cleancontaminated

Clean-contaminated is a category in surgical wound classification used to describe operative wounds that involve controlled entry into tracts that are normally colonized with bacteria, such as the respiratory, alimentary, genital, or urinary tracts. In clean-contaminated wounds, there is no extensive contamination and the procedure is performed under conditions that reduce the risk of infection, with no acute inflammation present at the time of surgery.

Criteria for classifying a wound as clean-contaminated include entry into these tracts under controlled circumstances, with minimal or no spillage of contents and without gross contamination or evidence of infection. The tracts are entered cleanly and the integrity of surrounding tissues is preserved. Examples typically cited include elective operations such as cholecystectomy, certain biliary or gastrointestinal procedures where there is controlled access to the tract, and some gynecologic or urologic surgeries that involve entering the genitourinary tract without major contamination.

Clinical significance and management: clean-contaminated wounds carry a higher risk of postoperative infection than clean wounds but a lower risk than contaminated or dirty wounds. This intermediate risk influences perioperative management, including considerations for antibiotic prophylaxis, which is commonly recommended to cover the flora of the involved tracts according to institutional guidelines and patient risk factors. Other aspects of care align with standard postoperative monitoring and wound care, aiming to prevent infection while allowing proper healing.

Note: terminology and thresholds can vary by guideline or institution, but the core concept remains consistent across surgical wound classifications.