Which type of surgical procedure is classified as Class III (contaminated)?

The classification of surgical procedures into Clean, Clean-Contaminated, Contaminated, and Dirty/Wound Infected categories is based on the level of microbial contamination present at the time of the procedure and the likelihood of infection. A Class III or contaminated procedure is typically associated with an increased risk of infection due to the presence of contaminants such as fecal matter, perforated viscera, or acute inflammation.

Open fractures fall into this category because they involve a break in the skin. This skin breach allows for potential contamination from outside pathogens, particularly from the environment and skin flora, directly into the wound. Since there is often dirt, bacteria, and other organisms present, this type of surgical intervention requires meticulous management to reduce the risk of postoperative infection, thus justifying its classification as contaminated.

In contrast, elective hernia repairs, routine appendectomies, and cosmetic surgeries generally involve less risk of contamination, as they are typically performed in a sterile environment without any acute inflammation or contamination present at the outset of the procedure.