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","text",{"type":12,"content":305},[306],{"type":15},{"type":12,"content":308},[309],{"type":15},[76,8],[312,327,607,693,1173,1220,1426,1501,1743],{"_uid":313,"link":314,"image":315,"title":317,"component":318,"media_type":319,"description":320},"a40f3c31-2be0-450d-8ec3-bc72ad634bf2",[],{"id":53,"alt":53,"name":16,"focus":53,"title":53,"source":53,"filename":16,"copyright":53,"fieldtype":289,"meta_data":316},{},"Goal","info-block-program","none",{"type":12,"content":321},[322],{"type":15,"attrs":323,"content":324},{"textAlign":53},[325],{"text":326,"type":303},"Reduce the incidence of wound disruption in surgical and obstetrical patients by assessing risk, implementing risk factor modifications prior to surgery and instituting good wound care management.",{"_uid":328,"content":329,"component":606},"1010ae87-305e-4413-a52a-63495dbe7cf3",[330],{"_uid":331,"content":332,"component":605},"a217acfe-5514-41a9-b405-799b24d56e71",{"type":12,"content":333},[334,341,364,369,374,379,384,390,395,557,562],{"type":335,"attrs":336,"content":338},"heading",{"level":337,"textAlign":53},2,[339],{"text":340,"type":303},"Overview",{"type":15,"attrs":342,"content":343},{"textAlign":53},[344,346,362],{"text":345,"type":303},"Healthcare Excellence Canada has developed this ",{"text":347,"type":303,"marks":348},"Hospital Harm Improvement Resource",[349],{"type":350,"attrs":351},"link",{"href":352,"uuid":353,"anchor":53,"custom":354,"target":355,"linktype":356,"story":357},"/resources/hospital-harm-improvement-resource","2fa59e87-8ca2-4dcf-96b5-e7ee0bf5217f",{},"_self","story",{"name":347,"id":358,"uuid":353,"slug":359,"url":360,"full_slug":360,"_stopResolving":361},119563150823813,"hospital-harm-improvement-resource","resources/hospital-harm-improvement-resource",true,{"text":363,"type":303}," – a compilation of resources to support patient safety and improvement efforts.",{"type":15,"attrs":365,"content":366},{"textAlign":53},[367],{"text":368,"type":303},"The healing process has four identified stages, namely: coagulation, inflammation, proliferative phase/granulation tissue formation and the remodeling phase, in reality it is a complex, continuous process (Demidova-Rice et al., 2012). Surgical wound dehiscence (SWD) has been defined as the separation of the margins of a closed surgical incision that has been made in skin, with or without exposure or protrusion of underlying tissue, organs, or implants. Separation may occur at single or multiple regions, or involve the full length of the incision, and may affect some or all tissue layers. A dehisced incision may, or may not, display clinical signs and symptoms of infection (Ousey,2018).",{"type":15,"attrs":370,"content":371},{"textAlign":53},[372],{"text":373,"type":303},"Despite improvements in contemporary preoperative care and suture materials, the rate of surgical wound disruption has not decreased in recent years (Sorensen et al., 2005). CIHI's Hospital Harm Results reports the number of preventable, unintended harm due to wound disruption as ranged from 3,581 events in fiscal 2014, to 5,435 events in fiscal 2019 (CIHI, 2020). This may be attributable to the increasing incidence of risk factors within the patient population outweighing the benefits of technical achievements (Sorensen et al., 2005).",{"type":15,"attrs":375,"content":376},{"textAlign":53},[377],{"text":378,"type":303},"The causes of SWD can be categorized as: technical issues with the closure of the incision (e.g., unravelling of suture knots); mechanical stress (e.g., coughing can cause breakage of the sutures or rupture of the healing incision after suture or clip removal/reabsorption); and disrupted healing (e.g., due to comorbidities or treatments that hamper healing, or