Help! My Surgical Incision Is Opening!

What To Do If Your Surgical Wound Is Opening

Bracing an incision, supporting an incision, dehiscence and evisceration after surgery
Bracing an Incision After Surgery.

I recently had surgery and I have a four-inch long incision on my abdomen. I started coughing earlier today and when I looked down my incision had started to open. What should I do?

Having your incision start to open can be a very alarming complication after a surgical procedure. Luckily, it isn't always an emergency, but it can become a serious issue and should never be ignored.

Dehiscence After Surgery

When a surgical incision starts to open, a problem called dehiscence, you need to call your surgeon.

Even if it is minor, such as a suture pulling free and causing a small gap, the opening of an incision allows foreign material like bacteria inside of the wound. This increases the chances of your wound becoming infected and your wound opening further.

A small opening may not require medical attention, but your surgeon should be the judge of whether or not you should be seen in the office.  A small opening may require the placement of an additional staple, or sticky bandages called "steri-strips" to support the incision while it heals.

Evisceration After Surgery

In rare circumstances, the opening of a wound can become very serious by either completely opening or eviscerating, which means the internal organs begin to protrude outside of the body through the open incision.

What To Do If Your Incision Opens After Surgery

If your wound has just started to open, with only a small portion of the incision spreading apart, cover it with a clean bandage and call your surgeon.

If it is wide open, cover it, call your surgeon and plan to be seen by either your surgeon or an emergency room physician right away.

If your wound has opened completely (enough to see internal organs or tissues) or you have tissues bulging out of the wound, cover the area with moist sterile bandages.

 If you do not have bandages, moist clean linens, such as a clean pillow case, should be used to cover the area while activating the emergency response system (911).  In these severe cases, surgery may be required to stabilize the incision.  At the very least, the emergency room will notify your surgeon and potentially repair the incision. 

How to Prevent Wound Opening After Surgery

Bracing your wound can help prevent your incision from opening after surgery.  Plan to brace your wound when coughing, sneezing, rising from a seated position and even when having a bowel movement.  If you are straining to have a bowel movement, consider using a stool softener.

More Surgery Information: All About Incision Care

Sources:

Perioperative Nursing Care. Nursing Fundamentals http://www.brooksidepress.org/Products/Nursing_Fundamentals_II/lesson_8_Section_4.htm

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