Differential Diagnosis for Mild Dehiscence and Maceration around Incision Site

• Single most likely diagnosis:
  • Wound infection or superficial surgical site infection: This is the most likely diagnosis given the presence of mild dehiscence and maceration around the incision site. These signs often indicate the beginning of an infectious process that could lead to more serious complications if not addressed promptly.
• Other Likely diagnoses:
  • Suture reaction or allergy: Some patients may react to the sutures used in their surgery, leading to inflammation, maceration, or even dehiscence of the wound.
  • Moisture-associated skin damage: Prolonged exposure to moisture can lead to maceration of the skin around the wound, potentially causing or exacerbating dehiscence.
  • Pressure ulcer or pressure injury: If the patient has been immobile or has applied pressure on the wound site, it could lead to pressure ulcers, which might present similarly.
• Do Not Miss diagnoses:
  • Deep surgical site infection or abscess: Although less likely given the description of "mild" dehiscence, a deep infection could have severe consequences, including sepsis or the need for further surgical intervention.
  • Osteomyelitis: An infection of the bone, which could be a complication of a surgical site infection, especially in foot surgeries where bones are closer to the surface.
  • Necrotizing fasciitis: A rare but life-threatening infection that requires immediate medical attention. Early signs can be similar to those of less severe infections, making it crucial not to miss.
• Rare diagnoses:
  • Erythrasma: A bacterial infection of the skin folds, which could potentially occur around a wound site, especially in moist areas.
  • Fungal infections: Such as candidiasis, which thrives in moist environments and could contribute to maceration and dehiscence around a wound site.