as a result of a surgical site infection [SSI]) (Ousey, 2018). However, overall SSI is the strongest predictor of wound disruption (Moghadamyeghaneh et al., 2015). Abdominal wound disruption typically occurs at 10 +/- 6.5 days (median eight days) after surgery (Kenig et al., 2014). Hospital stay is significantly longer for patients with wound disruption, with a median of 36 days, compared to 16 days in a control group (van Ramshorst et al., 2010).",{"type":15,"attrs":380,"content":381},{"textAlign":53},[382],{"text":383,"type":303},"The prevention and management of surgical wound complications is a growing area of concern for patients, healthcare professionals, and administrators alike. In these times of rationalization of healthcare dollars, it is important to ensure that patients receive appropriate screening and care, beginning at the pre-operative assessment and continuing through to post-operative care and monitoring in the community. 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Hear her story of overcoming this difficult situation. ",[682],{"type":658,"attrs":683},{"color":660},"Importance to Patients and Families","accordion-2-columns",{"type":12,"content":687},[688],{"type":15,"attrs":689,"content":690},{"textAlign":53},[691],{"text":692,"type":303},"Wound complications are a burden for patients, their families, and the healthcare system (Butcher & White, 2014).  Poor healing can result in wound disruption which not only affects the patient's quality of life, but may also delay adjuvant therapies, increase post-operative discomfort, delay return to activity, and increase costs as a result of re-intervention, longer hospitalization and readmission. Pain, particularly during dressing change remains a significant factor. Apart from the distress caused, pain can lead to feelings of anxiety, anger, and depression (Woo, 2010). Accurate pain assessment and understanding of the type of pain, helps with decisions about when and how to give analgesia and what information needs to be shared with the multidisciplinary team (Taylor, 2010). Several risk factors can be mitigated before, during and after the operative period, suggesting that the risk of developing wound disruption in vulnerable patients also can be reduced.",{"_uid":694,"items":695,"title":1124,"component":685,"description":1125},"56ab3959-1b16-41e9-818d-10a351c10b24",[696],{"_uid":697,"title":698,"ctaLeft":699,"ctaRight":700,"component":624,"columnLeft":701,"columnRight":724},"610b88a1-8386-4bd1-868e-1ec5ba02ae49","Expand to see a full list of resources",[],[],{"type":12,"content":702},[703],{"type":15,"attrs":704,"content":705},{"textAlign":53},[706,712,719],{"text":707,"type":303,"marks":708},"To develop a more in-depth understanding of the care delivered to patients, chart audits, incident analyses and prospective analyses can be helpful in identifying quality improvement opportunities. Links to key resources for conducting chart audits and analysis methods are included in the ",[709],{"type":658,"attrs":710},{"color":711},"#000000",{"text":713,"type":303,"marks":714},"Hospital Harm Improvement Resource Introduction",[715],{"type":350,"attrs":716},{"href":352,"uuid":353,"anchor":53,"custom":717,"target":355,"linktype":356,"story":718},{},{"name":347,"id":358,"uuid":353,"slug":359,"url":360,"full_slug":360,"_stopResolving":361},{"text":720,"type":303,"marks":721},".",[722],{"type":658,"attrs":723},{"color":711},{"type":12,"content":725},[726,731],{"type":15,"attrs":727,"content":728},{"textAlign":53},[729],{"text":730,"type":303},"If your review reveals that your cases of wound disruption are linked to specific processes or procedures, you may find these resources