Wound dehiscence after augmentation and implantation

A toxic wound environment can develop as a result of bacterial contamination, charaterized by a fulminant reaction of polymorphonuclear cells with elevated concentrations of toxic oxygen radicals and aggressive proteinases, as well as the activation of thrombolysis. Proteinases digest and degrade the collagen of the neighboring tissues. Subsequently, the mechanical strength of the connective tissues decreases, and the sutures can tear out. Wound dehiscence is originally a bacteria-meditated inflammatory reaction. Countermeasures include the application of collagen products in the wound (eg, fleece, membranes), which act as substrates and bind the abundant proteinases. Thus, the extracellular matrix of the regenerating tissues is less degraded. If wound dehiscence is detected early during follow-up, an attempt to resuture the wound is justified and should be done before bacteria colonize the biomaterials and a deep infection develops.