What is the correct approach to an open abdomen or eviscerated organs in the field?

• A. Do not attempt to replace organs; cover with sterile moist dressings; prevent contamination; expedite evac
• B. Replace organs gently into the abdomen and cover
• C. Remove organs entirely from the field to avoid contamination
• D. Wrap organs in dry gauze and delay evac

Answer: (A)

In this situation, the priority is to protect the exposed tissues from contamination and drying while getting the patient to definitive care. Do not try to replace organs back inside the abdomen in the field. Replacing them can cause additional injury, impair blood flow, and slow transport. Instead, cover the exposed organs with sterile dressings that are moistened with saline to keep them moist and reduce the chance of contamination, then secure a bulky dressing to hold everything in place without squeezing. Avoid drying the tissues with dry gauze or delaying evacuation for any field intervention. The goal is rapid transport to definitive surgical care, while preserving tissue viability and minimizing contamination.