helpful:",{"type":396,"content":732},[733,789,817,845,874,903,925,954,983,1012,1040,1082,1096],{"type":399,"content":734},[735,747],{"type":15,"attrs":736,"content":737},{"textAlign":53},[738,740],{"text":739,"type":303},"Agency for Healthcare Research and Quality (AHRQ) ",{"text":741,"type":303,"marks":742},"www.ahrq.gov",[743],{"type":350,"attrs":744},{"href":745,"uuid":53,"anchor":53,"custom":746,"target":619,"linktype":620},"http://www.ahrq.gov",{},{"type":396,"content":748},[749,763,776],{"type":399,"content":750},[751],{"type":15,"attrs":752,"content":753},{"textAlign":53},[754,756],{"text":755,"type":303},"Selected Best Practices and Suggestions for Improvement PDI 11: Postoperative Wound Dehiscence [in children]. 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Can J Infect Dis Med Microbiol J Can Mal Infect Microbiol Medicale. 2010;21(1):11-37. doi:10.1155/2010/580340 ",{"text":868,"type":303,"marks":869},"Canadian Practice Guidelines for Surgical Intra-Abdominal Infections (hindawi.com)",[870],{"type":350,"attrs":871},{"href":872,"uuid":53,"anchor":53,"custom":873,"target":619,"linktype":620},"https://www.hindawi.com/journals/cjidmm/2010/580340/",{},{"type":399,"content":875},[876,888],{"type":15,"attrs":877,"content":878},{"textAlign":53},[879,881],{"text":880,"type":303},"Centers for Disease Control and Prevention ",{"text":882,"type":303,"marks":883},"www.cdc.gov",[884],{"type":350,"attrs":885},{"href":886,"uuid":53,"anchor":53,"custom":887,"target":619,"linktype":620},"http://www.cdc.gov",{},{"type":396,"content":889},[890],{"type":399,"content":891},[892],{"type":15,"attrs":893,"content":894},{"textAlign":53},[895,897],{"text":896,"type":303},"Berríos-Torres SI, Umscheid CA, Bratzler DW, et al. 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World Union of Wound Healing Societies (WUWHS) Consensus Document. Surgical wound dehiscence: improving prevention and outcomes. Wounds International, 2018. ",{"text":1119,"type":303,"marks":1120},"https://www.woundsinternational.com/download/resource/7394",[1121],{"type":350,"attrs":1122},{"href":1119,"uuid":53,"anchor":53,"custom":1123,"target":619,"linktype":620},{},"Clinical and System Reviews, Incident Analyses",{"type":12,"content":1126},[1127,1132,1138,1171],{"type":15,"attrs":1128,"content":1129},{"textAlign":53},[1130],{"text":1131,"type":303},"Given the broad range of potential causes of wound disruption, in addition to recommendations listed above, we recommend conducting clinical and system reviews to identify latent causes and determine appropriate recommendations.",{"type":15,"attrs":1133,"content":1135},{"textAlign":1134},"left",[1136],{"text":1137,"type":303},"Occurrences of harm are often complex with many contributing factors. 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However, be aware that modifying measures may limit the comparability of your results to others.","small-text-image-item",{"type":12,"content":1185},[1186],{"type":15},{"_uid":1188,"image":1189,"title":1191,"component":1183,"description":1192},"498e534c-913a-4ac0-90da-3396951645da",{"id":1179,"alt":16,"name":16,"focus":16,"title":16,"source":16,"filename":1180,"copyright":16,"fieldtype":289,"meta_data":1190,"is_external_url":277},{},"Evaluate your choice of measures in terms of the usefulness of the final results and the resources required to obtain them; try to maximize the former while minimizing the latter.",{"type":12,"content":1193},[1194],{"type":15},{"_uid":1196,"image":1197,"title":1199,"component":1183,"description":1200},"5c88ef3c-3fd2-442e-b9cf-478a0643de91",{"id":1179,"alt":16,"name":16,"focus":16,"title":16,"source":16,"filename":1180,"copyright":16,"fieldtype":289,"meta_data":1198,"is_external_url":277},{},"Whenever possible, use measures you are already collecting for other