3. Potential Uses of Tissue Engineered Wound Matrix (Wound Dehiscence)

Definition: Partial or total disruption of any or all layers of an operative wound site.

Wound dehiscence is a post-operative complication which occurs in less than 1% of surgical procedures. 

The most common causes are:

1. excess tension on the sutured edges leading to sutures pulling through and dehiscence.

2. necrosis of closed wound edges.

3. seroma or hemotoma beneath incision causing pressure beneath.

4. wound infection.

Common Areas of Dehiscence Wound Re-opening

The reopened wound often needs debridement of the edges and base.  A tissue defect is left which usually cannot be simply immediately re-closed as more tension will develop.  Often a partial closure is performed leaving an open gap of tissue.  Placement of OASIS wound matrix on the exposed full thickness wound provides immediate wound closure and allows for the wound to re-epithelialize across the edges, along the matrix dressing.  This approach is especially advantageous for smaller wounds such as disruption of breast biopsy wound.  The exposed fatty tissue can be nicely closed with OASIS wound matrix and either managed by a secondary closure or a delayed primary closure.

Figure 11: Dehiscence of Vascular Surgery 

Cause of dehiscence felt to be due to post-operative edema and increased tension on incision. Exposed soft tissue is clean and would benefit from closure by OASIS^® matrix followed by a delayed primary closure.