An abdominal evisceration to the left lower quadrant occurred after a knife injury. After addressing ABCs and assessing for other life-threatening injuries, how should you care for the wound?

• A. Cover it with moist, sterile gauze and secure with an occlusive dressing.
• B. Push the contents back inside the abdomen.
• C. Apply dry sterile gauze and leave exposed.
• D. Remove any protruding tissue.

Answer: (A)

Abdominal evisceration requires protecting the protruding organs from drying and from contamination while you continue evaluation and transport. Do not push the contents back inside or remove any protruding tissue. The best care is to gently cover the exposed tissues with sterile, moist gauze to keep them from drying out, then secure an occlusive dressing over the moistened gauze to seal the area and protect against infection. Dry dressings or leaving the organs exposed increase the risk of desiccation and contamination, and attempting to push or replace tissue can cause further injury. After covering, treat for shock, keep the patient warm, and transport promptly.