Wound Classification

Question 1

What are 4 classifications of operative wounds?

Answer 1

• Clean
• Clean-contaminated
• Contaminated
• Dirty

Question 2

What is an example of a clean wound?

Answer 2

Surgically created wound

Question 3

With what type of wound has no infection been encountered, aspetic technique been maintained and no structure normally containing bacteria has been opened?

Answer 3

Clean wound

Question 4

A surgically created wound where a hollow viscus or organ normally containing bacteria is opened but no contents are spilled is considered what?

Answer 4

Clean-contaminated

Question 5

If a minor break in aseptic technique occurs this can create what type of wound?

Answer 5

Clean-contaminated

Question 6

A surgical wound where a hollow viscus is opened with gross spillage is considered what?

Answer 6

Contaminated

Question 7

A major break in technique can cause what type of wound?

Answer 7

Contaminated

Question 8

A traumatic wound is considered to be what?

Answer 8

Contaminated

Question 9

If a wound contains pus or contents of perforated hollow viscus, it is considered to be what?

Answer 9

Dirty

Question 10

What is the goal of aseptic technique?

Answer 10

Minimize the incidence of surgical wound infection.

Question 11

The risk of infection doubles with what duration of time with surgery?

Answer 11

Doubles every 70-90 minutes of surgery.

Question 12

What is the rule of thumb for the risk of infection in reference to time?

Answer 12

Risk doubles every hour.

Question 13

What is the incidence of surgical wound infections with clean procedures?

Answer 13

0 - 4.4%

Question 14

What is the incidence of surgical wound infections with clean-contaminated procedures?

Answer 14

4.5 - 9.5%

Question 15

What is the incidence of surgical wound infections with contaminated procedures?

Answer 15

5.8 - 28.6%

Question 16

What is the incidence of surgical wound infections with dirty procedures?

Answer 16

Implies infection

Question 17

What are 4 sources of operative wound infections?

Answer 17

• Operating room environment
• Operating team
• Surgical instruments and supplies
• Patient’s endogenous flora

Question 18

What is the most common source of operative wound infection?

Answer 18

Patient’s endogenous flora

Question 19

Surgical site infection can occur up to how many days post-surgery?
Up to how long with implants?

Answer 19

• Within 30 days

- Up to 1 year

Question 20

What should the use of antibiotics and surgery be based on?

Answer 20

Based on sound principles and established benefit.

Question 21

Antibiotics are often overused/misused, increasing the risk of what?

Answer 21

Risk of developing antibiotic resistant strains.

Question 22

What is not a good substitute for good surgical technique?

Answer 22

Antibiotics

Question 23

What are 2 ways to use antibiotics for surgery?

Answer 23

• Prophylactic

- Therapeutic

Question 24

What can be used if the risk of infection is high or an infection would have catastrophic results?

Answer 24

Prophylactic antibiotics

Question 25

When are prophylactic antibiotics administered?

Answer 25

Prior to induction for surgery

Question 26

How soon before a skin incision is made for surgery are prophylactic antibiotics administered?

Answer 26

30-60 minutes prior to skin incision.

Question 27

What are the 2 most commonly used antibiotics with surgery?

Answer 27

• Cefazolin

- Cefoxitin

Question 28

How can post-operative infections be minimized?

Answer 28

Good nursing care practices.