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Questions and Answers
Surgical wounds are classified into ______ categories according to the degree of microbial contamination and are referred to in the patient record by _____ _____.
Surgical wounds are classified into ______ categories according to the degree of microbial contamination and are referred to in the patient record by _____ _____.
four, Roman numeral
What is the classification for an uninfected, uninflamed operative wound where the respiratory, alimentary, genital, or uninfected urinary tracts are not entered?
What is the classification for an uninfected, uninflamed operative wound where the respiratory, alimentary, genital, or uninfected urinary tracts are not entered?
Clean (Class I)
What classification describes an uninfected operative wound where the respiratory, alimentary, genital, or urinary tract is entered under controlled circumstances?
What classification describes an uninfected operative wound where the respiratory, alimentary, genital, or urinary tract is entered under controlled circumstances?
Clean contaminated (Class II)
What classification would an acute, nonpurulent, inflamed operative wound fall under?
What classification would an acute, nonpurulent, inflamed operative wound fall under?
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How is a clinically infected operative wound classified?
How is a clinically infected operative wound classified?
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What is the primary goal of postoperative wound care?
What is the primary goal of postoperative wound care?
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_____ are devices that have been designed to remove unwanted fluids or gases from the body.
_____ are devices that have been designed to remove unwanted fluids or gases from the body.
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If a dressing must be changed within _____ hours of initial application, what technique must be employed?
If a dressing must be changed within _____ hours of initial application, what technique must be employed?
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For a contaminated wound, the skin and subcutaneous tissues are generally left open and packed loosely with fine mesh gauze, such as ______.
For a contaminated wound, the skin and subcutaneous tissues are generally left open and packed loosely with fine mesh gauze, such as ______.
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What are ligatures used for?
What are ligatures used for?
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What is the surgical technologist's responsibility regarding needle holders?
What is the surgical technologist's responsibility regarding needle holders?
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What should be done with stick ties in anticipation of hemorrhage?
What should be done with stick ties in anticipation of hemorrhage?
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Study Notes
Surgical Wound Classification
- Surgical wounds are categorized into four types based on microbial contamination: Clean (Class I), Clean Contaminated (Class II), Contaminated (Class III), and Dirty (Class IV).
- Class I wounds are uninfected and involve ideal surgical conditions without entry into certain tracts.
- Class II wounds are also uninfected but involve controlled entry into the respiratory, alimentary, or genitourinary tracts.
- Class III wounds involve acute inflammation or a break in sterile technique, leading to potential contamination.
- Class IV wounds are clinically infected or involve perforated viscus and retained necrotic tissue.
Examples of Wound Types
- Class I: Coronary artery bypass graft, total hip, and craniotomy procedures.
- Class II: Appendectomy, cholecystectomy, and tonsillectomy.
- Class III: Open fractures and colon resections with GI spillage.
- Class IV: Resection of a ruptured appendix.
Postoperative Care
- Primary goals include preventing infection and managing complications.
- Use of drains is common to remove fluids or gases; multiple types may be necessary.
- Dressings are applied using sterile technique to create an optimal environment for healing.
- Dressings need to be changed under sterile conditions if they become wet or soiled, generally within 48 hours.
Drainage and Dressing Techniques
- Open contaminated wounds are typically packed with fine mesh gauze and repacked twice daily.
- Dressings support wound healing and require changes based on condition and signs of infection.
- Iodoform packing is typically removed after 4 to 5 days if no infection is present.
Suturing and Ligature Information
- Choice of suture depends on the patient's health, underlying conditions, and the nature of the wound.
- Ligatures are used to control hemorrhage during surgical procedures and include various tying methods: free-ties, ligature reels, instrument ties, and stick ties.
- Non-needled suture material standard lengths are typically 54 inches for absorbable and 60 inches for nonabsorbable types.
- Superficial and deep bleeders require different suture lengths, generally 18 inches for superficial and 18-30 inches for deeper bleeders.
Suture Handling Best Practices
- Proper handling prevents deterioration and damage to sutures, especially gut sutures and nylon.
- Avoid crushing sutures and follow protocols to maintain sterilization and integrity during surgery.
Surgical Instrumentation
- The needle holder clamps on the needle based on distance from the swaged end; never clamp the swaged area itself.
- Upon use, the needle holder is placed in a neutral zone to ensure safety and sterility.
- Needle holders can be exchanged on a one-for-one basis with a focus on maintaining sterility of both instruments and sutures.
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Description
Test your knowledge of surgical wound classifications with these flashcards from Chapter 11 Part 3 of the Surgical Technology textbook. Learn about the categories of wounds and how they are documented in patient records. Prepare yourself for practical applications in the surgical setting.
