A 33-year-old male sustained abdominal evisceration to the left lower quadrant after a cut. After managing ABCs and assessing for other life threats, how should you care for the wound?

• A. Cover the exposed bowel and keep his legs in a straight position.
• B. Cover it with moist, sterile gauze and secure with an occlusive dressing.
• C. Carefully replace the exposed bowel into the abdomen and transport.
• D. Irrigate it with sterile water and cover it with a dry dressing.

Answer: (B)

Protecting exposed intra-abdominal tissue by keeping it moist and protected is the priority after identifying an abdominal evisceration. The best approach is to cover the protruding bowel with moist sterile gauze and secure it with an occlusive dressing. Keeping the tissue moist helps prevent drying and further tissue injury, while an occlusive layer traps warmth and moisture, reducing the risk of infection and heat loss. Do not try to replace the bowel into the abdomen in the field, as manipulating it can cause additional injury and delay definitive care. Do not irrigate or place a dry dressing, as that can dry out or contaminate the tissue. After this protection, transport promptly for surgical management.