programs.",{"type":12,"content":1201},[1202],{"type":15},{"_uid":1204,"image":1205,"title":1207,"component":1183,"description":1208},"6c6d04c8-d218-424c-945d-1f645847d838",{"id":1179,"alt":16,"name":16,"focus":16,"title":16,"source":16,"filename":1180,"copyright":16,"fieldtype":289,"meta_data":1206,"is_external_url":277},{},"Try to include both process and outcome measures in your measurement scheme.",{"type":12,"content":1209},[1210],{"type":15},"Measures","small-text-image",{"type":12,"content":1214},[1215],{"type":15,"attrs":1216,"content":1217},{"textAlign":53},[1218],{"text":1219,"type":303},"Vital to quality improvement is measurement, and this applies specifically to implementation of interventions. The chosen measures will help to determine whether an impact is being made (primary outcome), whether the intervention is actually being carried out (process measures), and whether any unintended consequences ensue (balancing measures). 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complication",{"type":399,"content":1324},[1325],{"type":15,"attrs":1326,"content":1327},{"textAlign":53},[1328,1332],{"text":1329,"type":303,"marks":1330},"O90.102",[1331],{"type":1241},{"text":1333,"type":303},": Disruption of perineal obstetric wound, delivered with mention of postpartum complication",{"type":399,"content":1335},[1336],{"type":15,"attrs":1337,"content":1338},{"textAlign":53},[1339,1343],{"text":1340,"type":303,"marks":1341},"T81.3",[1342],{"type":1241},{"text":1344,"type":303},": Disruption of operation wound, not elsewhere classified",{"type":399,"content":1346},[1347],{"type":15,"attrs":1348,"content":1349},{"textAlign":53},[1350,1354],{"text":1351,"type":303,"marks":1352},"T81.83*",[1353],{"type":1241},{"text":1355,"type":303},": Postoperative leak",{"_uid":1357,"title":1358,"ctaLeft":1359,"ctaRight":1360,"component":624,"columnLeft":1361,"columnRight":1365},"298700c3-a866-4c7b-9c20-e87c98c04dea","Additional codes & Inclusions",[],[],{"type":12,"content":1362},[1363],{"type":15,"attrs":1364},{"textAlign":53},{"type":12,"content":1366},[1367,1376,1394],{"type":15,"attrs":1368,"content":1369},{"textAlign":53},[1370,1374],{"text":1371,"type":303,"marks":1372},"Additional Codes",[1373],{"type":1241},{"text":1375,"type":303},": Inclusions",{"type":396,"content":1377},[1378],{"type":399,"content":1379},[1380],{"type":15,"attrs":1381,"content":1382},{"textAlign":53},[1383,1385,1392],{"text":1384,"type":303},"Y60-Y84: Complications of medical and surgical care (refer to Appendix A) of the ",{"text":1386,"type":303,"marks":1387},"Hospital Harm Indicator General Methodology Notes",[1388],{"type":350,"attrs":1389},{"href":1390,"uuid":53,"anchor":53,"custom":1391,"target":619,"linktype":620},"http://indicatorlibrary.cihi.ca/download/attachments/10453027/Hospital%20Harm%20Indicator%20General%20Methodology%20Notes.pdf?version=1&modificationDate=1561404418000&api=v2",{},{"text":1393,"type":303}," ",{"type":15,"attrs":1395},{"textAlign":53},"Discharge Abstract Database",{"type":12,"content":1398},[1399,1404,1417],{"type":15,"attrs":1400,"content":1401},{"textAlign":53},[1402],{"text":1403,"type":303},"Discharge Abstract Database (DAD) Codes included in this clinical category: ",{"type":396,"content":1405},[1406],{"type":399,"content":1407},[1408],{"type":15,"attrs":1409,"content":1410},{"textAlign":53},[1411,1415],{"text":1412,"type":303,"marks":1413},"D23",[1414],{"type":1241},{"text":1416,"type":303},": Would Disruption",{"type":15,"attrs":1418,"content":1419},{"textAlign":53},[1420,1424],{"text":1421,"type":303,"marks":1422},"Concept",[1423],{"type":1241},{"text":1425,"type":303},": Disruption of surgical wound during the same hospital stay or an obstetric wound during the delivery episode of