Classification of Wounds – Guides to Antibiotic Prophylaxis

Wound 1 – Clean wound: An uninfected operative wound in which no inflammation is encountered and the respiratory, alimentary, genital, or uninfected urinary tracts are not entered. In addition, clean wounds are primarily closed and, if necessary, drained with closed drainage. Operative incisional wounds that follow nonpenetrating (blunt) trauma
should be included in this category if they meet the criteria.

Clean uninfected operative wound: Clean wounds are primarily closed and if necessary, drained with closed drainage.

Wound 2 – Clean-contaminated: Operative wounds in which the respiratory, alimentary, genital, or urinary tracts are entered under controlled conditions and without unusual
contamination. Specifically, operations involving the biliary tract, appendix, vagina,
and oropharynx are included in this category, provided no evidence of infection or
major break in technique is encountered.

Wound 3 – Contaminated: Open, fresh, accidental wounds. In addition, operations with major breaks in sterile technique (e.g., open cardiac massage) or gross spillage from the
gastrointestinal tract, and incisions in which acute, nonpurulent inflammation is
encountered including necrotic tissue without evidence of purulent drainage (e.g., dry
gangrene) are included in this category.

Wound 4 – Dirty or infected: Includes old traumatic wounds with retained devitalized tissue and those that involve existing clinical infection or perforated viscera. This definition suggests that the organisms causing postoperative infection were present in the operative field before the operation.

Source: Procedure-associated Module SSI, CDC, January 2016



As a rule, clean wounds and uninfected operative wound do NOT need antibiotic prophylaxis.

Wound 1 – Clean wound: An uninfected operative wound in which no inflammation is encountered and the respiratory, alimentary, genital, or uninfected urinary tracts are not entered. In addition, clean wounds are primarily closed and, if necessary, drained with closed drainage. Operative incisional wounds that follow nonpenetrating (blunt) trauma

should be included in this category if they meet the criteria.

Clean uninfected operative wound: Clean wounds are primarily closed and if necessary, drained with closed drainage.



As a rule, antibiotics are indicated for contaminated and dirty or infected wounds.



Antibiotics may or may not be given for clean-contaminated wounds depending on the degree of contamination and the potential for infection.


ROJ@17dec23

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