What are the direct complications of a surgical knot coming untied?

The direct complications of a surgical knot coming untied primarily involve physical issues related to the integrity of the surgical closure. When a surgical knot becomes untied, it can lead to evisceration, where internal organs or tissues protrude through an opening, and dehiscence, which refers to the wound reopening. Both of these complications can occur as a result of a failure in wound closure, leading to serious concerns such as infection, hemorrhage, and the need for reoperation.

In contrast, the other choices point to potential complications that may arise from surgical procedures in general but are not immediate results of an untied knot. Fever and chills can signify an infection but are not direct outcomes of knot failure. Infection and scarring could follow once a wound is compromised, but again, they do not occur directly from an untied knot itself. Pain and discomfort are common after any surgery, but specifically linked to an untied knot, they are more of a secondary effect rather than a direct complication. Thus, evisceration and dehiscence are recognized as the immediate surgical concerns when a knot fails.