Clinical meaning
Wound dehiscence is the partial or complete separation of wound edges after surgical closure, most commonly occurring 5-10 days postoperatively when the wound is weakest (before collagen synthesis peaks). Evisceration is the most severe form where abdominal organs protrude through the disrupted wound - this is a surgical emergency requiring immediate intervention. The wound healing cascade involves inflammation (days 1-5), proliferation (days 5-21), and remodeling (weeks to months). Dehiscence occurs when forces acting on the wound (increased intra-abdominal pressure from coughing, vomiting, straining, obesity) exceed the wound's tensile strength during the vulnerable proliferative phase. Risk factors include malnutrition (albumin < 3.0 impairs collagen synthesis), diabetes (impaired neutrophil function and microvascular disease), chronic steroid use (inhibits inflammation and collagen deposition), obesity (increased tension on wound and poor blood supply to fat), and infection (enzymatic destruction of new tissue). A hallmark warning sign is sudden serosanguineous drainage from the incision.