Wound Class

Wound Class Definitions Class I: Clean•No breaks in sterile technique•No inflammation is encountered•An uninfected operative wound in which respiratory, alimentary, genital or uninfected urinary tract is not entered Updated 3/2019 Class II: Clean Contaminated•No breaks in sterile technique•No inflammation is encountered•An operative wound in which the respiratory, alimentary, genital or urinary tracts are entered under controlled conditions and without unusual contaminationExamples:Spinal fusion, thyroidectomy, ganglion incision, hernia repairExamples:Cholecystectomy, colon resection, tracheostomy, Malone/mitrofanoff, appendectomy (incidental, not inflamed) Class III: Contaminated•Major break in sterile technique•Incisions with acute, non-purulent inflammation•Open, fresh, or accidental wounds less than four hours old•Gross spillage from gastrointestinal tractExamples:Non-perforated appendicitis, inflamed gallbladder (bile spillage), open fracture (fresh, no gross contamination), penetrating wound (fresh) Class IV: Dirty•Old traumatic wounds over four hours•Trauma from a contaminated source or gross spillage of infected source•Organisms causing post-operative infection were present in the operative field before the operationExamples:Perforated appendicitis, open fracture (old, contaminated trauma), drainage of intra-abdominal abscess Updated 3/2019 Wound Class Definitions Source: Zinn JL. Surgical Wound Classification: Communication is Needed for Accuracy. AORN Journal. 2012;95(2): 274-278