Surgical wound classification


  • An uninfected operative wound in which no inflammation is encountered and no systemic tracts entered (respiratory, alimentary)
  • Closed by primary intention and are usually not drained

Clean, contaminated

  • An operative wound in which systemic tract(s) are entered under controlled conditions and without contamination


  • Includes:
    • Open traumatic wounds (open fractures, penetrating wounds)
    • Operative procedures involving:
      • Spillage from the GI, GU or biliary tracts
      • A break in aseptic technique (open cardiac massage). 
  • Microorganisms multiply so rapidly that a contaminated wound can become infected within 6 hours.


  • Heavily contaminated/infected wound before an operation
  • Includes:
    • Perforated viscera
    • Abscesses
    • Wounds with undetected foreign body/necrotic tissue.1

Most wounds are usually easy to manage and result in desirable secondary outcome if appropriate steps are taken during contact with medical care.

Learning Bite:

Most ED presentation will fall within the clean-contaminated or contaminated wound classification. While clean-contaminated wounds can be closed by primary intention, contaminated and dirty wounds will be referred to the appropriate speciality for irrigation, debridement and formal closure in theatre.

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