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Dehiscence is a term which refers to the spontaneous creation of an opening. It can take several forms in both botany and medicine. Most commonly, however, people use this term to refer to a potentially fatal complication of surgery called wound dehiscence, in which a surgical wound reopens after surgery. This can be very dangerous to the patient, and is one reason why surgical sites are so very closely monitored, to ensure that any signs of wound dehiscence are identified early.
In the case of wound dehiscence, the phenomenon is associated with a number of things. Abdominal surgery can be a risk factor, as can diabetes, general ill health, and other factors which complicate healing. If a surgery is performed on a site where surgery has been performed before, the risk can increase, and surgery as a result of severe trauma can also be a risk factor, as the surgeon may not be able to control the incision as much as he or she desires. Especially large incisions are also a risk factor.
Wound dehiscence can happen as late as a week after surgery. Signs that the patient may be at risk can include a slow healing time, increased discharge around the wound, severe bruising around the wound, and the lack of tissue granulation around the wound during the healing process. These signs can indicate that the patient should be monitored closely so that signs of splitting and separation along the incision will be quickly spotted.
If a patient experiences surgical dehiscence, it can be fatal. It increases the risk of peritonitis and infection, can result in evisceration, and may present other problems, depending on the patient and the location of the wound. It needs to be treated promptly by a surgeon who can repair the rupture. The risk of wound dehiscence is one reason why patients may be asked to remain in a hospital during the early stages of the healing process if they have had traumatic surgery or if they are at risk of developing dehiscence.
The medical community also uses this term to refer to a very rare balance disorder called Superior Canal Dehiscence Syndrome (SCDS). In this condition, an opening to the inner ear appears spontaneously, disrupting the patient's balance and creating a sense of vertigo. The treatment for this condition is surgery to repair the opening. Since the condition is often caused by severe head trauma, the patient may also be monitored for signs of neurological complications.