A 50-year-old destitute is brought to the emergency with a foul-smelling wound on his left foot. On examination, the wound is seen to have maggots with a lot of necrotic tissue. What is the class of this wound according to the CDC wound classification?
Class 4
The correct answer is Class 4. The CDC classifies wounds by microbial contamination into four classes. Class 4 (dirty-infected) covers old traumatic wounds with retained devitalised tissue, established clinical infection, faecal contamination or perforated viscus. A foul-smelling neglected foot wound with maggots (myiasis) and extensive necrotic slough already harbours organisms, so it is dirty-infected, with an expected infection rate greater than 27 percent. It needs aggressive debridement, delayed or secondary closure and therapeutic antibiotics.
Class 1 (clean) is an elective, atraumatic, uninfected wound with no entry into respiratory, alimentary or genitourinary tracts (infection rate 1-2 percent). Class 2 (clean-contaminated) involves controlled viscus entry without significant spillage, as in elective cholecystectomy. Class 3 (contaminated) includes fresh accidental wounds less than 6 hours old, major GI spillage or a major break in sterile technique, with acute non-purulent inflammation only, so it does not fit a frankly infected necrotic wound.
Key point: Necrotic tissue, pus or pre-existing infection make a wound Class 4; Class 3 means contaminated but not yet clinically infected.
Important Questions from Wounds
Which of the following are risk factors for wound infection?
1. Malnutrition
2. Poor perfusion
3. Antibodies
4. Foreign body material
Select the correct answer using the code given below.
Which of the following are types of wound healing?
1. Primary Intention
2. Secondary Intention
3. Tertiary Intention
4. Quaternary Intention
Select the correct answer using the code given below :
Untidy wounds are characterised by which of the following ?
1. Crushed or avulsed tissues
2. Contamination wound
3. Devitalised tissue
4. No loss of tissue
Select the correct answer using the code given below :
Which of the following are types of wound healing?
1. Primary Intention
2. Secondary Intention
3. Tertiary Intention
4. Quaternary Intention
Select the correct answer using the code given below :- Untidy wounds are characterised by which of the following?
1. Crushed or avulsed tissues
2. Contamination wound
3. Devitalised tissue
4. No loss of tissue
Select the correct answer using the code given below :
