In plain words
Dehiscence means a wound that was closed by stitches or staples comes apart, partly or fully. After birth it can happen to a incision or to a repair of the after a tear or . Partial opening is more common than full opening. Signs include a wound that looks gaping, fluid or blood from the edges, increasing pain, redness, warmth, or fever. Many small openings heal on their own with care. Some need a provider to close or clean them. Infection often goes with dehiscence and needs prompt care. A mother who sees a wound that is opening, or who has fever with wound pain, should call her provider the same day. Heavy bleeding or a wound that comes fully open needs urgent care.
The deeper version
Wound dehiscence after cesarean and perineal repair is a surgical complication often associated with infection, obesity, diabetes, smoking, and tension on the closure. and dehiscence after perineal repair are uncommon but are reported across series. The CDC National Healthcare Safety Network surveillance definitions classify superficial and deep incisional infection and organ-space infection, which overlap with dehiscence. ACOG Practice Bulletin 198 (2018) addresses repair of obstetric lacerations and the infection risks that come with them. Management ranges from observation and local wound care to re-suturing or opening and packing, depending on depth and infection. The evidence on closure technique, including suture versus staple and layered versus non-layered closure, is mixed.
Where it comes up
- Breastfeeding after a cesareanFeeding Your Baby
- Cesarean recovery, week by weekPostpartum: Your Body
- Healing a tear or stitchesPostpartum: Your Body
- Perineal massage, tearing, and episiotomyGetting Ready for Birth
- Signs of infection after birthPostpartum: Your Body
- Scar care: cesarean and perineal scarsPostpartum: Your Body
What mothers here say about dehiscence
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Sources
- American College of Obstetricians and Gynecologists — Practice Bulletin 198: Prevention and Management of Obstetric Lacerations at Vaginal Delivery, 2018
- Centers for Disease Control and Prevention — National Healthcare Safety Network Surgical Site Infection Event protocol