Which of the following is correct management of an open abdominal wound with evisceration?

• A. Replace the bowel into the abdomen and apply an occlusive dressing.
• B. Apply a tight pressure to stop external bleeding.
• C. Apply a moist, sterile dressing covered by a dry, sterile dressing.
• D. Apply a dry sterile dressing covered by an occlusive dressing.

Answer: (C)

When tissue is exposed from an open abdominal wound with evisceration, the priority is to protect the viscera from drying and contamination while you arrange rapid transport. You never replace the organs. The best method is to cover the exposed tissue with a sterile dressing moistened with sterile saline to keep it hydrated, then cover that with a dry sterile dressing. This moist-to-dry layering helps preserve tissue viability and provides a barrier against contamination and heat loss.

Other approaches fail because replacing the bowel is not advised, applying pressure can worsen injury or spread contamination, and using a dry dressing first without moisture can cause rapid desiccation of the exposed tissues.