SURGICAL WOUND CLASSIFICATIONS I. Clean: - Uninfected, no inflammation - Resp, GI, GU tracts not entered - Closed primarily Examples: Ex lap, mastectomy, neck dissection, thyroid, vascular, hernia, splenectomy II. Clean-contaminated: - Resp, GI, GU tracts entered, controlled - No unusual contamination Examples: Chole, SBR, Whipple, liver txp, gastric surgery, bronch, colon surgery III: Contaminated: - Open, fresh, accidental wounds - Major break in sterile technique - Gross Spillage from GI tract - Acute nonpurulent inflammation Examples: Inflamed appy, bile spillage in chole, diverticulitis, Rectal surgery, penetrating wounds IV: Dirty: - Old traumatic wounds, devitalized tissue - Existing infection or perforation - Organisms present BEFORE procedure Examples: Abscess I&D, perforated bowel, peritonitis, wound debridement, positive cultures pre-op
