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Wound dehiscence is a surgical complication in which a wound ruptures along a surgical incision. Risk factors include age, collagen disorder such as Ehlers–Danlos syndrome , diabetes , obesity , poor knotting or grabbing of stitches , and trauma to the wound after surgery.
An old cesarean scar may undergo dehiscence; with further labor the woman may experience abdominal pain and vaginal bleeding, though these signs are difficult to distinguish from normal labor. Often a deterioration of the fetal heart rate is a leading sign, but the cardinal sign of uterine rupture is loss of fetal station on manual vaginal exam.
Deficient scar formation: Results in wound dehiscence or rupture of the wound due to inadequate formation of granulation tissue. Excessive scar formation: Hypertrophic scar, keloid, desmoid. Exuberant granulation (proud flesh). Deficient contraction (in skin grafts) or excessive contraction (in burns).
The wound usually appears red and can be accompanied by drainage. Clinicians delay re-opening the wound unless it is necessary due to the potential of other complications. If the surgical wound worsens, or if a rupture of the digestive system is suspected the decision may be to investigate the source of the drainage or infection. [2] [3]
Bremner, a 38-year-old mother and waitress, said she then felt her C-section scar "burst" open, leaving her cradling her intestines, which poured out of the wound.
Tobacco use: During pregnancy, causes twice the risk of premature rupture of membranes, placental abruption and placenta previa. [68] Also, it increases the odds of the baby being born prematurely by 30%. [69] Prenatal cocaine exposure: Associated with premature birth, birth defects and attention deficit disorder.
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