The wound has opened
The edges of the suture have separated, and the wound is visible between them.
CONDITION / SKIN AND SCARS
Separation of stitches after surgery.
Wound dehiscence is when the edges of a stitched post-surgical wound come apart: over a few millimeters or the entire length, involving only the skin or also deeper layers. Such a wound should be shown to a surgeon the same day; wide or deep separation requires immediate attention, and abdominal separation with organ protrusion is a reason to call 103.
CONCEPTUAL VISUALIZATION- What it is
- The edges of a stitched wound come apart—partially or along its entire length, superficially or deeply.
- How common
- In a meta-analysis of 24 studies (741,118 patients after laparoscopic and open abdominal surgeries) — 1% within 30 days; the authors consider this estimate underestimated. After shoulder repair — 6.81% (29 studies, 1,578 patients).
- when
- In a series of 2,376 eyelids after upper blepharoplasty, the suture came apart on average on the 9th day, ranging from 0 to 30 days.
- The most dangerous
- Abdominal wall dehiscence when organs are visible in the wound (evisceration). This is 103.
01 / WHAT IS ITWhat is
What is
Suture dehiscence.
After surgery, the edges of the wound are joined with sutures, staples, or glue, and after a few weeks they heal together. Sometimes this does not happen — for example, due to wound infection or poor nutrition of its edges. Then the wound opens — in a small area or along its entire length.
Sometimes only the skin and the fat under it separate. Such a wound is cleaned and closed again or managed with dressings until it heals. Another situation is when, after abdominal surgery, the deep layer, the abdominal wall, separates. This is associated with a significant number of complications and mortality, and in the most severe case, the intestines or other organs are visible through the wound — this is called evisceration.
Wound dehiscence prolongs healing and becomes a stress for the person and their family. Different studies defined it differently, so the frequency after various surgeries varies: after breast reduction on a medial pedicle in a meta-analysis of 25 studies (1033 patients) — 8%, after upper blepharoplasty in a series of 2376 eyelids — 1.4%.
This is general information. The doctor will tell you what will suit you after the examination.
02 / SIGNSHow to notice
How to notice
de hiscence.
Dehiscence can be noticed during dressing changes or at home when you look at the suture.
Moist
Fluid is coming from the wound or under the dressing, the dressing constantly becomes wet.
Signs of infection
The skin around is red, hot, pus flows from the wound, and the temperature rises.
Edges darkening
The skin at the edges of the wound turns blue, dark, or black — possible necrosis. This is a reason to immediately see a surgeon.
Skin necrosis after surgeryNot healing
The wound does not close for weeks, remains open, or is covered with a scab under which it is oozing.
Organs in the wound
After abdominal surgery, the intestine or other organs are visible in the wound. This is 103.
03 / REASONSWhy seams?
Why seams?
They are separating.
The reasons are different: the condition of the wound itself, the person’s health, and the specifics of the surgery.
Infection and weight
In the review of 15 studies, the most common risk factors were obesity and wound infection, especially after abdominal surgeries.
Smoking
In a meta-analysis of 140 cohorts (479,150 patients), smokers had 2.07 times higher chances of slow healing and wound separation. Smoking was also associated with wound separation after breast reduction.
Body mass index
According to a meta-analysis of 61 studies (71,149 patients), after breast reduction, a body mass index of 30 and above was associated with a higher risk of wound separation and slow healing.
Prolonged and repeat surgery
In a meta-analysis of data from 741,118 patients after abdominal surgeries, wound dehiscence was associated with the duration of surgery and repeat operations.
Suture and sex
In a series of 2,376 eyelids after blepharoplasty, independent risk factors were male sex and fast-absorbing suture (catgut).
04 / SEEK MEDICAL ADVICE
When to seek medical advice?
Wound dehiscence does not resolve on its own: the wound must be shown to the surgeon who performed the operation the same day. If any of the signs listed below appear, call 103 and do not go by yourself. If organs are visible in an abdominal wound, cover them with a clean, preferably sterile, moist dressing until the ambulance arrives, do not press or try to push them back in; the person can lie in whichever position is comfortable for them.
103 immediately if:
- organs such as intestines are visible in the abdominal wound, or they are protruding outward;
- after eyelid surgery: severe or increasing pain in or around the eye, the eye protrudes, the eyelids do not open, double vision appears or vision worsens;
- the neck or face swells quickly after surgery, and it becomes difficult to breathe;
- bleeding from a wound that does not stop;
- blood spurts from the wound;
- confusion, slurred speech;
- very frequent breathing;
- skin all over the body or lips bluish, pale, or blotchy;
- very high or very low temperature, severe chills;
- a rash that does not go away when pressed.
