Body Dehiscence or Wound Separation

During a tummy tuck, your surgeon will create an incision in your skin and the underlying structures so they can remove excess tissue and sculpt a firm and flat abdomen. Once the procedure is complete, the incision will be closed with sutures or staples, and you’ll be sent home to recover. With wound dehiscence or separation, the edges of the incision pull apart before the area is completely healed. It’s a serious complication that requires immediate medical attention – but it’s also one that can be avoided with proper care from your surgeon.

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My procedure was more than successful. I did not experience the swelling, bruising, or pain that are usually associated with liposuction. All this I credit to his expertise.

Mike L.

Understanding wound separation

There are two types of wound dehiscence: partial and complete. If you have a partial separation, the superficial layers of the tissue will reopen. With complete separation, all of the layers reopen, revealing underlying tissue such as the abdominal muscles.

Depending on the severity of your wound dehiscence, you may notice the following symptoms:

Bleeding at the incision site
An open wound
Broken sutures
Pain in the area
Pus and drainage

What causes wound separation after a tummy tuck?

A number of factors can cause wound separation after a tummy tuck – and almost all of them are preventable. That’s why it’s so important to select a highly skilled surgeon who can ensure that your wound heals properly and without any complications.

Poor Closure

In many cases, wound separation after a tummy tuck develops due to problems with the way your tissues were closed. For example, if an inadequate number of sutures are placed. Additionally, it could be due to the fact that only superficial tissues were sutured, but underlying layers which bear the most tension were not.

The removal of too much skin

If the surgeon removes too much skin from the area, it places undue tension on the closure, which can cause the wound to eventually separate. To prevent this from happening, Dr. Rahban uses a conservative approach when performing his tummy tucks, and will leave just enough tissue to allow for an ideal closure. If your surgeon feels you will not have enough tissue to remove, he will deny your candidacy for the procedure.

The premature removal of sutures

While most of your sutures should be deep and absorbable, there are often superficial sutures that also need to be removed. Your plastic surgeon needs to remove your sutures once the area is fully healed. If they are taken out too soon, wound dehiscence can develop.

An infection

If you acquire an infection after a tummy tuck, the wound edges may separate. As such, preventing an infection is a critical part of your aftercare guidelines. To that end, Dr. Rahban takes multiple precautions before, during and after surgery to lower that risk.

A chronic medical condition

Certain conditions – such as diabetes, heart disease and anemia – can lead to poor healing, which increases your risk of developing wound separation.

Excess pressure at the incision site

Excess pressure due to strenuous exercise, vomiting, excessive movement, straining, constipation, sneezing and coughing may prevent your wound from healing properly. As such, Dr. Rahban will talk to you about reducing pressure in the abdominal area as you heal and uses a very specific abdominal binder to assist with your healing.

Smoking

The use of nicotine has been shown to greatly affect wound healing often leading to separation. Smoking reduces the circulation in small blood vessels. Dr. Rahban will insist that you refrain from smoking for 4 weeks prior and 2 weeks after your surgery.

In addition, certain factors increase your risk of developing wound separation after a tummy tuck. They include being obese, increased age, and poor nutrition. If you possess any of these risk factors, Dr. Rahban will offer personalized guidance regarding steps you can take to improve your chances of enjoying a complication-free recovery period.

Schedule A Consultation

When Dr. Rahban does a consultation with a prospective patient, he wants it to be two things above all others: thorough and honest. He will find out from you just what you want from cosmetic surgery. And he will tell you honestly if you can get the result you want, and how he can best help you do so.

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How is wound separation treated?

Wound separation is a serious surgical complication that requires immediate medical attention. To begin, antibiotics will be administered to prevent a new infection from developing. Surgical debridement will then be performed to clean the area, remove dead tissue or infected tissue, and encourage the wound to heal properly. From there, the incision will be carefully closed once again.

Over the next several weeks, you will be monitored closely for any signs of a recurrence. You’ll also be advised to change your surgical dressings frequently as you recover, as this will prevent an infection and allow healing air to reach the area.

How to prevent a recurrence

Once a patient experiences wound separation, a recurrence is always a possibility. However, there are steps that you can take to encourage your wound to heal optimally, thus preventing dehiscence from developing again. They include:

Follow your surgeon’s post-operative instructions

This is one of the most important steps you can take to prevent a recurrence of wound separation. Taking all medications as directed, cleaning your wound regularly and changing your dressings as instructed are all very effective ways to promote proper healing.

Stay healthy

Your overall health also impacts your body’s ability to heal. As such, it’s important to maintain a proper diet and stay hydrated. These steps will not only keep you healthy, but they’ll also prevent constipation, which can cause you to bear down when passing a bowel movement and may increase your risk of a recurrence.

Avoid straining

Until you are fully healed, it’s important to avoid placing any unnecessary tension on your abdominal area by refraining from heavy lifting, strenuous exercise and aggressive vomiting and coughing.