What to Do If a Surgical Wound Opens

First, judge how serious it is

Clinicians call an incision that separates a dehisced wound. Knowing what to do if a surgical wound opens starts with a quick look at how much has opened and what you can see.

A small gap in the skin with the tissue underneath still closed is the most common kind. It needs a prompt call to the surgeon, not an ambulance.
A long or deep opening where you can see below the skin needs to be seen urgently.
An opening in the abdomen with tissue pushing through is an emergency.

When to call 911

Call 911 if:

An abdominal incision opens widely, or anything bulges out of it
Bleeding does not slow with firm, steady pressure
A chest incision opens, or the breastbone clicks or shifts, with chest pain or shortness of breath
You feel faint or confused, have trouble breathing, or have a high fever with shaking chills

For an open abdominal incision, lie down with your knees bent while you wait. Cover the area with a clean cloth dampened with clean water. Do not push anything back in, and do not eat or drink in case surgery is needed.

Steps to take for a smaller opening

Stop what you are doing and sit or lie down so nothing strains the area.
Wash your hands.
Cover the opening with a clean, dry dressing or cloth. Sterile gauze is best if you have it.
If it is bleeding, press gently and steadily over the dressing.
Do not put anything into the opening, and do not try to close it with tape, glue or strips.
Do not apply ointment, peroxide, alcohol or powder unless the surgeon tells you to.
Call the surgeon’s office right away, including after hours.

Avoid lifting, bending and straining until you have instructions.

Who to call, and in what order

The surgeon who did the operation should hear first, because they know what was done beneath the skin. Use the number on your discharge papers. After hours, the recording usually gives an on-call option.

If you cannot reach anyone and the opening is deep, is draining heavily or comes with fever, go to an urgent care center or emergency department. If a home health nurse comes to your home, call the agency too, and let your primary care clinician know.

Gateway is not an emergency service and does not replace your surgeon. Once the surgeon has set the plan, we can arrange the wound visits that follow.

What to tell the surgeon’s office

The date and type of surgery
When you noticed the opening and what you were doing (coughing, lifting, standing up)
How long the opening is (compare it with a coin) and whether you can see below the skin
The color, amount and smell of any drainage
Fever, chills, redness or increasing pain
Whether you have diabetes or take blood thinners or steroids

The office may ask for a photo. Our guides on sending wound photos and describing wound changes can help you give a clear picture.

What usually happens next

The surgeon decides based on the depth, the cause and whether infection is present. The incision may be closed again. Often it is left open to heal from the bottom up, with dressings or packing changed on a schedule. Some wounds are managed with negative pressure wound therapy.

If a surgical site infection is suspected, the surgeon may take a culture, prescribe antibiotics or remove unhealthy tissue. An open wound takes longer to heal than a closed incision, and regular measurement shows whether it is on track.

If your incision is still closed, our guide to what to expect from a healing incision lists the early warning signs.

How Gateway arranges care for an opened incision

Gateway arranges follow-up for dehisced surgical wounds with partner clinicians who see people at home, in rehabilitation centers and in skilled nursing across Greater St. Louis and the Metro East. We request the surgeon’s orders and operative note, schedule visits, arrange the ordered supplies and send updates back to the surgical office.

This is part of our wound follow-up after hospital discharge. Call 314-325-0126 or request care online with a name and phone number.

Common questions

Can an opened surgical wound heal without being stitched again?

Yes. Many opened incisions are left open on purpose. They heal by filling in from the base with new tissue and then closing over with skin. Surgeons often choose this when infection or fluid may be present, because sealing the surface could trap it. Expect regular dressing care, follow-up visits and a wider scar. The surgeon decides which approach fits your wound.

Is a small gap between stitches an emergency?

Usually not, but call the surgeon’s office the day you notice it. A shallow gap in the skin edges with no fever, heavy drainage or spreading redness is often managed with dressings and closer watching. Cover it, avoid strain and describe it carefully. It becomes urgent if it widens, deepens, drains pus or bleeds steadily.

What does a sudden gush of pink fluid from my incision mean?

A sudden release of pink or straw-colored fluid can mean that fluid collected under the incision has found a way out. From an abdominal incision, it can also be an early warning that deeper layers are separating, even when the skin still looks closed. Cover the area, lie down and call the surgeon right away. Call 911 if the incision opens or you feel unwell.

Did I cause my incision to open?

There is rarely a single cause. A hard cough or a heavy lift can be the final strain, but infection, fluid under the skin, swelling and health conditions that slow healing usually set the stage. Tell the surgeon plainly what you were doing when it happened, since that helps them judge the cause. Ask which movements to avoid while the wound heals.

General information to help you talk with your own clinician. It is not medical advice, and the treating clinician makes every clinical decision. For a medical emergency, call 911.

Updated October 2026

What to do if a surgical wound opens.