Wound Classification Flashcards

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.

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.