To a surgeon without delay:
Immediately - to the surgeon who operated, and if it does not work - to the reception department: the wound has widely or deeply separated; severe or increasing pain in the surgical area if it is not near the eye; the area swells and becomes tense quickly; the skin near the wound darkens, turns blue or black. On the same day: To the surgeon who performed the operation, and if this is not possible — to any surgeon, if the suture has come apart, even in a small area; the wound is red, hot, and oozes pus; the temperature has risen to 38°C or higher. Cover the wound with a clean dressing before examination and do not pull the edges together yourself. Planned: the wound has healed, but the scar is wide, retracted, or noticeable.
05 / DIAGNOSTICSHow to evaluate
How to evaluate
the wound.
- Conversation
What operation was performed and when, when the suture came apart, if there was a fever, whether you smoke, whether you have diabetes.
- Examination of the wound
Length and depth of the separation, which layers are visible, condition of the edges, whether there is pus, necrosis, fluid accumulation.
- Examination as needed
Wound culture in case of signs of infection, blood tests, ultrasound — if fluid may accumulate under the skin.
- Choice of tactic
Whether it can be sutured immediately, or the wound first needs to be cleaned and managed under dressings.
06 / TREATMENTHow we treat
How we treat
de hiscence.
Treatment depends on the depth of the separation and whether there is an infection. According to the NHS, an infected wound or a wound at risk of infection may not be sutured immediately.
01
Small separation
Only the skin, without infection.
- Dressings
- Some of these wounds are managed under dressings until they heal on their own — this is called secondary intention healing.
- Repeat suture or glue
- Others are sutured again or closed with medical glue. In series 2376 of eyelids after blepharoplasty, 17 eyelids healed under observation, 14 were sutured again, 3 were closed with glue; the approach was chosen individually.
02
Infected or wet wound
First, cleaning.
- Cleansing
- The wound is cleaned, fluid or dead tissue is removed, infection is treated if necessary; it is sutured when it is clean.
- Vacuum dressing
- The device drains discharge from the wound. In a randomized study of 686 people with open wounds, mostly on the legs after vascular surgeries, the vacuum did not reduce healing time compared to standard dressings. And prophylactic vacuum on sutured wounds, according to a Cochrane review of 62 studies, probably reduces wound infections but has little effect on dehiscence. Therefore, it is used according to indications, not for everyone.
03
Deep abdominal dehiscence
Emergency surgery.
- Surgery
- Abdominal wall dehiscence is treated in a surgical hospital: the organs are repositioned and the wound is closed by a surgeon.
- What's next
- Later, a postoperative hernia may form in this area: in a review of 19 studies (632 patients), it occurred in 11.1% to 30.7% depending on the closure method, but the quality of the studies is low.
04
scar
After healing.
- Correction
- After healing, a scar remains. If it is wide or noticeable, it can be corrected once the wound has healed and the swelling has subsided.
07 / AT THE VALIKHNOVSKYI INSTITUTE
How
How
we treat it.
Wound dehiscence at the Valikhnovskyi Institute of Surgery is treated in the field of "Treatment of Complications of Cosmetic Surgery" — including cases when the surgery was performed at another clinic or abroad. Dehiscence of the abdominal wall with organ protrusion is treated in an emergency surgical hospital; a postoperative hernia, if it develops later, is treated in the field of "Slim Abdomen".
CLINIC SERVICE
Treatment of complications of aesthetic operations
Skin necrosis, dehisced wounds, capsular contracture, liposuction irregularities, and gross scarring.
View service
What we do for this condition
- Wound cleaning — the wound is cleaned, and fluid under the skin (seroma) is removed.
- Vacuum therapy — if necessary, a vacuum dressing is applied: it drains exudate from the wound, reduces swelling, and helps prepare the wound for closure.
- Repeated suture — when the wound is clean, it is sutured again.
- Closure of necrosis — if the edges of the wound are necrotic, they are removed and the wound is closed with local flaps or a graft.
- Scar care and correction — silicone from the first weeks, fractional laser, and when the scar has matured — excision if needed.
Rostislav Valikhnovskyi
Plastic surgeon, candidate of medical sciences, founder of Dr. Valikhnovskyi Institute of Surgery.
How treatment works with us
- Photo onlineSend a photo of the wound, a description of the operation, and the discharge summary. If there are any signs from list 103, call an ambulance first.
- ReviewThe surgeon assesses the depth of the wound separation, the edges of the wound, and signs of infection.
- PlanSuture immediately or clean the wound first; is a vacuum needed.
- TreatmentCleaning, dressings, repeat suture — in one or several stages.
- RecoveryDressings and check-ups until healing, then scar care.
