1. D.Mahamed Hussein General Surgeon Azadi Teaching Hospital
Surgical wounds
D.Mahamed Hussein
General Surgeon
Azadi Teaching Hospital

2. What is a wound?
It is a circumscribed injury which is caused by an external force and it can involve any tissue or organ.
surgical, traumatic
It can be mild, severe, or even lethal.
Simple wound
Compound wound
Acute
Chronic

3. Classification of wound 1. Based on the origin
I. Mechanical: 1. Abraded wound. 2. Puncured wound. 3. Incised wound. 4. Cut wound. 5. Crush wound. 6. Torn wound. 7. Bite wound. 8. Shot wound.

4. Classification of wound 1. Based on the cause
II. Chemical: 1. Acid 2. Base III. Wounds caused by radiation IV. Wounds caused by thermal forces: 1. Burning 2. Freezing V. Special

5. 2.According to the wound depth
Superficial
Partial thickness
Full thickness
Deep wound

6. 3.According to contamination
Clean wound
Clean-contaminated wound
Contaminated wound
Heavily contaminated wound

7. Wound Class I: Clean
Respiratory, gastrointestinal, genital and urinary tracts not entered
No break in aseptic technique
No inflammation

8. Wound Class 1: Examples Breast surgery
C-section with non-ruptured membranes
Exploratory lap with no bowel resection
Eye Surgery (unless inflamed, infected, or with foreign body)
Hernia repair
Total joint arthroplasty

9. Wound Class II: Clean-Contaminated
Respiratory, gastrointestinal, genital, or urinary tract is entered under controlled conditions
No major break in aseptic technique
No acute inflammation
No spillage

10. Wound Class II: Examples
Cholecystectomy (chronic inflammation)
Gastrointestinal procedures
Gynecological procedures
Urological procedures

11. Wound Class III: Contaminated
Acute, nonpurulent inflammation is encountered
Open, fresh, accidental wounds
Operations with major breaks in sterile technique
Visible spillage from intestinal tract
Necrotic tissue without evidence of purulent drainage

12. Wound Class III: Examples
Appendectomy (inflamed, no rupture, no pus)
Bowel resection for infarcted and/or necrotic bowel
Cholecystectomy with acute inflammation or bile spillage
Compromised integrity of sterile field

13. Wound Class IV: Dirty/Infected
Presence of purulence or abscess
Perforated viscera
Fecal contamination
Traumatic wounds with retained devitalized (dying) tissue
Wet gangrene

14. Wound Class IV: Examples
Amputation in the presence of infection
Exploratory lap for intra-abdominal abscess
Incision & drainage for infection or abscess
Ruptured appendix
Ruptured bowel with or without fecal contamination
Ruptured gastric ulcer

15. Risk of developing a postsurgical infection

16. ANY
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