Intraopera. record keeping is importan tclean vs. contamin

Discussion in 'MRCS Forum' started by Lona., Dec 13, 2007.

  1. Lona.

    Lona. Guest

    Intraoperative record keeping is important. The OR staff cannot determine which cases were classified as clean vs. contaminated. The clean-contaminated case in this list is -
    a- Open cholecystectomy for cholelithiasis
    b- Herniorrhaphy with mesh repair
    c- Lumpectomy with axillary node dissection
    d- Appendectomy with walled-off abscess
    e- Gunshot wound to the abdomen with injuries to the small bowel and sigmoid colon
  2. Lona.

    Lona. Guest

    Answer: a. (Schwartz, 7/e, pp 130-131) Surgical wounds can be divided into three categories based on the amount of bacterial contamination. Clean wounds are those in which no part of the respirator, gastrointestinal or genitourinary tract is entered. Examples include herniorrhaphy and breast surgery. Clean-contaminated wounds encompass those cases in which the above systems are entered, but without evidence of active infection or gross spillage. Examples include elective cholecystectomy or elective colon resection with adequate bowel preparation. Contaminated wounds are those in which there is active infection (perforated appendicitis with abscess) or gross spillage (gunshot wound with large or small bowel injuries). While contaminated and clean-contaminated wounds require perioperative antibiotics, clean wounds need not be treated with prophylactic antibiotics.

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