have created mechanical stress that exceeded the wound's tensile strength during the healing process. Debridement, if necessary, should be performed by a healthcare professional, and the choice of debridement method, such as sharp debridement, autolytic dressings, or biological debridement, depends on the wound's specific characteristics and the patient's overall condition 1.
Key considerations in managing incisional wound dehiscence include:
- Evaluating the wound for signs of infection or necrotic tissue
- Assessing the surrounding tissue viability and wound bed
- Choosing the appropriate debridement method, if necessary
- Considering surgical reclosure in a sterile clinical environment
- Providing wound care instructions to promote healing and prevent further complications.
The primary goal is to enable wound healing, remove potential pathogens, and prevent further morbidity and mortality. Therefore, it is crucial to prioritize proper medical evaluation and treatment over self-closure attempts or inadequate wound care.
From the Research
Debridement and Re-closure of Incisional Wound Dehiscence
- The provided studies do not directly address the specific question of debriding and re-closing an incisional wound dehiscence after running.
- However, study 2 discusses the principles and techniques of modern debridement practices, emphasizing the importance of establishing a healthy wound bed through adequate debridement of infected, senescent, and/or devitalized tissue.
- According to study 2, surgical debridement is a crucial step in wound healing, and various techniques can be employed to optimize wound bed preparation.
Considerations for Wound Management
- Study 3 highlights the effectiveness of negative pressure wound therapy (NPWT) in promoting wound healing, which may be considered as an adjunctive measure in managing incisional wound dehiscence.
- Studies 4 and 5 focus on the duration of antibiotic therapy in necrotizing soft tissue infections, which may not be directly relevant to the management of incisional wound dehiscence after running.
- However, these studies suggest that shorter durations of antibiotic therapy may be sufficient in certain cases, which could be considered in the context of wound management.
Debridement and Re-closure
- Given the lack of direct evidence addressing the specific question, it is essential to consider the general principles of wound management and debridement.
- Debridement of the wound may be necessary to remove any devitalized tissue and promote healing, as discussed in study 2.
- Re-closure of the wound with sutures may be considered after debridement, taking into account the individual patient's condition and the wound's characteristics.