Separation of previously healed wound edges is?

Appeared in: RUHS, Jaipur, PB B.Sc Nursing Entrance-2018

Explanation

Dehiscence is the specific medical term for the partial or complete separation of the layers of a surgical incision or wound.
The question provides a direct definition of wound dehiscence.
This complication typically occurs 5 to 10 days postoperatively and is often associated with risk factors that impair healing, such as infection, obesity, malnutrition, and excessive coughing or straining.

Option A: Adhesions are bands of scar tissue that form between internal organs. They are an internal complication and do not involve the separation of an external wound's edges.
Option C: Evisceration is the protrusion of internal organs through a dehisced wound. While it is related to dehiscence, it is a more severe, subsequent event, not the initial separation of the wound edges itself.
Option D: Keloid formation is an abnormality of excessive healing, where scar tissue grows beyond the original boundaries of the wound. It is a type of hypertrophic scarring, not a failure of the wound to stay closed.

Clinical Relevance

Nursing practice connection: Knowing Postoperative Wound Complications helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Nurses must diligently monitor postoperative patients, especially those with risk factors like obesity, diabetes, or poor nutrition, for signs of impaired wound healing.
A key sign of impending dehiscence is a sudden increase in serosanguineous (pink, watery) drainage from the wound, or the patient reporting a 'popping' or 'giving way' sensation. This requires immediate assessment and reporting.
What if? If the patient's wound not only separates but also has bowel loops protruding, the situation has escalated from dehiscence to evisceration. This is a surgical emergency. The nurse's priority is to cover the organs with sterile saline-soaked gauze, position the patient to reduce abdominal pressure, and notify the surgeon for immediate intervention.

How to Approach the Question

This is a definition-based recall question common in nursing exams.
First, analyze the keywords in the question: 'Separation' and 'wound edges'. This points to a complication where a closed wound comes apart.
Next, mentally define each of the options provided.
Adhesions are internal scar tissue bands.
Dehiscence is the separation of wound edges.
Evisceration is the protrusion of organs from a separated wound.

Concept Tested & Keywords

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E6 Pathology- ROBBINS & COTRAN PATHOLOGIC BASIS OF DISEASE 10TH Ed p. 119-121

E6 Gynecology Williams p. 65-88

Practise the full RUHS, Jaipur, PB B.Sc Nursing Entrance-2018

Attempt every question from this paper in a timed mock, then review the full solution for each one.