Inflammation/Wound Healing

Question 1

Operation with pus/purulent abdomen…. wound classification? Risk of surgical site infection (SSI)?

Answer 1

Class IV: Dirty/Infected

SSI risk: 40% (>27%)

Question 2

Operation with perforated bowel and spillage prior to operation OR necrotic tissue… wound classification?
Risk of surgical site infection (SSI)?

Answer 2

Class IV: Dirty/Infected

SSI risk: 40% (>27%)

Question 3

Lap chole with spillage of bile… wound classification?

Risk of surgical site infection?

Answer 3

Class III: Contaminated

SSI Risk: 13% (10-17%)

Question 4

Operation with accidental enterotomy with port placement causing some feculant spillage, and lots of GI spillage… wound classification?

Risk of surgical site infection?

Answer 4

Class III: Contaminated

SSI Risk: 13% (10-17%)

Question 5

Operation with a major break in sterile technique… wound classification?

Risk of surgical site infection?

Answer 5

Class III: Contaminated

SSI Risk: 13% (10-17%)

Question 6

Operation with dusky bowel, small bowel resection w/ primary anastamosis, and uncomplicated ostomy creation… wound classification?

Risk of surgical site infection?

Answer 6

Class II : Clean-contaminated

SSI Risk: 10% (3-11%)

Question 7

Operation for blunt trauma with no bowel or bladder injury… wound classification?

Risk of surgical site infection?

Answer 7

Class I: clean

SSI Risk: 1% - 5%

Question 8

Elective operation (inguinal herna) with no complications… wound classification?

Risk of surgical site infection?

Answer 8

Class I: clean

SSI Risk: 1% -5%

Question 9

During the inflammation stage of wound healing, what is the most important cell type?

Answer 9

Macrophages

Source of 30+ growth factors and cytokines!! (as well as phagocytosis)

Question 10

Initial predominant inflammatory cell in first 24 to 48 hours of wound healing?

Answer 10

neutrophils

Question 11

During which days after wound creation is the inflammatory stage of wound healing?

Answer 11

Immediately after injury to 10 days