Surgical Wound Classifications PDF

Surgical Wound Classifications Classificatio n Description Clean ● Uninfected operative wounds without inflammation ● Respiratory, alimentary, genital, or urinary tracts are not entered Clean-conta minated ● Operative incisions in the respiratory, alimentary, genital, or uninfected urinary tr...

Surgical Wound Classifications Classificatio n Description Clean ● Uninfected operative wounds without inflammation ● Respiratory, alimentary, genital, or urinary tracts are not entered Clean-conta minated ● Operative incisions in the respiratory, alimentary, genital, or uninfected urinary tracts, which are electively entered without gross spillage Contaminat ed ● Operations with a major break in sterile technique or gross spillage from the GI tract ● Incisions in which acute non-purulent inflammation is encountered Dirty ● Traumatic wounds with retained devitalized tissue or those with existing clinical infection Renal Changes with Aging Anatomical ● Decreased renal mass ● Increased renal fat and fibrosis ● Progressive glomerulosclerosis Functional ● Decreased renal blood flow ● Impaired vasodilation in response to dopamine ● Decreased creatinine clearance ● Impaired sodium excretion and conservation ● Decreased potassium excretion and conservation ● Decreased concentrating and diluting capacity ● Impaired excretion of acid loads ● Decreased serum renin and aldosterone ● Altered intrarenal nitric oxide actions ● Increased dependence on renal prostaglandins to maintain intrarenal perfusion ● Decreased vitamin D activation ● Increased vulnerability to nephrotoxins and ischemia ● Impaired recovery after insults