TABLE 50.13.

Wound Classification System

Wound Category	Description
Class I/clean	Uninfected wound with no inflammation, and the respiratory, alimentary, genital, or uninfected urinary tract is not entered. Clean wounds primarily are closed and drained, when necessary, with closed drainage. Operative wounds after blunt trauma may be included in this category if they meet criteria.
Class II/clean contaminated	Operative wound in which the respiratory, alimentary, genital, or urinary tract is entered under controlled conditions and without unusual contamination. Specifically, operations involving the biliary tract, appendix, vagina, and oropharynx are included in the category, provided no evidence of infection or major break in technique is encountered.
Class III/contaminated	Open, fresh, accidental wounds; operations with major breaks in sterile technique (e.g., open cardiac massage) or gross spillage from the gastrointestinal tract; and incisions in which acute, nonpurulent inflammation is encountered
Class IV/dirty-infected	Old traumatic wounds with retained devitalized tissue and those that involve existing clinical infection or perforated viscera, suggesting that the organisms causing postoperative infection were present in the operative field before operation.

From Neville HL, Lally KP. Pediatric surgical wound infections. Semin Pediatr Infect Dis. 2001;12:124–129.