Questions and Answers
When is the wound classification recorded on the intra-operative record?
At the end of the case
When reviewing a chart, the wound classification tells us the degree of microbial contamination that was present or occurred during the operation. This information can indicate the likelihood of the patient developing or having a postoperative infection.
True
What is the wound classification for a breast biopsy with a frozen section indicating cancer?
Clean wound
What is the wound classification for a laparoscopic cholecystectomy where the gallbladder was removed with an Endobag?
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What is the wound classification for a cystoscopy with retrograde pyelogram where no stones were found?
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What is the wound classification for a scheduled bowel resection where a scrub observes a bloody hole in their glove and regloved?
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What is the wound classification for an emergency bowel resection where feces were noted during anastomosis?
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What is the wound classification for a laparoscopic-assisted vaginal hysterectomy where purulence was noted in the left ovary?
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What is the wound classification for a hernia repair using mesh?
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Study Notes
Wound Classification in Surgery
- Wound classification is recorded on the intra-operative record at the end of the surgical case.
- Understanding wound classification is essential as it indicates the degree of microbial contamination, which relates to the patient's risk of postoperative infection.
Types of Wound Classifications
-
Clean Wound:
- Example: Breast biopsy with a frozen section indicating cancer.
- Associated with minimal microbial contamination.
-
Closed Wound:
- Examples include:
- Laparoscopic cholecystectomy where the gallbladder is removed with an Endobag.
- Cystoscopy with a retrograde pyelogram (RPG) where no stones are found.
- This classification signifies that the wound has been effectively closed with little to no contamination.
- Examples include:
-
Contaminated Wound:
- Examples:
- Scheduled bowel resection with a noted bloody hole in the glove, leading to regloving.
- Emergency bowel resection where fecal matter is observed during anastomosis.
- Such wounds indicate a higher risk of infection due to the presence of bacteria.
- Examples:
-
Complicated Wound:
- Example: Laparoscopic-assisted vaginal hysterectomy resulting in a purulent left ovary.
- These wounds involve additional complications beyond contamination.
Additional Examples
- Clean Wound: Hernia repair utilizing mesh demonstrates a low risk of contamination and infection.
- Wound classifications assist in guiding postoperative care and antibiotic prophylaxis to mitigate infection risks.
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Description
Test your knowledge with these flashcards on hemostasis, wound healing, and wound closure from Chapter 11. Understand the importance of wound classification and its implications during surgical procedures. Perfect for medical students and professionals alike.
