Related Experiment Video
Updated: Jun 22, 2026
07:16
Swine Model of Biofilm Infection and Invisible Wounds
Published on: June 16, 2023
Conflicts in wound classification of neonatal operations
Lan T Vu1, Kerilyn K Nobuhara, Hanmin Lee
1Department of Surgery, University of California, San Francisco, CA 94143-0570, USA.
Journal of Pediatric Surgery
|June 16, 2009
Summary
Pediatric surgeons show poor agreement on classifying neonatal surgical wounds, impacting infection risk assessment. An improved system is needed for better antibiotic prophylaxis and patient outcomes.
Area of Science:
- Neonatal surgery
- Surgical wound classification
- Infection control
Background:
- Current wound classification guidelines lack consistent application in neonatal surgery.
- Reliability of existing systems for neonatal procedures is not well-established.
Purpose of the Study:
- To assess the reliability of standard wound classification guidelines for neonatal operations.
- To identify inconsistencies in the application of these guidelines by pediatric surgeons.
Main Methods:
- Cross-sectional web-based survey of pediatric surgeons.
- Participants classified 22 neonatal operations and perioperative antibiotic durations.
- Interrater reliability was measured using the unweighted kappa statistic.
Main Results:
- Overall interrater reliability for wound classification was poor (kappa = 0.30).
- Specific neonatal operations were inconsistently classified across the "clean," "clean-contaminated," and "dirty" categories.
- Significant variation existed in classifying procedures like omphalocele repair and gastroschisis closure.
Conclusions:
- There is a lack of consensus among surgeons regarding neonatal surgical wound classification.
- An improved classification system is crucial for accurate surgical site infection risk assessment.
- A better system will help identify neonates who require antibiotic prophylaxis.
Related Concept Videos
01:24Healing II: Complications
Complications during healing arise when tissue repair is altered by local or systemic factors. These changes involve abnormal collagen deposition, altered biomechanics, and reduced vascular supply, impairing restoration of normal structure and function.Loss of FunctionScar tissue differs significantly from the original tissue it replaces. In the skin, fibrosis lacks adnexal structures such as hair follicles, sebaceous glands, and sweat glands. Their absence reduces tactile sensitivity, impairs...
01:28Phases of Wound Repair
Following injury, the integrity of the injured tissues must be reestablished. For example, in skin tissue, wound repair involves coordination among resident skin cells, blood mononuclear cells, extracellular matrix, growth factors, and cytokines to complete the healing cascade.
Formation of Blood Clot
In case of deep injuries, trauma to blood vessels results in blood loss. In the meantime, phospholipids released from the ruptured endothelial cellular membrane are converted into arachidonic...
Formation of Blood Clot
In case of deep injuries, trauma to blood vessels results in blood loss. In the meantime, phospholipids released from the ruptured endothelial cellular membrane are converted into arachidonic...
01:22Burn Injuries
Burn injuries occur when the skin and underlying tissues are damaged due to exposure to heat, electricity, chemicals, radiation, or friction. They can vary in severity, from minor superficial burns to severe deep burns that can be life-threatening.
The damage results in the death of skin cells, which can lead to a massive loss of fluid. Dehydration, electrolyte imbalance, and renal and circulatory failure follow, which can be fatal. Burn patients are treated with intravenous fluids to offset...
The damage results in the death of skin cells, which can lead to a massive loss of fluid. Dehydration, electrolyte imbalance, and renal and circulatory failure follow, which can be fatal. Burn patients are treated with intravenous fluids to offset...
01:23Peripheral Artery Disease V: Postoperative Nursing Management
During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...