Surgical procedures wound classification

The traditional classification system developed by the National Research Council (NRC) stratifying surgical procedures by infection risk is reproduced in Table 48-1. The NRC wound classification for a specific procedure is determined intraoperatively and is the primary determinant of whether antibiotic prophylaxis is warranted. 

The Study of the Efficacy of Nosocomial Infection Control (SENIC) identified four independent risk factors for postoperative wound infections operations on the abdomen, operations lasting more than 2 hours, contaminated or dirty wound classification, and at least three medical diagnoses. Patients with at least two SENIC risk factors who undergo clean surgical procedures have an increased risk of developing surgical wound infections and should receive antimicrobial prophylaxis. 

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