What is the first action for post-op wound dehiscence with evisceration?

• A. Cover with sterile saline-soaked dressings
• B. Immediately return to OR
• C. Apply dry sterile dressing
• D. Remove protruding organs to clean wound

Answer: (A)

When wound dehiscence occurs with evisceration, the immediate priority is to protect the exposed viscera and prevent further injury. The best first action is to cover the protruding organs with sterile dressings that are moistened with sterile saline. Keeping the tissues moist helps prevent desiccation and contamination, preserves tissue viability, and creates a barrier while the patient is prepared for definitive surgical management.

Do not attempt to push the organs back in, do not use dry dressings that can dry out and damage tissue, and do not delay definitive care without first protecting the viscera. After covering, summon the surgical team promptly and continue with emergent stabilization (IV access, NPO status, monitoring) in anticipation of urgent operative repair.