A diabetic patient on long-term corticosteroids undergoes abdominal surgery. Six days post-operatively, clear pink fluid ('salmon-coloured fluid') soaks the wound dressings and the wound edges separate. What is the most likely diagnosis and immediate management?

• A Wound infection — wound swab and antibiotics
• B Seroma — needle aspiration
• C Burst abdomen (wound dehiscence) — immediate return to theatre for mass closure ✓
• D Enterocutaneous fistula — conservative management

Explanation

Discharge of salmon-coloured (serosanguinous) fluid between post-operative days 5-10, followed by wound separation, is the classic presentation of burst abdomen (complete wound dehiscence). Risk factors include obesity, malnutrition, diabetes, corticosteroids, wound infection, and increased intra-abdominal pressure. This is a surgical emergency requiring immediate return to theatre for mass closure (Jenkins rule: suture length:wound length ratio ≥4:1 using a slowly absorbable or non-absorbable mass closure technique) to prevent evisceration.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.