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Types of Wound Certifications

A standardized system for wound classification is used in hospitals to grade the condition of pre-existing wounds and surgical wounds after surgery. Separating the condition of healing wounds into analytical categories allows the surgeons and medical staff to determine to what extent there is infection or contamination in the wound and what treatment is required to facilitate healing. It also can predict the likely outcome of the surgical procedure. There are four classes in the wound classification system.

  1. Class I or Clean Wounds

    • A Class I, or clean wound, is a surgical wound that is not infected after surgery. No inflammation is present, and the wounds are primarily closed. They are drained with closed drainage, if necessary. The respiratory, alimentary, genital and urinary tracts of the body are not entered during the procedure, which reduces the possibility of contamination, and all remain uninfected. In this situation, a patient is considered to be at the lowest risk for developing a postoperative infection on the surgical site, and has the best predicted outcome of surgery.

    Class II or Clean-Contaminated Wounds

    • A Class II, or clean-contaminated wound, is a surgical wound where the respiratory, alimentary, genital or urinary tract are entered under surgical conditions, but without contamination occurring and there is no evidence of infection. This includes surgery on the biliary tract, the appendix, the vagina and the oropharynx. A patient in this category is considered to be at somewhat more risk for developing postoperative infection. The patient has a somewhat poorer possible outcome of surgery than one with a Class I wound.

    Class III or Contaminated Wounds

    • Class III, or contaminated wounds, are considered to be both fresh wounds and open accidental wounds present before surgery, as well as those surgical wounds made when a major break in sterile technique occurs during surgery. Also, if there is a great amount of spillage from the gastrointestinal tract when surgery is performed, this would affect the risk of contamination of a wound. This category also considers contaminated wounds to be surgical incisions that afterward result in acute, but non-purulent, inflammation.

    Class IV or Dirty or Infected Wounds

    • Class IV, or dirty or infected wounds, are old traumatic wounds with retained and devitalized tissue. They have existing purulent infection, where the infection may have been present in the wound before surgery. A patient in this circumstance would be at greater risk for postoperative infection, and they would have a poorer outcome for healing after surgery than patients with surgical wounds graded in the Class I through Class III categories.

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