Weigelt et al classified wounds after traumatic injury based on the nature and extent of the injury. This correlates with the theoretical amount of bacterial contamination in the wound. The authors are from the University of Texas in Dallas.
Wound classes used by Weigelt et al:
(1) clean
(2) clean-contaminated
(3) contaminated
Clean wound:
(1) a penetrating injury without external contamination from a missile and without organ injury
(2) a blunt injury without organ injury
(3) a blunt injury to the kidney, spleen or liver
(4) a blunt injury to an extremity
Clean-contaminated:
(1) a penetrating injury with external contamination from a foreign body
(2) a penetrating injury communicating between the external environment and a body cavity
(3) a penetrating injury with organ injury
(4) a penetrating injury to an extremity
(4) a blunt injury with organ injury (except kidney, spleen or liver)
Contaminated:
(1) an injury to the colon (with potential for fecal contamination)
where:
• Normally the surgical wound classification (as listed in 26.12.01) has a class for "dirty and contaminated" wounds. This may include wounds from a "dirty" source, devitalized tissue, retained foreign body, or with delayed treatment.
• Some of the classes assigned in Table I do not seem to match the rules given in the text.
• Injuries to the head and neck were not listed in Table I. I would think injuries to the mouth would be clean-contaminated.
If multiple injuries were present, then the classification assigned is the one that is worst.
