Surgery>>>>>Surgical Infections
Question 6#

During a laparoscopic appendectomy, a large bowel injury was caused during trochar placement with spillage of bowel contents into the abdomen.

What class of surgical wound is this?

A. Class I (clean)
B. Class II (dean/contaminated)
C. Class III (contaminated)
D. Class IV (dirty)

Correct Answer is C

Comment:

Surgical wounds are classified based on the presumed magnitude of the bacterial load at the time of surgery. Clean wounds (Class I) include those in which no infection is present; only skin microflora potentially contaminate the wound, and no hollow viscus that contains microbes is entered. Class ID wounds are similar except that a prosthetic device ( eg, mesh or valve) is inserted. Clean/contaminated wounds (Class II) include those in which a hollow viscus, such as the respiratory, alimentary, or genitourinary tracts, with indigenous bacterial flora is opened under controlled circumstances without significant spillage of contents. Contaminated wounds (Class III) include open accidental wounds encountered early after injury, those with extensive introduction of bacteria into a normally sterile area of the body due to major breaks in sterile technique (eg, open cardiac massage), gross spillage of viscus contents such as from the intestine, or incision through inflamed, albeit nonpurulent, tissue. Dirty wounds (Class IV) include traumatic wounds in which a significant delay in treatment has occurred and in which necrotic tissue is present, those created in the presence of overt infection as evidenced by the presence of purulent material, and those created to access a perforated viscus accompanied by a high degree of contamination.