08 / QUESTIONS AND ANSWERSCommon
Common
questions
Short answers. What is right for you, the doctor will tell you during the consultation.
The stitch has come apart. What should I do now?
Cover the wound with a clean dressing and contact the surgeon who performed the operation on the same day. If this is not possible — to any surgeon. If the wound has opened widely or deeply — immediately, and if it is not possible to get in touch — to the emergency department. If abdominal organs are visible in the wound, bleeding does not stop, confusion or severe chills appear — call 103.
Is it possible to cover the wound with a plaster and wait?
It is not worth pulling the edges by yourself: there may be an infection underneath. What to cover the wound with and whether to stitch it again is decided by the surgeon after examination.
Will the wound be stitched again?
Often yes, if it is clean. An infected wound is first cleaned, and small separations sometimes heal under dressings.
How long does a wound that has separated take to heal?
It depends on the size, depth, and infection. Repeat surgeries take longer to heal; the doctor will give the timeframe after an examination.
Will a noticeable scar remain?
After healing, a scar remains. If it is wide or noticeable, it can be corrected later, once the wound has healed and the swelling goes down.
Does smoking affect it?
Yes. In a meta-analysis of 140 cohorts, the chances of slow healing and wound separation in smokers were 2.07 times higher. It is better not to smoke during healing.
What is evisceration?
This is the separation of all layers of the abdominal wall, when organs are visible through the wound. Call 103, cover them with a clean, damp dressing, and do not try to put them back.
Sources
16 sources · systematic reviews, meta-analyses, randomized study, guideline and NHSshowCollapse
- Incidence of wound dehiscence in patients undergoing laparoscopy or laparotomy: a systematic review and meta-analysisJournal of Wound Care, 2023doi:10.12968/jowc.2023.32.Sup8a.S31 ↗
- Determining risk factors for surgical wound dehiscence: a literature reviewInternational Wound Journal, 2015doi:10.1111/iwj.12088 ↗
- Wound healing and infection in surgery. The clinical impact of smoking and smoking cessation: a systematic review and meta-analysisArchives of Surgery, 2012doi:10.1001/archsurg.2012.5 ↗
- Risk factors for complications after reduction mammaplasty: a systematic review and meta-analysisEuropean Journal of Medical Research, 2025doi:10.1186/s40001-025-02723-z ↗
- Evidence-based insights into medial pedicle reduction mammaplasty: A systematic review and meta-analysisJournal of Plastic, Reconstructive & Aesthetic Surgery, 2026doi:10.1016/j.bjps.2026.07.023 ↗
- Complications in Brachioplasty: A Systematic Review and Meta-AnalysisPlastic and Reconstructive Surgery, 2022doi:10.1097/PRS.0000000000008652 ↗
- Wound Dehiscence Following Upper Blepharoplasty: A Review of 2,376 CasesOphthalmic Plastic and Reconstructive Surgery, 2021doi:10.1097/IOP.0000000000001816 ↗
- Negative pressure wound therapy for surgical wounds healing by primary closureCochrane Database of Systematic Reviews, 2022doi:10.1002/14651858.CD009261.pub7 ↗
- Negative pressure wound therapy versus usual care in patients with surgical wound healing by secondary intention in the UK (SWHSI-2): an open-label, multicentre, parallel-group, randomised controlled trialThe Lancet, 2025doi:10.1016/S0140-6736(25)00143-6 ↗
- Management of abdominal wound dehiscence: update of the literature and meta-analysisHernia, 2021doi:10.1007/s10029-020-02294-4 ↗
- The Management of Abdominal Evisceration in Tactical Combat Casualty Care: TCCC Guideline Change 20-02Journal of Special Operations Medicine, 2021doi:10.55460/9U6S-1K7M ↗
- SepsisNHS, 2026nhs.uk/conditions/sepsis ↗
- Cuts and grazesNHS, 2026nhs.uk/conditions/cuts-and-grazes ↗
- Tummy tuck (abdominoplasty)NHS, 2023nhs.uk/tests-and-treatments/cosmetic-procedures/cosmetic-surgery/tummy-tuck ↗
- Breast reduction (female)NHS, 2023nhs.uk/tests-and-treatments/cosmetic-procedures/cosmetic-surgery/breast-reduction-female ↗
- Eyelid surgeryNHS, 2023nhs.uk/tests-and-treatments/cosmetic-procedures/cosmetic-surgery/eyelid-surgery ↗
The figures on the page are from these sources.
The suture has come undone
after the operation?
First contact the surgeon who performed the operation. If this is impossible or a second opinion is needed — send a photo of the wound and discharge summary, and the doctor will advise on what to do next.