Certified Nurses Operating Room (CNOR) Practice Exam

What is the appropriate classification for a ruptured appendicitis during surgery?

1. Clean Wound

2. Dirty/Infected Class

3. Clean/Contaminated

4. Contaminated Wound

The correct answer is: Dirty/Infected Class

A ruptured appendicitis during surgery is classified as a Dirty/Infected Class wound due to the presence of purulent material and a breach in the integrity of the intestinal tract. When an appendicitis ruptures, bacteria from the gastrointestinal tract are released into the peritoneal cavity, which creates a significant risk for infection. This exposure to bacteria and infected material qualifies the surgical site as being highly contaminated. In surgical wound classification, the Dirty/Infected category is reserved for wounds that have significant contamination with viscus contents, necrotic tissue, or pus. The situation here aligns perfectly as there is not only the presence of infection but also a high likelihood of pathogens from the intestines that can lead to postoperative complications. In contrast, the other classifications do not apply in this scenario. A Clean Wound would involve no entry into the gastrointestinal tract, while Clean/Contaminated would refer to a surgical procedure in which the gastrointestinal tract is entered but without contamination (typically handled in a more controlled manner). Contaminated Wound applies to procedures where there is a breach in aseptic technique or acute inflammation but does not reach the severe level of a Dirty/Infected wound. Thus, the correct classification for a ruptured appendicitis during