PAEA Surgery End Of Rotation (EOR) Practice Exam

Which classification describes open, fresh, accidental wounds with major breaks in sterile technique or gross spillage from the GI tract?

1. Clean

2. Contaminated

3. Dirty or infected

4. Clean-contaminated

The correct answer is: Contaminated

The classification that describes open, fresh, accidental wounds that involve significant breaches in sterile technique or gross spillage from the gastrointestinal tract is categorized as contaminated. This classification indicates that the wound is at a higher risk for infection due to the presence of bacteria, particularly from the GI tract, which can introduce pathogens. In surgical terms, a contaminated wound arises when there is direct exposure to microbial organisms, as is the case with major breaks in sterile technique or the release of contents from the intestines, potentially carrying fecal flora. This requires careful management to reduce the risk of surgical site infections, and such wounds usually necessitate prompt antibiotic treatment and stringent postoperative care. The other classifications serve different contexts: clean wounds are those that are surgically made under sterile conditions without any possibility of infection; dirty or infected wounds are those that contain necrotic tissue or have signs of existing infections; clean-contaminated wounds are surgical wounds that involve the respiratory, alimentary, genital, or urinary tracts but still maintain a controlled environment with minimal contamination. Each classification has specific implications for surgical management and post-operative care, but in the case of open, accidental wounds with gross contamination, the contaminated classification is accurate.