What to Do if Stitches Break Open After Surgery

How to Manage Dehiscence at Home and When to Call 911

Knowing what to do if stitches break open after surgery can prevent complications later. If stitches start to separate, the incision should be covered with a clean bandage. Keep an eye on the wound in case it opens up further, and see your healthcare provider as soon as possible.

Most of the time, a surgical team will provide written wound care instructions for you to follow as your surgical incision heals. But it can be hard to know when small amounts of drainage, possible signs of infection, symptoms of a fever, and other developments are worrisome. A stitch that breaks open isn't necessarily an emergency, but it can become a potentially life-threatening problem if the entire incision opens or you see tissue pressing through.

This article explains how an incision may open, and why it requires proper care and a close eye on healing. It discusses who may be at risk, tips for prevention, and when to seek medical care.

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Surgical Wound Opens

When a surgical incision starts to open, called dehiscence, you need to closely watch for signs that it's getting worse. If one of your sutures comes loose or the glue strips holding your incision fall off, this is not overly concerning. But if it starts to gape open and leaves space between the sides of the incision, you should tell your surgeon. 

That's because even small openings allow foreign materials like bacteria inside the wound. This increases the chances that your wound may become infected and open even more. 

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A small opening may not need medical attention, but your surgeon should be the judge of whether or not you should be seen in the office. A small opening will likely need close monitoring as the wound closes on its own. When an incision opens, it often takes longer to heal and may leave a larger scar.

Your surgeon will know how the surgery was performed (and how long it took) when considering any complications. Risk factors such as obesity or a smoking history may be an issue. The surgeon can also evaluate the possibility of slow wound healing times due to diabetes or conditions like chronic pulmonary obstructive disease (COPD) that may contribute to wound dehiscence.

This information, combined with what the wound looks like, will help to determine what to do if your stitches break open and how it will be treated.

When to Call Your Healthcare Provider

Call your healthcare provider if the incision has just started to open a little and is covered with a clean bandage. You also should call about symptoms that include:

  • Fever of 101 degrees F or more
  • A wound that is sore, becoming red, or feeling warm
  • Pus or drainage from the wound that has a bad odor

Also call your healthcare provider if you have signs of an allergic reaction, like a rash, or symptoms like nausea, vomiting, or feeling faint.

Evisceration After Surgery

Evisceration means the incision opens wide and the internal organs, often the intestines, begin to push out through the opening. In rare circumstances, the wound may completely open and eviscerate. This can become quite serious, even life-threatening.

In some rare cases, the intestines can begin to fall out of the abdominal cavity through the incision. In these severe cases, surgery is needed to stabilize the incision. 

When to Call 911

Your wound may open wide enough to see internal organs or tissues. Tissues may bulge out of the wound. If this happens, cover the area with a moist sterile bandage and call 911. To prevent shock, lie down with your legs elevated 8 to 12 inches. Also, call 911 if you are bleeding or have difficulty breathing during your healing process.

Risk Factors

Factors that increase the risk of an incision opening up include:

  • Obesity
  • Diabetes
  • Smoking
  • Ischemia (poor blood supply to the wound)
  • Wound infection
  • Poor nutrition
  • Radiation therapy

Prevention

Inspect your incision daily during wound care. This will help you spot any changes or issues before they become severe.

Look at your incision. Is it draining any fluid that looks suspicious? Does it look better than it did the week before? Does your incision look red or "angry" instead of steadily getting better each day?

If your incision is not healing in a slow and steady manner, you should talk with your surgeon or the healthcare staff at your surgeon's office.

Bracing Your Wound

Bracing your wound when you cough, sneeze, or strain to move your bowels can help to prevent your incision from opening after surgery. You can cross your arms and squeeze, hug a pillow, or press your hands on the incision. Try drinking more water or using a stool softener or laxative to ease bowel strain as you heal.

Alternatives

Stitches are the most common way incisions are closed, but alternative materials are used, including adhesive tape, staples, glue, staples, and zippers.

Adhesive tape: Sticky strips of tape, such as Steri-strips, can be used to pull together the edges of a small or minor incision, such as a laparoscopic incision. But tape can lose its stickiness over time, especially if it gets wet, so it's not commonly used on a surgical incision. They may also be used in addition to stitches.

Surgical glue: Also called skin glue, tissue adhesive, and liquid stitches, this glue is sometimes used to close a surgical incision and usually stays on for five to 10 days. They cause minimal wound inflammation, have a lower infection rate than sutures, and are removed easily. The glue forms into a scab that peels or falls off on its own. If it leaves a scar, it may take up to six months to fade.

Staples: A skin stapler is sometimes used to close an incision quickly and can be used internally or on the skin's surface. They are not recommended for curved incisions or on the face. Along with closing a wound faster than stitching, there's a lower risk of infection compared to stitches, and may be less painful.

Zippers: This method combines a zipper with two strips of adhesive, placed on either side of the incision. When the zipper closes, it pulls the edges of the skin together. One of the advantages of the zipper is that it can be opened and closed for wound inspection. Studies show it’s painless to remove and leaves less of a scar. The zipper may be a good option for children but can’t be used in obese patients or on incisions that are curved.

Summary

If you've had surgery, then it's likely you have an incision that needs to heal for several weeks. Keep an eye on your healing process and check the incision daily to ensure it's been gently cleaned.

With careful monitoring, you'll know if the incision has opened slightly. It may not be a serious issue, but call your surgeon's office to be sure. If the incision appears to be getting worse or starting to open, let the surgeon's office know and they can guide you on the next steps to take.

If the opening is wide, and especially if tissues are visible inside the incision or organs begin to push through, seek emergency care right away.

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Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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Additional Reading

By Jennifer Whitlock, RN, MSN, FN
Jennifer Whitlock, RN, MSN, FNP-C, is a board-certified family nurse practitioner. She has experience in primary care and hospital medicine.