Surgical Wound Classification

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Questions and Answers

Match the surgical wound classification with its corresponding characteristic:

Class I: Clean = Uninfected surgical wound without inflammation. Class II: Clean-Contaminated = Surgical wound involving the respiratory, alimentary, or urinary tracts, but without evidence of infection. Class III: Contaminated = Open, fresh accidental wounds or major breaks in sterility. Class IV: Dirty-Infected = Old traumatic wounds with existing clinical infection.

Match the surgical procedure with its corresponding wound classification based on potential contamination:

Hernia Repair = Class I: Clean Appendectomy = Class II: Clean-Contaminated Exploratory Laparotomy with bowel spillage = Class III: Contaminated Incision and drainage of an abscess = Class IV: Dirty-Infected

Match the scenario with its corresponding surgical wound classification:

Elective hip replacement = Class I: Clean Cesarean section = Class II: Clean-Contaminated Gunshot wound to the abdomen = Class III: Contaminated Perforated bowel = Class IV: Dirty-Infected

Match the type of surgical approach with the factors influencing wound classification.

Laparoscopic surgery = Often associated with Class I: Clean due to minimal tissue trauma. Open surgery = May increase risk of contamination depending on the organs exposed (Class II: Clean-Contaminated or Class III: Contaminated). Emergency surgery = Often involves situations that increase contamination risk, potentially leading to Class III or Class IV classifications. Elective surgery = Typically allows for optimal preparation, reducing contamination risk and favoring Class I or II classifications. Signup and view all the answers

Match the element of surgical technique with the factors influencing wound classification

Meticulous hemostasis = Reduces the risk of hematoma formation, minimizing a potential source for bacterial growth (favoring Class I or II). Sharp dissection = Minimizes tissue trauma and devascularization, reducing the risk of infection (favoring Class I or II). Gentle tissue handling = Prevents tissue damage that could increase susceptibility to infection (favoring Class I or II). Adequate debridement = Removes necrotic tissue in contaminated wounds, reducing the bacterial load and risk of infection (shifting Class IV towards Class III). Signup and view all the answers

Match the patient factor affecting wound healing with how it influences the classification of surgical wounds:

Diabetes mellitus = Poor glycemic control increases infection risk, potentially elevating wound classification to Class III or IV. Immunosuppression = Impaired immune function increases susceptibility to infection post-surgery, potentially elevating wound classification to Class III or IV. Malnutrition = Compromised nutritional status impairs wound healing and increases infection risk, potentially elevating wound classification to Class III or IV. Advanced age = Age-related decline in immune function and wound healing can increase infection risk, potentially elevating wound classification to Class III or IV. Signup and view all the answers

Match the postoperative intervention and prevention associated with the type of surgical wound it is typically used to treat:

Prophylactic antibiotics = May be used for Class II: Clean-Contaminated wounds to prevent infection. Wound irrigation = Used for Class III: Contaminated wounds to reduce bacterial load. Debridement = Used for Class IV: Dirty-Infected wounds to remove devitalized tissue. Primary closure = Often suitable for Class I: Clean wounds with minimal risk of infection. Signup and view all the answers

Match the potential consequence to the scenario based on incorrect surgical wound classification:

Underestimation of risk = Can result in inadequate preventative measures, like inappropriate choice or dosing of antibiotic prophylaxis, leading to surgical site infections. Overestimation of risk = Can cause unnecessary use of broad-spectrum antibiotics, increasing the risk of antibiotic resistance and C. difficile infection. Inappropriate surgical technique = Increases risk of dehiscence, infection, or other complications. Compromised documentation = Incorrect charting of wound classification can impact communication among healthcare providers, potentially leading to confusion and errors in patient management. Signup and view all the answers

Match each process to how it plays a role in surgical wound classification:

Intraoperative assessment of tissue = The surgeon assesses the degree of contamination and tissue damage to assign the appropriate wound classification. Review of patient's medical history = Factors such as diabetes, immunosuppression, or malnutrition can influence the risk of infection and wound healing. Documentation in the operative report = The assigned wound classification is documented to guide postoperative care. Communication with the surgical team = The surgeon discusses the wound classification with the surgical team to ensure alignment and appropriate wound care. Signup and view all the answers

Match scenario with the action affecting wound classification:

Surgeon adheres to strict sterile technique. = Reduces extrinsic contamination, thus minimizing infection risk. Surgical team uses prophylactic antibiotics appropriately. = Reduces the risk of infection in clean-contaminated cases. Surgeon performs thorough irrigation during abdominal surgery. = Decreases bacterial load. Incision of a chronic wound leads to heavy bleeding but little inflammation. = Wound is likely rated Class IV: Dirty-Infected Signup and view all the answers

Flashcards

Class I/Clean

Uninfected surgical wound without inflammation. Respiratory, alimentary, genital, or urinary tracts are not entered. Primarily closed or drained with closed system. Incisions that follow nonpenetrating, blunt trauma.

Class II/Clean-Contaminated

Surgical wound involving the respiratory, alimentary, genital, or urinary tracts. Entered under controlled conditions without unusual contamination. No evidence of infection. No major break in technique.

Class III/Contaminated

Open, fresh accidental wounds. Major breaks in sterility during surgery. Spillage from the GI tract. Incisions with nonpurulent inflammation.

Class IV/Dirty-Infected

Old traumatic wounds. Existing clinical infection. Perforated viscera.

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