A woman undergoes elective caesarean section at 39 weeks. She develops a wound haematoma on Day 3 with induration and fluctuation. Temperature is 38.2°C. The haematoma is 8 cm in diameter with purulent discharge. The MOST appropriate management is:
- A IV antibiotics alone for 7 days
- B Immediate re-suturing after debridement
- C Wound opening, debridement, irrigation and secondary intention healing with antibiotics ✓
- D Ultrasound-guided aspiration only
Correct answer: C. Wound opening, debridement, irrigation and secondary intention healing with antibiotics
Explanation
An infected caesarean wound haematoma with purulent discharge requires surgical management: opening the wound completely, evacuating the haematoma, debriding necrotic tissue, irrigating with saline, and leaving the wound open to heal by secondary intention with wound care. Antibiotics are adjunctive but do not replace surgical drainage of an infected collection. Immediate re-suturing (delayed primary closure) is inappropriate when there is active infection. Aspiration alone is insufficient for infected haematoma with purulent discharge.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.