Questions and Answers
What is Class 1?
What is Class 2?
What is Class 3?
What is Class 4?
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What is an example of a Class 4 dirty or infected wound?
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What is an example of a Class 3 contaminated wound?
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What is an example of a Class 2 clean contaminated wound?
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What is an example of a Class 1 clean wound?
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What is phase 1 of wound healing?
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What is phase 2 of wound healing?
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What is phase 3 of wound healing?
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Inflammatory is not ____________.
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What is first intention?
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What is second intention?
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What is third intention?
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What are the classic principles of wound closure by Halstead?
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Study Notes
Wound Classification
- Class I: Clean wounds that are uninfected and do not involve entry into respiratory, alimentary, or genitourinary tracts. Typically elective and closed primarily.
- Class II: Clean contaminated wounds where normal flora may be present. Involves respiratory or alimentary tracts without significant spillage.
- Class III: Contaminated wounds from open accidents or procedures with gross spillage from the gastrointestinal tract. Major breaks in aseptic technique also classified as contaminated.
- Class IV: Dirty or infected wounds, including old traumatic wounds with devitalized tissue or existing clinical infections. Organisms causing infections are present preoperatively.
Examples of Wound Classes
- Class I Wound Examples: Adrenalectomy, Breast biopsy, CABG, Elective eye surgery, and other orthopedic procedures.
- Class II Wound Examples: Abdominal Hysterectomy, Appendectomy, Cesarean section, Cholecystectomy, and other surgeries involving oropharyngeal or biliary tracts.
- Class III Wound Examples: Appendectomy for a ruptured appendix, gunshot or knife wounds, and other contaminated injuries.
- Class IV Wound Examples: Excision and drainage of abscesses, surgical access to pus collections, and any wound with pus present.
Phases of Wound Healing
- Phase 1: Inflammatory phase, crucial for clearing debris and preventing infection.
- Phase 2: Migration/proliferation phase, where new tissue forms and begins to close the wound.
- Phase 3: Maturation phase, involved in remodeling and strengthening the wound.
Wound Healing Intention Types
- First intention (Primary Intention): Incision heals swiftly with minimal scarring and no separation of edges.
- Second intention: Wound left open to heal from the inner layer outward due to infection or trauma, may result in more scarring.
- Third intention (Delayed Primary Closure): Involves contaminated wounds with tissue loss. Closure occurs 4 to 6 days postoperatively after non-viable tissue is debrided.
Classic Principles of Wound Closure by Halstead
- Gentle handling of tissue and accurate dissection.
- Careful hemostasis to minimize bleeding.
- Aseptic technique to prevent infection.
- Minimize tissue tension to promote healing.
- Accurate approximation of tissues to enhance healing.
- Obliteration of dead space to prevent fluid accumulation.
Additional Notes
- Inflammatory phase is not synonymous with infection; inflammation is a natural response during healing.
- Wound dehiscence refers to the splitting or opening of a wound, indicating potential complications in recovery.
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Description
This quiz covers the classification of wounds, including the definitions of clean, clean contaminated, contaminated, and dirty or infected wounds. Each card presents a specific class and its corresponding definition. Test your knowledge on wound classifications and enhance your understanding of surgical wound care.