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Surgery General 5537df5d

Which one of the following cases is considered a clean contaminated wound?

A
Open cholecystectomy for cholelithiasis
B
Herniorrhaphy with mesh repair
C
Lumpectomy with axillary node dissection
D
Gunshot wound to the abdomen with injuries to the small bowel
High-Yield Explanation
Surgical wounds can be divided into three categories based on the amount of bacterial contamination. Clean wounds are those in which no pa of the respiratory, 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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