In surgical wound classification, which category describes a dirty wound, often with pre-existing infection?

• A. Dirty
• B. Contaminated
• C. Clean-contaminated
• D. Clean

Answer: (A)

Wound classification in surgery hinges on the level of contamination and infection present. The term that best fits a wound described as dirty is the category that denotes an established infection or infection with devitalized tissue. A dirty wound is one that already harbors infection or has visible pus and dead tissue, such as an old traumatic wound with necrotic tissue or a perforated hollow organ with purulent drainage. This situation carries a high risk of postoperative infection, guiding the surgeon to more aggressive management: thorough debridement and irrigation, timely antibiotic therapy tailored to cultures, and often delayed closure rather than immediate primary closure.

In contrast, clean wounds have no infection and involve noncontaminated areas; clean-contaminated wounds involve controlled entry into tracts like the GI, respiratory, or urinary systems without established infection; contaminated wounds are open, fresh injuries or major breaches in sterile technique with likely contamination but not yet infected. The presence of established infection and devitalized tissue is what makes the wound category dirty.