The patient exhibits signs of wound dehiscence with visible bowel, indicating an evisceration, a surgical emergency. Immediate action is to cover the exposed bowel with sterile saline-moistened gauze to prevent desiccation and contamination, minimizing risk of infection and further injury. Prompt referral for emergency reoperation is critical to properly repair the wound and prevent life-threatening complications such as bowel ischemia or sepsis. Attempting to close the wound bedside or simply observing risks worsening the patient’s condition. Oral antibiotics alone do not address the urgency of surgical repair.

Reference: Sabiston Textbook of Surgery, Townsend et al., 21st Edition.