Clinical meaning
Wound dehiscence is the partial or complete separation of wound edges along a surgical incision. It most commonly occurs 5-10 days postoperatively when collagen synthesis is insufficient to maintain wound integrity against mechanical stress. The proliferative phase of wound healing requires adequate fibroblast activity, collagen cross-linking, and angiogenesis. Factors that impair collagen synthesis include malnutrition (especially protein and vitamin C deficiency), diabetes (hyperglycemia impairs leukocyte function and collagen maturation), corticosteroid use (inhibits inflammatory phase), and infection (bacterial proteases destroy collagen matrix). Evisceration occurs when abdominal organs protrude through the dehisced wound, representing a surgical emergency with risk of organ ischemia, peritonitis, and septic shock.
Exam relevance
Risk factors: - Obesity (increased wound tension) - Malnutrition and hypoalbuminemia - Wound infection - Diabetes mellitus - Chronic corticosteroid use - Increased intra-abdominal pressure (coughing, vomiting, straining) - Advanced age (>65 years) - Emergency surgery - Previous wound dehiscence - Smoking (vasoconstriction impairs healing)