Surgical Wound Classification - Clean

Wound Class

Clean Classification Criteria

Examples

Class I / Clean

(Note:  A surgical wound classification should be assigned upon completion of an operation.)

(Note:  Class I represents about 75% of all wounds.  Clean wounds are usually elective surgical incisions. Clean wounds have an expected infection rate of 1% - 3%.)

• Operative site is uninfected

• No inflammation

• No break in sterile technique

• Primarily closed and, if necessary, drained with closed drainage

• Respiratory, gastrointestinal and genitor-urinary tracts are not entered

• Surgical wounds made after non-penetrating blunt trauma, if the above criteria are met

Examples of Clean Procedures (This list does not include all possible examples):

• Vascular Procedures

• Neurological Procedures (Unless: inflamed = Class II, infected = Class III)

• Endocrine Procedure

• Orthopedic Procedures (Unless: trauma = Class III, old wound = Class IV)

• Skin, e.g., Mastectomy, lumpectomy, lesions, lipoma (Unless: old wound = Class III, inflamed = Class III, infected = Class IV)

• Exploratory lap (Unless: Bowel involvement = Class II)

• Caesarean Section, elective, no pre-rupture of membranes or trial of labor

Additional  Examples of Clean Surgical Wounds/Procedures (This list does not include all possible examples):

• Embolectomy

• Herniorrhaphy (All types)

• Laminectomy

• Mastectomy (Radical or Simple)

• Orthopedic Reconstruction Procedures (Hip Nailing, Total Hip or Knee Replacement, Meniscectomy, Bunionectomy, Bone Graft)

• Radical Neck (Outside Incision)

• Resection of Ovary

• Salpingo-oophorectomy

• Splenectomy

• Thyroidectomy

• Vascular Surgeries (All Types, including Coronary Artery Bypass Graft)

June 2011