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