care.",{"_uid":1427,"items":1428,"title":1496,"component":685,"description":1497},"42ac371a-afd2-4bc4-90ef-f04fd7c47843",[1429,1453,1476],{"_uid":1430,"title":1431,"ctaLeft":1432,"ctaRight":1433,"component":624,"columnLeft":1439,"columnRight":1446},"1206198e-595d-425e-8728-addb2417da98","Wound Care Distance Consulting ",[],[1434],{"_uid":1435,"link":1436,"label":1438,"component":623},"c1934137-2603-4787-928e-d9574e5a5961",{"id":16,"url":1437,"target":619,"linktype":620,"fieldtype":621,"cached_url":1437},"https://healthstandards.org/leading-practice/wound-care-distance-consulting/","Read the report",{"type":12,"content":1440},[1441],{"type":15,"attrs":1442,"content":1443},{"textAlign":53},[1444],{"text":1445,"type":303},"HSO Health Standards Organization, 2009",{"type":12,"content":1447},[1448],{"type":15,"attrs":1449,"content":1450},{"textAlign":53},[1451],{"text":1452,"type":303},"St. Adolphe Personal Care Home, a rural long-term care home, takes photos of difficult to heal wounds and e-mails them to a consulting dermatologist in the city. With this visual aid, the home's physician receives a more meaningful consult and has been successful in healing advanced ulcers. The consulting dermatologist has endorsed this practice and encourages other rural homes to adopt it. ",{"_uid":1454,"title":1455,"ctaLeft":1456,"ctaRight":1457,"component":624,"columnLeft":1462,"columnRight":1469},"8d6634e1-93b3-4851-b7cc-a77b09e6f538","Pixalere Incision Module",[],[1458],{"_uid":1459,"link":1460,"label":1438,"component":623},"b4da11ed-d092-4ad4-979b-0d108375b2fc",{"id":16,"url":1461,"target":619,"linktype":620,"fieldtype":621,"cached_url":1461},"https://healthstandards.org/leading-practice/pixalere-incision-module/",{"type":12,"content":1463},[1464],{"type":15,"attrs":1465,"content":1466},{"textAlign":53},[1467],{"text":1468,"type":303},"HSO Health Standards Organization, 2010",{"type":12,"content":1470},[1471],{"type":15,"attrs":1472,"content":1473},{"textAlign":53},[1474],{"text":1475,"type":303},"Wound care is an ongoing, important issue with many home care clients. The efforts and resources provided by the home care staff using the Pixalere system, together with the support and consultation of RNs with specialized training in wound care management, have resulted in the Home Health program providing leading edge care. The ability to track a client's progress through a series of digital photos along with a clinical narrative allows staff to make appropriate and timely changes to care plans, helping to ensure quality patient outcomes.",{"_uid":1477,"title":1478,"ctaLeft":1479,"ctaRight":1480,"component":624,"columnLeft":1485,"columnRight":1489},"cc5a2cb9-4d7e-47e0-8384-4eb4c6086c14","Wounds Australia",[],[1481],{"_uid":1482,"link":1483,"label":622,"component":623},"ec2825d1-4e91-41b6-99a7-e03f53d976e3",{"id":16,"url":1484,"target":619,"linktype":620,"fieldtype":621,"cached_url":1484},"https://www.youtube.com/watch?v=Y0nDdcLVHdA",{"type":12,"content":1486},[1487],{"type":15,"attrs":1488},{"textAlign":53},{"type":12,"content":1490},[1491],{"type":15,"attrs":1492,"content":1493},{"textAlign":53},[1494],{"text":1495,"type":303},"Pharmacist describes his experience with a long-standing, chronic leg ulcer and eventually receiving a new approach to care that was successful. ","Success Stories",{"type":12,"content":1498},[1499],{"type":15,"attrs":1500},{"textAlign":53},{"_uid":1502,"items":1503,"title":1738,"component":685,"description":1739},"d27e0ee6-d543-4ffe-ba19-0beac7b5077d",[1504],{"_uid":1505,"title":1506,"ctaLeft":1507,"ctaRight":1508,"component":624,"columnLeft":1509,"columnRight":1513},"d1d27db9-bb85-49f3-bb9e-7342f7791eb1","Expand to see the full list of references",[],[],{"type":12,"content":1510},[1511],{"type":15,"attrs":1512},{"textAlign":53},{"type":12,"content":1514},[1515,1528,1539,1551,1565,1582,1599,1609,1619,1635,1646,1663,1674,1688,1705,1722],{"type":15,"attrs":1516,"content":1517},{"textAlign":53},[1518,1520,1522],{"text":1519,"type":303},"AHRQ PDI 11 - Selected Best Practices and Suggestions for Improvement PDI 11: Postoperative Wound Dehiscence [in children]. Toolkit for using the AHRQ quality indicators: How to Improve Hospital Quality and Safety. AHRQ, 2016 #5",{"type":1521},"hard_break",{"text":761,"type":303,"marks":1523},[1524,1526],{"type":350,"attrs":1525},{"href":761,"uuid":53,"anchor":53,"custom":53,"target":619,"linktype":620},{"type":1527},"underline",{"type":15,"attrs":1529,"content":1530},{"textAlign":1134},[1531,1533,1534],{"text":1532,"type":303},"AHRQ PSI 14 - Selected Best Practices and Suggestions for Improvement PSI 14: Postoperative Wound Dehiscence [in adults] Toolkit for using the AHRQ quality indicators: How to Improve Hospital Quality and Safety. AHRQ, 2016 #6. ",{"type":1521},{"text":771,"type":303,"marks":1535},[1536,1538],{"type":350,"attrs":1537},{"href":771,"uuid":53,"anchor":53,"custom":53,"target":619,"linktype":620},{"type":1527},{"type":15,"attrs":1540,"content":1541},{"textAlign":1134},[1542,1544,1549],{"text":1543,"type":303},"Butcher M, White R. Factors affecting cost-effectiveness in wound care decision making. ",{"text":1545,"type":303,"marks":1546},"Nurs Stand",[1547],{"type":1548},"italic",{"text":1550,"type":303},". 2014; 28 (35): 51-58. doi: 10.7748/ns2014.04.28.35.51.e7671.",{"type":15,"attrs":1552,"content":1553},{"textAlign":1134},[1554,1556,1563],{"text":1555,"type":303},"Canadian Institute for Health Information. ",{"text":1557,"type":303,"marks":1558},"Hospital Harm Results",[1559,1562],{"type":350,"attrs":1560},{"href":1561,"uuid":53,"anchor":53,"custom":53,"target":619,"linktype":620},"https://www.cihi.ca/sites/default/files/document/hospital-harm-results-2014-2022-data-tables-en.xlsx",{"type":1527},{"text":1564,"type":303},", 2014–2015 to 2019–2020. Ottawa, ON: CIHI; 2020.",{"type":15,"attrs":1566,"content":1567},{"textAlign":1134},[1568,1570,1574,1576],{"text":1569,"type":303},"Demidova-Rice T, Hamblin M, Herman IM. Acute and impaired wound healing: pathophysiology and current methods for drug delivery, part 1: normal and chronic wounds: biology, causes, and approaches to care. ",{"text":1571,"type":303,"marks":1572},"Adv Skin Wound Care",[1573],{"type":1548},{"text":1575,"type":303},". 2012; 25 (7): 304-314. doi: 10.1097/01.ASW.0000416006.55218.d0. ",{"text":1577,"type":303,"marks":1578},"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3428147/",[1579,1581],{"type":350,"attrs":1580},{"href":1577,"uuid":53,"anchor":53,"custom":53,"target":619,"linktype":620},{"type":1527},{"type":15,"attrs":1583,"content":1584},{"textAlign":1134},[1585,1587,1591,1593],{"text":1586,"type":303},"Harris CL, Kuhnke J, Haley J, Cross K, Somayaji R, Dubois J, et al. ",{"text":1588,"type":303,"marks":1589},"Best practice recommendations for the prevention and management of surgical wound complications. ",[1590],{"type":1548},{"text":1592,"type":303},"In: Foundations of Best Practice for Skin and Wound Management. A supplement of Wound Care Canada; 2017. 66 pp. Retrieved from: ",{"text":1594,"type":303,"marks":1595},"www.woundscanada.ca/docman/public/health-care-professional/bpr-workshop/555-bpr-prevention-and-management-of-surgical-wound-complications-v2/file",[1596,1598],{"type":350,"attrs":1597},{"href":1077,"uuid":53,"anchor":53,"custom":53,"target":619,"linktype":620},{"type":1527},{"type":15,"attrs":1600,"content":1601},{"textAlign":1134},[1602,1604],{"text":1603,"type":303},"Health Standards Organization, 2009 , Leading Practices Library, Wound Care Distance