Wounds classification: Clean - 5% Clean contaminated - 10% Contaminated - 20-30% Diy - 30-40% Wounds Class Definition I: Clean Uninfected operative wound without inflammation Respiratory, alimentary, genital or infected urinary tract is not entered Wounds are closed primarily, if necessary drained with closed drain Examples of Clean Wound Inguinal hernia Joint replacement Thyroidectomy Mastectomy Abdominal aoic aneurysm (AAA) repair II: Clean contaminated Operative wound in which respiratory tract GIT or genitourinary tract is entered under controlled condition without unusual contamination Examples of Clean Contaminated Wound Cholecystectomy CBD exploration Elective GI surgeries (elective colonic resection, gastrectomy) III: Contaminated Open, fresh accidental wounds Operations with major break in sterile techniques Gross spillage from GIT Incision in which acute non-purulent inflammation is encountered Examples of Contaminated Wound Spill during elective GI surgery Perforated gastric ulcer Appendicular perforation Penetrating abdominal trauma Enterotomy during bowel obstruction Human bite Open fracture TYPE OF SURGERY INFECTION RATE WITH PROPHYLAXIS IN % INFECTION RATE WITHOUT PROPHYLAXIS IN % CLEAN(no viscus opened) 1-2 1-2 CLEAN CONTAMINATED (viscus opened, minimal spillage) 3 6-9 CONTAMINATED (open viscus with spillage or inflammatory disease) 6 13-20 DIY (pus/perforation/incision through abscess) 7 40 Table no. 5.4 from Bailey and love's Sho practice of surgery, 27 Ed , Pg no-53
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