Wound Classification Flashcards
What are the classifications of operative wounds?
Clean
Clean-contaminated
Contaminated
Dirty
What is a clean wound?
Surgically created
No infection
Aseptic technique maintained
No structure containing bacteria is opened
What is a clean-contaminated wound?
Surgically created but…
- hollow viscus or organ that normally contains bacteria is opened, but no contents are spilled
- minor break in aseptic technique occurs (eg hole in glove)
What is a contaminated wound?
Surgical wound but…
- hollow viscus opened with gross spillage
- minor break in technique
Traumatic wounds
What is a dirty wound?
Contains pus
Contains contents of perforated hollow viscus
bacterial contamination
T/F: the risk of infection doubles with every 70-90mins of surgery
True
Rule of thumb… doubles every hour
What is the difference between infection and infection with inflammation?
Infection
- > presence of purulent drainage
- > abscess
- > fistula
Infection/inflmmation
- > infection OR
- > more than 3 of: red, swelling, pain, heat, serous discharge, wound dehiscence
What re the 3 major risk factors of infection
Duration of surgery
Increased number of people in operating room
Dirty surgical site
Infection/inflmmation is associated with what 6 significant factors?
Duration of anesthesia Duration of post op ICU stay Wound drainage Increased patient weight Dirty surgical site Antimicrobial prophylaxis
What is the most common source of infection from operative wound sites?
Patients endogenous flora
Eg skin or GI
Other sources are
- operating room environment
- operating team
- surgical instruments and supplies
T/F: A surgical site infection is an infection occurring within 30days of surgery at that surgical site
True
-can be up to 1 year with implants
When would you use prophylactic antibiotics with surgery?
Risk of infection is high
OR
Infection would have catastrophic results
When should prophylactic antibiotics be administered?
PRIOR to surgery
30-60mins prior to skin incision
Conintued perioperative but not longer than 24hrs
What broad spectrum antibiotic is commonly given perioperative for prophylactic purposes?
Cefazolin
When would you use therapeutic antibiotics withsurgery?
Systemic infection present
Infection present at surgical site or in body cavity
Contaminated or dirty productive
