From the Guidelines
Superficial wound dehiscence should be managed by cleaning the wound gently with sterile saline solution or mild soap and water, then applying an appropriate dressing such as a hydrocolloid or foam dressing to maintain a moist healing environment, as recommended by the 2024 American Heart Association and American Red Cross guidelines for first aid 1.
Management of Superficial Wound Dehiscence
To manage superficial wound dehiscence, the following steps should be taken:
- Clean the wound gently with sterile saline solution or mild soap and water
- Apply an appropriate dressing such as a hydrocolloid or foam dressing to maintain a moist healing environment
- Change dressings daily or as directed by a healthcare provider
- For small dehiscences without signs of infection, this conservative management is often sufficient
- However, if the wound shows signs of infection (increased redness, warmth, swelling, purulent discharge, or fever), seek medical attention promptly as antibiotics may be necessary
Prevention of Infection
It is essential to prevent infection in superficial wound dehiscence by:
- Using running tap water or sterile saline solutions for wound irrigation instead of antiseptic agents such as povidone-iodine 1
- Covering clean superficial wounds and abrasions with an occlusive dressing to promote wound healing 1
- Removing the dressing, inspecting the wound, and obtaining medical care if signs of infection develop 1
Nutritional Support
Nutritional support with adequate protein intake (1.2-1.5g/kg/day) and vitamin C supplementation (500mg twice daily) can promote healing, as supported by general medical knowledge.
Addressing Underlying Causes
Wound dehiscence occurs due to factors like excessive tension, poor tissue perfusion, infection, or inadequate surgical technique, and addressing these underlying causes is essential for proper healing, as discussed in the guidelines for the diagnosis and management of skin and soft-tissue infections 1.
From the Research
Superficial Wound Dehiscence
- Superficial wound dehiscence is a complication that can occur after surgery, where the wound partially or completely reopens [ 2 ].
- The treatment of surgical wound dehiscence involves surgical exploration of cavities, sinuses, and specific antibiotic therapy to control cutaneous infection [ 2 ].
- Topical treatment of wound dehiscence may vary based on the evaluation of the lesion, experience of the healthcare team, and the environment [ 2 ].
Prevention of Surgical Site Infections
- The use of topical antibiotics on surgical wounds healing by primary intention can reduce the risk of surgical site infections (SSIs) [ 3 ].
- Topical antibiotics have been shown to be more effective than topical antiseptics in reducing the risk of SSIs [ 3 ].
- The selection of a suitable antimicrobial dressing depends on various parameters, including cost, wound type, local microbial burden, and the location and condition of the wound [ 4 ].
Management of Surgical Site Infections
- Surgical site infections represent a considerable burden for healthcare systems, and the management of these infections is crucial to reduce harm to patients and costs for the hospital [ 5 ].
- Early discharge programs and the use of antibiotics that allow early discharge can be cost-effective and improve the quality of life for patients with surgical site infections [ 5 ].
- Reducing the length of hospital stays by applying early discharge protocols and implementing new treatment alternatives is crucial to reduce harm to patients and costs for the hospital [ 5 ].