From the Guidelines
The healing time for wound dehiscence can vary significantly, but typically ranges from 4 to 6 weeks, with proper care and management. The healing process is influenced by several factors, including the severity and location of the dehiscence, as well as individual patient factors such as diabetes, age, and nutritional status 1. For minor dehiscence, healing may occur within 2-3 weeks, while more severe cases involving deep tissue layers may take 8 weeks or longer. Treatment generally involves keeping the wound clean with gentle washing using mild soap and water, applying appropriate dressings that maintain a moist healing environment, and changing these dressings regularly as directed by a healthcare provider. Some key principles of wound care include:
- Offloading of plantar ulcerations
- Debridement of necrotic, nonviable tissue
- Revascularization of ischemic wounds when necessary
- Management of infection: soft tissue or bone
- Use of physiologic, topical dressings 1. Nutritional support is also crucial for healing, particularly adequate protein intake and sufficient vitamins A, C, and zinc. The healing process works through three overlapping phases: inflammatory, proliferative, and remodeling. Factors that can delay healing include infection, poor blood supply, diabetes, advanced age, smoking, obesity, and certain medications like corticosteroids. Regular medical follow-up is essential to monitor healing progress and adjust treatment as needed, with consideration of advanced wound therapy if a wound fails to show a reduction of 50% or more after 4 weeks of appropriate wound management 1.
From the Research
Wound Dehiscence Healing Time
- The healing time for wound dehiscence can vary depending on several factors, including the size and location of the wound, the overall health of the patient, and the treatment methods used 2.
- Negative pressure wound therapy (NPWT) has been shown to be effective in reducing the healing time for wound dehiscence, with one study reporting an average complete wound closure time of 21.5 days with NPWT compared to 35.5 days with traditional dressings 2.
- Another study found that NPWT with instillation and dwell time (NPWTi-d) reduced the number of dressing changes and accelerated wound healing, with a step-by-step closure protocol making it possible to achieve excellent results in managing wound dehiscence 2.
Factors Affecting Wound Dehiscence Healing Time
- The use of NPWT has been shown to reduce the risk of wound dehiscence, with a systematic review and meta-analysis of randomized controlled trials finding that NPWT reduced wound dehiscence by 20% compared to standard surgical dressing or conventional therapy 3.
- However, another study found that there was probably little or no difference in dehiscence between people treated with NPWT and those treated with standard dressing, although there was imprecision around the estimate that included risk of benefit and harms 4.
- The effectiveness of NPWT in reducing wound dehiscence and promoting wound healing may depend on various factors, including the type of surgery, the size and location of the wound, and the overall health of the patient 5, 6.
Treatment Methods for Wound Dehiscence
- NPWT is a commonly used treatment method for wound dehiscence, and has been shown to be effective in reducing the healing time and promoting wound closure 2, 3.
- Other treatment methods, such as conventional dressings and surgical debridements, may also be used to manage wound dehiscence, although NPWT has been shown to be more effective in reducing the risk of surgical site infections and promoting wound healing 5, 6.
- A step-by-step closure protocol, in combination with NPWTi-d, has been shown to be effective in managing wound dehiscence, even in patients with muscle fascia defect and loop exposure 2.