WOUNDS

SURGICAL
Elizabeth Hernandez Diaz
Karina Manuel Trinidad
Leslie Nesme Cruz
It is the loss of continuity of the skin and/or

WHAT
IS IT?
mucous membranes and underlying
tissues, produced by mechanical means during a surgical
procedure carried out in order to access any anatomical plane.
Adequate healing of a surgical wound occurs through its healing. Its basic
treatment consists of facing the edges in planes to keep them in contact and rest
long enough for the body to carry out the healing phenomenon.
 Healing by first intention
It is the most frequently used form in the operating room, and
produces a better quality scar in less time.

Delayed healing due to secondary intention

The closure is performed after more than 24 hours and the edges are
 allowed to come together, without placing a suture or any other
material.

Closure or healing by third intention

It is a method that consists in principle of leaving the wound open, and
after approximately four days, and once clean granulation tissue is
observed, closing it through surgery and with a suture.
Closing by fourth intention
refers to the type of wounds that are intended to be closed using
flaps and grafts.
CLASSIFICATION OF SURGICAL
WOUNDS
clean wound

Contaminated wounds

clean contaminated wound

dirty wounds
 clean
wound
• Surgical wound without infection in which there is no inflammation.
• It originates during elective, non-traumatic surgery.
• aseptic technique and exposure to microorganisms is controlled, without the
presence of inflammation or infection.
• The risk of surgical site infection is minimal (lower 2%)
 Examples of a clean surgical wound are:
• uncomplicated inguinal hernia
• muscle or tendon surgery
• Thyroidectomy
• exploratory laparotomy without opening organs, elective eye surgery,
splenectomy, open heart surgery.
 clean contaminated
wound
• type of surgical wound that does penetrate the

02
respiratory, digestive, genital or urinary tract.
• No infection or discharge appears.
• The risk of surgical site infection ranges between 2
and 10%.
 Examples of a clean surgical wound
contaminated are:
• elective bowel resection
• appendectomy without perforation
• cholecystectomy without inflammation
• lung resection
• gynecological procedures
• upper airway surgery including oropharynx, nephrect
 contaminated
•
wound
It is an open wound of accidental origin.
• It occurs in surgeries where the sterile surgical technique is broken.
• Obvious inflammation
• The risk of surgical site infection in contaminated wounds is 13 to 20%.
 Examples of a contaminated surgical
wound
are:
• cholecystectomy in acute cholecystitis
• Ureterolithotomy with macroscopic effusion
• bladderplasty with macroscopic effusion
• lobectomy with macroscopic effusion
• nephrectomy with macroscopic effusion.
 dirty
wound
• Traumatic wound with retention of devitalized tissue that has clinical infection or
perforated viscus.
• It occurs when the critical time has elapsed (greater than 4 hours)
• Intense inflammation
• The wound may present with purulent exudate, redness and pain.
Examples of a DIRTY surgical wound are:
• appendectomy with peritonitis
• exposed fracture
• intestinal resection with presence of infection
• Infected wound
• nephrectomy with acute inflammation
• lobectomy with presence of infection
• infected pilonidal cyst
• osteomyelitis drainage
 REFERENCES
SANCHEZ, S. R. (2012). MANUAL OF SURGICAL NURSING.
MEXICO: INTERAMERICAN PUBLISHERS

Nájera, D. g. (April 4, 2020). SinergiaMedical Magazine.

Obtained from Revista Médica Sinergia :
https://www.revistamedicasinergia.com/index.php/rms/article/download/444/807?inline=1