Consulting. ",{"text":1437,"type":303,"marks":1605},[1606,1608],{"type":350,"attrs":1607},{"href":1437,"uuid":53,"anchor":53,"custom":53,"target":619,"linktype":620},{"type":1527},{"type":15,"attrs":1610,"content":1611},{"textAlign":1134},[1612,1614],{"text":1613,"type":303},"Health Standards Organization, 2010 , Leading Practices Library. Pixalere Incision Module. ",{"text":1461,"type":303,"marks":1615},[1616,1618],{"type":350,"attrs":1617},{"href":1461,"uuid":53,"anchor":53,"custom":53,"target":619,"linktype":620},{"type":1527},{"type":15,"attrs":1620,"content":1621},{"textAlign":1134},[1622,1624,1628,1630],{"text":1623,"type":303},"Institute for Healthcare Improvement (IHI). ",{"text":1625,"type":303,"marks":1626},"How-to Guide: Prevent surgical site infections.",[1627],{"type":1548},{"text":1629,"type":303}," Cambridge, MA: IHI; 2012. ",{"text":949,"type":303,"marks":1631},[1632,1634],{"type":350,"attrs":1633},{"href":949,"uuid":53,"anchor":53,"custom":53,"target":619,"linktype":620},{"type":1527},{"type":15,"attrs":1636,"content":1637},{"textAlign":1134},[1638,1640,1644],{"text":1639,"type":303},"Kamel A, Khaled  M. Episiotomy, and obstetric perineal wound dehiscence: Beyond soreness. ",{"text":1641,"type":303,"marks":1642},"J Obstet Gynaecol",[1643],{"type":1548},{"text":1645,"type":303},". 2014; 34 (3): 215-217. doi: 10.3109/01443615.2013.866080.",{"type":15,"attrs":1647,"content":1648},{"textAlign":1134},[1649,1651,1655,1657],{"text":1650,"type":303},"Kenig J, Richer P, Lasek A, Zbierska K, Zurawska S. The efficacy of risk scores for predicting abdominal wound dehiscence: a case – controlled validation study. ",{"text":1652,"type":303,"marks":1653},"BMC Surg",[1654],{"type":1548},{"text":1656,"type":303},". 2014; 14: 65. doi: 10.1186/1471-2482-14-65. ",{"text":1658,"type":303,"marks":1659},"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4159378/",[1660,1662],{"type":350,"attrs":1661},{"href":1658,"uuid":53,"anchor":53,"custom":53,"target":619,"linktype":620},{"type":1527},{"type":15,"attrs":1664,"content":1665},{"textAlign":1134},[1666,1668,1672],{"text":1667,"type":303},"Moghadamyeghaneh Z, Hanna MH, Carmichael JC, et al. Wound disruption following colorectal operations. ",{"text":1669,"type":303,"marks":1670},"World J Surg",[1671],{"type":1548},{"text":1673,"type":303},". 2015; 39(12): 2999-3007. doi: 10.1007/s00268-015-3208-0.",{"type":15,"attrs":1675,"content":1676},{"textAlign":1134},[1677,1679,1686],{"text":1678,"type":303},"Ousey K, Djohan R, Dowsett C, Ferreira F, Hurd T, Romanelli M, Sandy-Hodgetts K. World Union of Wound Healing Societies (WUWHS) Consensus Document. ",{"text":1680,"type":303,"marks":1681},"Surgical wound dehiscence: improving prevention and outcomes",[1682,1685],{"type":350,"attrs":1683},{"href":1684,"uuid":53,"anchor":53,"custom":53,"target":619,"linktype":620},"https://woundsinternational.com/consensus-documents/surgical-wound-dehiscence-improving-prevention-and-outcomes/",{"type":1527},{"text":1687,"type":303},". Wounds International, 2018.",{"type":15,"attrs":1689,"content":1690},{"textAlign":1134},[1691,1693,1697,1699],{"text":1692,"type":303},"Sorensen L, Hemmingsen U, Kallehave F, et al. Risk factors for tissue and wound complications in gastrointestinal surgery. ",{"text":1694,"type":303,"marks":1695},"Ann Surg",[1696],{"type":1548},{"text":1698,"type":303},". 2005; 241 (4): 654-658. ",{"text":1700,"type":303,"marks":1701},"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1357070/",[1702,1704],{"type":350,"attrs":1703},{"href":1700,"uuid":53,"anchor":53,"custom":53,"target":619,"linktype":620},{"type":1527},{"type":15,"attrs":1706,"content":1707},{"textAlign":1134},[1708,1710,1714,1716],{"text":1709,"type":303},"Taylor A. Principles of pain assessment. ",{"text":1711,"type":303,"marks":1712},"Wound Essentials",[1713],{"type":1548},{"text":1715,"type":303},". 