In the field, how should an open abdominal wound with evisceration be managed?

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Multiple Choice

In the field, how should an open abdominal wound with evisceration be managed?

When the abdomen is open with organs exposed, the priority is to protect the viscera from contamination and drying while getting the patient to definitive care quickly. The exposed intestines and other tissues are at high risk for infection and desiccation, and significant heat loss can worsen shock. Do not try to push the organs back inside the abdomen in the field; replacing them can cause further injury and isn’t something you should attempt outside surgery. Gently cover the exposed organs with sterile dressings that are moistened with normal saline if available, keeping them moist. Do not use a dry dressing over the viscera. Secure the dressings loosely to hold them in place without applying pressure, then add an outer layer to help keep them in place and reduce heat loss. Maintain the patient’s warmth and transport rapidly to a surgical facility. Monitor for signs of shock and manage accordingly. Replacing organs or using a dry dressing, leaving the wound exposed to air, or applying a tight abdominal tourniquet are not appropriate in this scenario; they increase risk of tissue damage, infection, and complications.

When the abdomen is open with organs exposed, the priority is to protect the viscera from contamination and drying while getting the patient to definitive care quickly. The exposed intestines and other tissues are at high risk for infection and desiccation, and significant heat loss can worsen shock. Do not try to push the organs back inside the abdomen in the field; replacing them can cause further injury and isn’t something you should attempt outside surgery.

Gently cover the exposed organs with sterile dressings that are moistened with normal saline if available, keeping them moist. Do not use a dry dressing over the viscera. Secure the dressings loosely to hold them in place without applying pressure, then add an outer layer to help keep them in place and reduce heat loss. Maintain the patient’s warmth and transport rapidly to a surgical facility. Monitor for signs of shock and manage accordingly.

Replacing organs or using a dry dressing, leaving the wound exposed to air, or applying a tight abdominal tourniquet are not appropriate in this scenario; they increase risk of tissue damage, infection, and complications.

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