Wound Dehiscence Due to Infection
Definition and Classification
- The medical term for a wound that reopens due to infectious complications is "wound dehiscence" or more specifically "infectious wound dehiscence", which is classified as a complication of surgical site infection (SSI) and represents a deep incisional SSI when it involves the fascia and deeper layers 1, 2
- Wound dehiscence is the general term for separation of wound edges after closure, and when occurring with infection, it is classified as a deep surgical site infection (SSI) if it involves fascia and deep muscle layers 1, 2
Clinical Presentation
- Purulent drainage and wound breakdown/dehiscence are confirmatory signs that infection is present 3, 4
- Wound breakdown is listed as a confirmatory diagnostic criterion for fracture-related infection (FRI) when wound dehiscence occurs with exposed hardware 3, 4
Specific Patient Populations
- In diabetic patients, wound dehiscence represents wound breakdown as part of diabetic foot infection (DFI), emphasizing the break in the protective skin envelope with subsequent infection 5, 6
Timing and Depth of Infection
- Early infection (first 48 hours) suggests virulent organisms like β-hemolytic streptococci or Clostridium species causing dehiscence, while late infection (4-6 days postoperatively) typically involves polymicrobial infections leading to wound breakdown 1, 2
- Deep incisional SSI with dehiscence involves fascia and deep muscle layers with wound separation, requiring more aggressive surgical management 1, 2, 7