2010; 5: 104-110. ",{"text":1717,"type":303,"marks":1718},"https://www.wounds-uk.com/download/resource/1155",[1719,1721],{"type":350,"attrs":1720},{"href":1717,"uuid":53,"anchor":53,"custom":53,"target":619,"linktype":620},{"type":1527},{"type":15,"attrs":1723,"content":1724},{"textAlign":1134},[1725,1727,1730,1732],{"text":1726,"type":303},"van Ramshorst G, Nieuwenhuizen J, Hop WC, et al. Abdominal wound dehiscence in adults: Development and validation of a risk model. ",{"text":1669,"type":303,"marks":1728},[1729],{"type":1548},{"text":1731,"type":303},". 2010; 34 (1): 20-27. doi: 10.1007/s00268-009-0277-y. ",{"text":1733,"type":303,"marks":1734},"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2795859/",[1735,1737],{"type":350,"attrs":1736},{"href":1733,"uuid":53,"anchor":53,"custom":53,"target":619,"linktype":620},{"type":1527},"References",{"type":12,"content":1740},[1741],{"type":15,"attrs":1742},{"textAlign":53},{"id":16,"_uid":1744,"items":1745,"component":1772},"b2d6641a-1c3b-4864-ba6c-19ee346da1d3",[1746],{"_uid":1747,"link":1748,"image":1759,"title":1763,"component":1764,"description":1765},"c7cfed08-2efd-4485-aa1e-73f8e8102be3",[1749],{"_uid":1750,"link":1751,"label":1757,"component":1758},"9ad5d873-9318-46d0-a224-c392ff477445",{"id":1752,"url":16,"linktype":356,"fieldtype":621,"cached_url":1753,"story":1754},"e810da59-1dac-470d-a9fa-5791fc96027f","resources/topics/hospital-harm",{"name":1755,"id":1756,"uuid":1752,"slug":9,"url":1753,"full_slug":1753,"_stopResolving":361},"Hospital Harm",147250689243354,"See all resources","simple-link",{"id":1760,"alt":16,"name":16,"focus":16,"title":16,"source":16,"filename":1761,"copyright":16,"fieldtype":289,"meta_data":1762,"is_external_url":277},121293076058734,"https://a-ca.storyblok.com/f/850807391887861/2068x1484/1aea4e8fb2/senior-woman-holding-doctors-hand.webp",{},"Hospital Harm Resources","image-text-colored-item",{"type":12,"content":1766},[1767],{"type":15,"attrs":1768,"content":1769},{"textAlign":53},[1770],{"text":1771,"type":303},"Healthcare Excellence Canada has developed Hospital Harm Improvement Resources – a compilation of resources to support patient safety and improvement efforts.","image-text-colored",[129,150,136,122,143,115,157],[185,192,200],"hec-page-resource-single","wound-disruption","resources/wound-disruption",-18650,[],103604225865405,"83a94f81-990a-4d3d-a6a6-aca10bb374b8","2025-12-09T21:48:41.399Z","default",[],[1786],{"path":1787,"name":1788,"lang":1789,"published":361},"ressources/rupture-d-une-plaie","Rupture d’une plaie","fr",1776087000,[],[1793,1794],{"name":347,"id":358,"uuid":353,"slug":359,"url":360,"full_slug":360},{"name":1755,"id":1756,"uuid":1752,"slug":9,"url":1753,"full_slug":1753},[1796,1803,1809],{"id":1760,"alt":16,"content_length":1797,"content_type":1798,"copyright":16,"created_at":1799,"deleted_at":53,"focus":16,"is_private":277,"title":16,"updated_at":1800,"s3_filename":1801,"meta_data":1802},282950,"image/webp","2025-12-09T17:42:47.391Z","2025-12-09T17:42:48.158Z","f/850807391887861/2068x1484/1aea4e8fb2/senior-woman-holding-doctors-hand.webp",{},{"id":287,"alt":16,"content_length":1804,"content_type":1798,"copyright":16,"created_at":1805,"deleted_at":53,"focus":16,"is_private":277,"title":16,"updated_at":1806,"s3_filename":1807,"meta_data":1808},41946,"2025-12-09T17:45:32.386Z","2025-12-09T17:45:33.077Z","f/850807391887861/2216x1568/ea857fcb8e/shapes.webp",{"alt":16,"title":16,"source":16,"copyright":16},{"id":1179,"alt":16,"content_length":1810,"content_type":1811,"copyright":16,"created_at":1812,"deleted_at":53,"focus":16,"is_private":277,"title":16,"updated_at":1813,"s3_filename":1814,"meta_data":1815},28051,"image/png","2025-12-04T18:40:03.538Z","2025-12-04T18:40:04.613Z","f/850807391887861/600x600/c301964117/checkmark-icon.png",{},1776087482521]