In dehiscence due to infection, which step is most appropriate first?

• A. Resuture immediately
• B. Proceed with secondary closure
• C. Treat underlying infection
• D. Use only dressings

Answer: (C)

When a wound dehisces because of infection, the top priority is to control the infection. Bacteria in the wound, especially with biofilm, disrupt healing and weaken tissue, so closing the wound right away is unlikely to succeed. By treating the infection—reducing bacterial load, addressing any abscess or drainage needs, and cleaning or debriding nonviable tissue—you create a healthier wound bed that can support later closure.

Resuturing immediately would likely trap infection and fail. Proceeding with secondary closure could be considered once the infection is controlled and the bed is clean and granulating, but not before. Merely using dressings protects the wound without addressing the infection, so it won’t lead to reliable healing.

So the first step is to treat the underlying infection, with appropriate wound care, drainage, and antimicrobial therapy as needed, before attempting closure.