On postoperative day 6 following an open sigmoid resection, an obese patient with a persistent cough experiences sudden drainage of large amounts of salmon-colored, serosanguinous fluid from the laparotomy wound. Inspection reveals separation of all abdominal wall layers with loop of bowel visible. What is this condition?

Answer and explanation

Correct answer: A. Complete wound dehiscence with evisceration; urgent return to theatre

  1. Step 1: Profuse serosanguinous ('salmon-pink') drainage from an abdominal incision is the classic warning sign of impending or complete fascial dehiscence.
  2. Step 2: When bowel loops protrude through the separated fascia and skin, complete evisceration has occurred.
  3. Step 3: Immediate management is covering the exposed viscera with sterile moist saline-soaked gauze and urgent return to the operating room for emergency fascial closure.
Answer
Complete wound dehiscence with evisceration; urgent return to theatre.
Why not the others: 'Superficial wound infection; treat with bedside suture removal and packing' addresses only skin and subcutaneous infection with intact fascia; 'Incisional hematoma; apply abdominal compression binder' ignores the disruption of the fascial layer; 'Benign seroma; aspirate using a sterile syringe' risks inoculating the peritoneal cavity when the fascia is separated.

Practise more General Surgery and Emergency Management.

Free questions with an explanation for every one, and full timed Oman Medical Specialty Board Examination (OMSB) mock tests.

All General Surgery and Emergency Management questionsTake a mock test

More General Surgery and Emergency Management questions