It is not uncommon that an incision might open up before a wound is healed
Various factors can cause dehiscence, however, there is action you can take to prevent or improve healing once a stitch pops.
Reasons incisions can open include:
- Suture techniques including tension or sub-optimal use of materials
- Co-morbidities known to delay healing
- Stress on incision site from swelling, coughing, vomiting, etc.
- As well as, not following activity recommendations like limiting lifting, bending or twisting.
- Poor nutrition
You may be at a greater risk of your incisions reopening especially if healing has been an issue in your past. Any chronic infections, chronic wounds, autoimmune issues, and circulatory problems can create delayed or problematic healing.
Make sure to communicate your entire physical history including medication and supplement regime with your surgeon before your procedure.
Lack of mobility causes decreased circulation and increasing edema and dependence. This puts your immune system at risk for infections like pneumonia. It is important to protect the area but healing rates improve with fewer complications if you do your best to move when the nurses, therapists and caregivers try to get you moving. One of the easiest ways to get movement is to continue drinking water so you have to get up and walk to the bathroom. Always communicate how you are feeling with your surgeon. Try your best to follow the recommendation given and attend all follow up appointments.
If your stitches open:
- Call give it a good cleaning with a wound cleanser or antibacterial wash
- Take a clear picture in good lighting.
- Dress the wound in any sterile dressing you have available. If the wound is not deep and you can pinch the skin together, steri strips may be useful.
- Give your surgeon a call if the wound opens or there are any signs of infection (red, pain, drainage)
If a single stitch popped and there is a very little open area and there are no underlying structures present then there is a good chance your MD will not stitch you back up and allow the wound to close up on its own.
Here are some wound care basics to improve your rate of healing
- If the wound is pink, do not pack it with dry gauze. (that is a sub-par outdated treatment)
- Keep open areas covered. Leaving things open to air to dry out; leaves your body open for infection.
- If you have no signs of infection, you probably do not need to use a silver or antimicrobial product. A simple hydrogel should do. Keep it moist but not wet to improve healing and have a better-looking scar. One tip here is to apply the gel with a sterile q-tip just to the open area vs. putting too much on a bandage and having the excess create a boggy mess.
- Supplements like collagen and eating meals high in protein, fruits and vegetables and low in simple carbs like white flours and sugar will improve healing rates.
- Stop Smoking! It limits blood supply!
- Maintain normal blood sugar levels!
- Prevent edema by deep diaphragmatic breathing and gentle mobility that you can do without excess strain on the area. You may consider wearing a compression garment if you are swelling a lot and/or have to be up on your feet a lot during the day.
- Trust your instincts! If your surgeon is telling you, it looks fine and you feel uneasy about it.
Contact your local wound clinic for information on how to set up an appointment.
If this is not an option for you, consider signing up for video consult at Better Wounds for assistance until you can find a local provider.
By Heather Flexer, Doctor of Physical Therapy, Certified Wound Specialist, Consultant, and Creator at Better Wounds