A post-operative client treating in post-operative general ward. After 6 days of the abdominal surgery surgical wounds are opened and intestine protruded from the wound. This type of surgical emergency is called?

1. A

   Wound rupture

2. B

   Wound sepsis

3. C

   Wound evisceration

4. D

   Wound dehiscence

Appeared in: PGIMS Rohtak NO - 2017

Explanation

• Wound evisceration is the protrusion of internal organs, such as the intestine, through a surgical incision.
• The scenario describes the classic presentation of evisceration: a post-operative abdominal wound opening with protrusion of the intestine.
• As shown in the image and described in the stem, this is a surgical emergency requiring immediate intervention to prevent organ damage and infection.
• This complication typically occurs 6 to 8 days after surgery, which aligns with the patient's timeline.

Why Other Options Were Wrong

• Option A: Wound rupture is a non-specific, general term and not the precise medical term for this complication.
• Option B: Wound sepsis refers to a wound infection. While infection is a major risk factor for evisceration, the term itself describes the presence of pathogens and inflammation (redness, warmth, pus, fever), not the protrusion of organs.
• Option D: Wound dehiscence is the separation of the surgical wound layers, but without the protrusion of internal organs. It is a precursor to evisceration.

Related Visual

Clinical Relevance

• Nursing practice connection: Prioritize focused assessment, early escalation, and real-time monitoring when managing Post-operative surgical wound complications in acute care settings.
• Recognizing wound evisceration is a critical nursing skill. Immediate and correct action can prevent organ necrosis and life-threatening peritonitis.
• The nurse's first actions—calling for help, positioning the patient, and covering the organs with a sterile saline dressing—are vital to protect the patient while awaiting surgical intervention.
• Patient education on preventing increased intra-abdominal pressure (e.g., splinting the incision when coughing) is a key post-operative nursing role to prevent this complication.

How to Approach the Question

• First, analyze the clinical scenario for key details. The patient is 6 days post-op from abdominal surgery.
• Identify the most critical finding in the question stem: 'intestine protruded from the wound'.
• Examine the provided image, which visually confirms the protrusion of intestines from an abdominal incision.
• Evaluate the options based on this key finding. 'Wound evisceration' is the specific medical term for the protrusion of internal organs through a wound.
• Differentiate this from 'wound dehiscence', which is only the separation of wound layers, and 'wound sepsis', which is an infection.
• Select the most precise and accurate term that describes the entire clinical picture presented.

Concept Tested & Keywords

• Concept Tested: Post-operative surgical wound complications
• Stem keywords: post-operative, abdominal surgery, surgical wounds are opened, intestine protruded
• Lead-in keywords: surgical emergency
• Clinical cues: 6 days post-op: This timeframe is significant as it's when wound strength is low, and complications like dehiscence/evisceration are more likely.
• Clinical cues: Intestine protruded: This is the defining sign of wound evisceration.

Question ID

QnQz7P4JbdmWrGrA7W0XcG

Copy ID

Reference Book

E6 Nursing Brunner Adult Health 3SA Vol 1 Part 1 p. 126-128

E6 Nursing Fundamentals Potter Perry 12e Part 6 p. 200-202