SU5.1-4,SU6.1-2 | Wound Healing and Surgical Infection — Glossary

A superficial graze involving only the epidermis and superficial dermis, with no true tissue gap.

A localised, walled-off collection of pus whose essential treatment is drainage; antibiotics alone do not cure it.

A wound in which skin is torn away from its underlying attachments.

A four-class grading of operative wounds by contamination (clean, clean-contaminated, contaminated, dirty/infected) that predicts surgical-site-infection risk.

A spreading, non-suppurative infection of skin and subcutaneous tissue, usually streptococcal, treated with antibiotics.

An uninfected operative wound with no inflammation and no entry into a hollow viscus; SSI rate ~1–2%.

A wound entering a hollow viscus in a controlled manner without unusual spillage; SSI rate ~3–5%.

A fresh traumatic wound, or surgery with gross spillage or a major sterile-technique break; SSI rate ~10–15%.

Blunt injury with intact overlying skin but haemorrhage into the underlying tissues.

A crackling sensation on palpation due to gas in the tissues, a sign of gas-forming infection such as gas gangrene or some necrotizing infections.

The idea that wound-infection risk is proportional to the dose of contamination multiplied by bacterial virulence and divided by host resistance.

Narrowing broad-spectrum empirical antibiotics to the specific effective agent once culture and sensitivity results are known.

Surgical removal of dead (devitalised) tissue and foreign material from a wound to allow healing and reduce infection.

Dead or non-viable tissue in a wound that acts as a nidus for infection and a barrier to healing and must be removed.

A wound with established infection, perforated viscus or devitalised tissue; SSI rate >27%.

Initial antibiotic treatment directed at the likely organisms before culture results are available, later refined to the proven sensitivity.

Migration and proliferation of epithelial cells across a wound surface to restore the epidermal covering.

Clostridial myonecrosis, usually caused by Clostridium perfringens, presenting with severe pain, crepitus and toxaemia; treated by urgent debridement and antibiotics.

Red, granular tissue of new capillaries and fibroblasts that fills an open wound during the proliferative phase.

The more serious legal category of bodily injury, enumerated in section 320 of the Indian Penal Code (e.g. fracture/dislocation of a bone, permanent loss of sight or hearing, hurt endangering life).

The first phase of healing — vasoconstriction, platelet plug formation and fibrin clot deposition that stops bleeding and provides a provisional scaffold.

A wound from a sharp object with clean, well-defined edges, in which surface length typically exceeds depth.

The phase (day 1 to ~3–5) in which neutrophils then macrophages clear debris and bacteria and secrete growth factors that drive repair.

A wound from blunt force with irregular, ragged edges and intact tissue bridges spanning its depth.

The key orchestrating cell of wound healing, continuing debridement and releasing growth factors that initiate the proliferative phase.

A dated, objective documented record of an injury prepared when a wound may have legal significance, recording site, size, type and surrounding features factually.

A rapidly spreading necrotizing soft-tissue infection tracking along fascial planes — a surgical emergency needing immediate radical debridement.

Healing of a clean wound whose edges are brought together and held in apposition, as in a sutured surgical incision; fast with a neat scar.

The phase (~day 3 to 3 weeks) of fibroblast collagen synthesis, angiogenesis, granulation-tissue formation, epithelialisation and wound contraction.

An antibiotic given to prevent infection — a single IV dose within 60 minutes before incision, re-dosed for long operations and stopped within 24 hours.

A wound with a small surface opening but potentially great depth, dangerous because the surface belies underlying damage.

The final phase (weeks to ~1–2 years) in which type III collagen is replaced by organised type I, the scar matures and tensile strength rises to ~70–80% of normal.

Healing of an open wound from its base by granulation, contraction and epithelialisation, used when there is tissue loss, contamination or infection.

The physical removal or drainage of the focus of infection — incision and drainage of pus, debridement of dead tissue, removal of infected foreign material — the paramount step in treating established surgical infection.

The commonest cause of skin and surgical-site infection; meticillin-resistant strains (MRSA) require glycopeptide cover such as vancomycin.

An infection that either requires surgical treatment (e.g. an abscess to be drained) or arises as a consequence of a surgical procedure.

Infection at or near a surgical incision occurring after operation; its risk rises with the contamination class of the wound.

The capacity of a wound or scar to resist disruption under tension; a healed scar regains at most ~70–80% of normal.

Deliberate leaving of a contaminated wound open for a few days, then closing it surgically once it is clean.

A neurotoxin-mediated disease caused by Clostridium tetani entering a tetanus-prone wound, prevented by appropriate wound prophylaxis.

A wound at higher risk of tetanus — more than 6 hours old, deep, soil/faeces-contaminated, containing devitalised tissue, or a puncture, missile or bite wound.

An antibiotic given to treat an established infection — started empirically after cultures, then de-escalated by sensitivity, and always adjunctive to source control.

Strands of stronger tissue (vessels, nerves) left intact across a lacerated wound, distinguishing it from an incised wound.

Any breach in the normal structure and function of skin or underlying tissue, whether traumatic or surgical.

Centripetal drawing-in of wound edges by myofibroblasts during the proliferative phase, reducing the area to be healed.

The orderly biological process by which injured tissue is restored, proceeding through overlapping phases of haemostasis, inflammation, proliferation and remodeling.

Cleaning of a wound by copious irrigation (usually with saline) to wash out dirt, clot and loose contamination.