Guidelines for Complications of Cancer Treatment Vol VIII Part B

Category 1B: Do not routinely use vancomycin forantimicrobial prophylaxisSurgical Wound Classification 4Class I/Clean: An uninfected operative wound in which noinflammation is encountered and the respiratory, alimentary,genital, or uninfected urinary tract is not entered. In addition,clean wounds are primarily closed and, if necessary, drainedwith closed drainage.Class II/Clean-Contaminated: An operative wound in whichthe respiratory, alimentary, genital or urinary tracts are enteredunder controlled conditions and without unusualcontamination.Class III/Contaminated: Open, fresh, accidental wounds. Inaddition, operations with major breaks in sterile technique (e.g.,open cardiac massage) or gross spillage from thegastrointestinal tract, and incisions in which acute, nonpurulentinflammation is encountered are included in this category.Class IV/Dirty-Infected: Old traumatic wounds with retaineddevitalized tissue and those that involve existing clinicalinfection or perforated viscera. This definition suggests thatthe organisms causing postoperative infection were present inthe operative field before the operation.References1. Horan TC, Gaynes RP, Martone WJ, et al. CDCdefinitions of nosocomial surgical site infections, 1992:a modification of CDC definitions of surgical woundinfections. Infect Control Hosp Epidemiol1992;13(10):606-8.2. Nichols RL. Preventing surgical site infections: asurgeon’s perspective. Emerg Infect Dis2001;7(2):220 4.45