Wound Classification

Question 1

Class I : Clean

Answer 1

– Incision under ideal surgical
conditions
– No drain
– No break in sterility
– Primary closure
– Closed drain
– Respiratory, GIT, GUT not touched
– 1-5% infection rate
– Examples: lap, mastectomy, neck dissection, thyroid, vascular, hernia, splenectomy

Question 2

Class II: Clean
Contaminated

Answer 2

– Primary closure
– OPEN Wound drained
– No inflammation
– Minor break in sterility
– Controlled entry to GIT, GUT
– Infection rate 8-11%
– Examples: Cholecystectomy,
Thoracic lobe, hernia, Vag.
Hyster., liver transplant(txp),
gastric sx, thyroidectomy,
colon surgery, rhinoplasty

Question 3

Class III: Contaminated

Answer 3

– Open traumatic wound less
than 4 hrs.
– Major break in sterility
– Acute inflammation
– Entry to the GIT GUT with
spillage
– Infected bile/urine
– Infection rate 15-20%
– Examples: Inflamed appy, bile
spillage in chole, diverticulitis,
Rectal surgery, penetrating
wounds

Question 4

Class IV: Dirty

Answer 4

– Open traumatic wound more than
4hrs
– Contamination prior to procedure
(necrosis, rupture or spillage of
intestinal contents)
– Perforated bowel, viscus, purulent
inflammation, foreign body, fecal
mater (e.g. Intestine)
– Infection rate 27-40%
– Examples: Abscess I&D, perforated
bowel, peritonitis, wound
debridement, positive cultures pre-op 7