Wounds classification

TABLE 82-1. National Red Cross Wound Classification, Risk of Surgical Site Infection (SSI), and Antibiotic Indication6 24... 

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 National Research Council (NRC) Wound Classification Criteria have served as the basis for recommending antimicrobial prophylaxis. NRC criteria consist of four classes (see National Research Council (NRC) Wound Classification Criteria). 

National Research Council (NRC) Wound Classification Criteria... 

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. 

TABLE 121—1. NRC Wound Classification, Risk of SSI, and Indication for Antibiotics... 

TABLE 121—3. Surgical Site Infection Incidence (%) Stratified by National Research Council Wound Classification and SEN 1C Risk Factors ... 

Armstrong DG, Lavery LA, Harkless LB. Validation of a diabetic foot wound classification system contribution of depth infection and vascular disease to the risk of amputation. Diabetes Care 1998 21 855-859. 

Pneumonia is inflammation of the lung with consolidation. The cause of the inflammation is infection, which can result from a wide range of organisms. There are five classifications of pneumonia community-acquired, aspiration, hospital-acquired, ventilator-associated, and health care-associated. Patients who develop pneumonia in the outpatient setting and have not been in any health care facilities, which include wound care and hemodialysis clinics, have community-acquired pneumonia (CAP). Aspiration is of either oropharyngeal or gastrointestinal contents. Hospital-acquired pneumonia (HAP) is defined as pneumonia that occurs 48 hours or more after admission.1,2 Ventilator-associated pneumonia (VAP) requires endotracheal intubation for at least 48 to 72 hours before the onset of... 

Assessment of the impact of the use of gas in the First World War on the Western, Eastern and Italian Fronts is difficult. Analysis of casualty figures is doomed to failure because of a contemporary lack of definition and classification. Gas casualty estimates by several national sources exceed a million but elements of uncertainty exist on the precise cause of death or major source of injury in those who were both gassed and wounded. Also comparison of gas and other battlefield injuries shows vast swings in the proportions on different fronts in different years (Table 2.2). 

CLIMAT (classification of Industrial and Marine Atmospheres,21 gives data on uniform or galvanic corrosion of aluminum wire wound around threaded bolts made of steel or copper in an atmosphere of interest)... 

However, this method is not used for medium and large industrial drives, because of the practical difficulty in designing a high resistance rotor. If a slip-ring wound rotor design is used then an external high resistance can be added, but this method is seldom acceptable in the oil industry because of restrictions imposed by hazardous area classification. 

The incidence of surgical site infections traditionally has been stratified by the National Nosocomial Infection Surveillance (NNIS) system. Participating hospitals are categorized by size and medical school affiliation. Surgical site wounds are classified by the degree of microbial contamination at the operative site. The classification scheme is as follows [1,3] ... 

Death and surgical complications seem relatively unambiguous outcomes. However, some indicators of morbidity, such as wound infection, anastomotic leak and postpartum haemorrhage are difficult to define with precision (Lilford etal, 2004). Even death can pose difficulties of classification, in the sense that a death in hospital can simply mean the arrival of a terminally ill person who died shortly after admission. A death in those circumstances says nothing at all about the quality or safety of care in that hospital. 

A classification for a work injury, which includes (1) all disabling work injuries (2) nondisabling injuries in the following categories (a) eye injuries from work-produced objects, corrosive materials, radiation, burns, etc., requiring treatment by a physician, (b) fractures, (c) any work injury that requires hospitalization for observation, (d) loss of consciousness (work related), and (e) any other work injury (such as abrasion, physical or chemical burn, contusion, laceration, or puncture wound) that requires (i) treatment by a medical doctor, or (ii) restriction of work or motion or assignment to another regularly established job. 

Chemical peeling is a common dermatosurgical procedure, which is basically an accelerated form of exfoliation induced by the use of a chemical cauter-ant or escharotic agent on the skin. It has been known since ancient times and modified by different workers over several decades. But, it was only in 1980, when Stegman s benchmark work on the histological changes of wound injury after chemical peeling provided scientific basis for the classification of peels [1]. 

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