During an abdominal evisceration, which dressing is best to secure exposed organs during transport?

• A. Cover the exposed bowel and keep legs straight.
• B. Cover with moist sterile gauze and occlusive dressing.
• C. Replace bowel into abdomen and transport.
• D. Irrigate with sterile water and cover with a dry dressing.

Answer: (B)

In an abdominal evisceration, the priority is to protect the exposed organs from drying, contamination, and temperature loss while getting the patient to definitive care. The best approach is to place moist sterile gauze over the exposed bowel or organs and then cover with an occlusive dressing. The moisture prevents desiccation and preserves tissue viability, while the occlusive layer seals in moisture, provides a barrier to contaminants, and helps keep the organs secure and protected during transport. This is preferable to leaving the area dry or applying a dry dressing, which can dry out tissues and increase infection risk, or attempting to replace the bowel inside the abdomen, which should not be done in the field. Irrigating with fluids is not indicated in this scenario and can create further contamination.