surgical wound classification grade

Question 1

contaminated

Answer 1

This is the correct surgical wound classification grade for the above procedure given the intra-operative complication. It describes operations with a breach of viscus and/or spillage or opening of colon. The infection risk of a contaminated wound is 12-20%

A 45 year old lady undergoes an elective laparoscopic cholecystectomy. During the operation, which proves challenging, the surgeon accidentally makes a tear in the gastrointestinal tract. This is repaired and the operation is completed without further complications. The surgeon completes his operation note and writes down the surgical wound classification grade for the operation given the complication encountered. What is this most likely to be?

Question 2

clean-contaimnated

Answer 2

This is the incorrect classification as this describes the non-accidental intra-operative breach of a viscus (but not colon) under controlled conditions and without unusual contamination. The infection risk of a clean-contaminated wound is 8-10%

Question 3

dirty

Answer 3

This is the incorrect option as it describes a site/wound that is already contaminated with pus or faeces or from exogenous contagion e.g. trauma.

Question 4

clean

Answer 4

This is the incorrect option as it describes incising uninfected skin without opening a viscus. The infection risk of a clean wound is <2%

Question 5

when do you avoid the D2 porkinetic domperidone

Answer 5

It should be avoided in patients at risk of a prolonged QT interval.

Diabetic patients are at increased risk of developing gastroparesis secondary to autonomic neuropathy.