How should an open abdominal wound with exposed viscera be managed in the field?

• A. Cover exposed viscera with sterile moist dressing; do not push organs back; evac
• B. Replace viscera into abdomen and secure
• C. Leave exposed to air
• D. Apply dry dressing and apply pressure

Answer: (A)

Open abdominal wounds with exposed viscera need to be protected from drying out and contamination while you arrange definitive care. The best field management is to cover the exposed organs with a sterile moist dressing and keep them in place without attempting to replace them inside the abdomen. This moist barrier helps preserve tissue viability and reduces the risk of infection until surgery can occur. Replacing the viscera in the field is not recommended because it can cause further injury and complications, and only a sterile surgical environment should handle such repair. Leaving the organs exposed to air increases drying, infection risk, and heat loss, while a dry dressing or applying pressure can harm the tissues and worsen injury. After covering, secure the dressing and evacuate promptly to a surgical facility.