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Wound Dihiscence After Cesarean Section

written by: R. Elizabeth C. Kitchen • edited by: Leigh A. Zaykoski • updated: 8/29/2009

This article will focus on explaining what wound dihiscence after a cesarean section is and what risk factors can contribute to its development.

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    Wound dehiscence is after a cesarean section is a complication that may occur after the surgery is performed. It is a complication that occurs in a small, but significant number of women. Wound dehiscence is a surgical complication that occurs when the outer layers of a joined incision experience either complete or partial separation.

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    What is a Cesarean Section?

    A cesarean section is a surgical procedure done to deliver a baby. During this procedure a large horizontal incision will be made directly above the pubic hairline. Through this incision the baby will be lifted out. Every year, approximately thirty percent of all pregnant women deliver their babies through this surgical procedure.

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    How Often Does it Occur?

    This complication occurs in approximately three percent of patients who have had a cesarean section. It can be quite serious and results in death approximately fourteen to fifty percent of the time. It can also lead to a more serious complication known as evisceration. When evisceration occurs internal organs protrude through the wound. The bowel is the organ that most often protrudes. When this happens the patient may experience septic shock or peritonitis.

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    What Causes This Complication?

    A number of things can cause this surgical complication. Some of these causes are related to the operation and some are related to what the patient does afterwards. Operation-related causes include poorly closed sutures, sutures that are too tight and incorrect suture technique. Patient-related causes include putting pressure on the sutures, injuring the wound area and having weak muscle or tissue at the area of the wound. Other causes include the wound getting infected, a severe vitamin C deficiency and taking a high dose of corticosteroids for a prolonged period of time.

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    What are the Risk Factors?

    There are certain risk factors that make women more susceptible for experiencing a wound dehiscence. Medical conditions can be a risk factor and these include diabetes, a malignant growth, kidney disease, immune problems and cancer. Not complying with post-operative instructions, being obese, poor nutrition, smoking, chemotherapy, increasing age, radiation and using corticosteroids for a prolonged period of time are risk factors. Some women experience this complication due to surgical error. Also, when the abdomen experiences increased pressure due to things such as fluid accumulation, vomiting, inflamed bowel, straining or coughing can increase a woman's risk.

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    Resources

    Beattie, S. RN, MS, CNS, GNP. (2007). Bedside Emergency: Wound Dehiscence. Retrieved on August 28, 2009 from Website: http://rn.modernmedicine.com/rnweb/article/articleDetail.jsp?id=433110

    Carson-DeWitt, R. MD. (2008). Wound Dehiscence. Retrieved on August 28, 2009 from Website: http://www.mbmc.org/healthgate/GetHGContent.aspx?token=9c315661-83b7-472d-a7ab-bc8582171f86&chunkiid=99918