Surgical Wound ICD-10-CM Codes

A surgical wound, also known as a surgical incision, is a wound created intentionally by a cutting instrument such as a scalpel during a surgical procedure. It is made in a sterile environment to access internal tissues or organs for treatment or diagnosis.

Surgical wounds are classified into four types based on their level of contamination: Class I (clean) wounds are uninfected and do not involve entry into respiratory, gastrointestinal, or genitourinary tracts; Class II (clean-contaminated) wounds involve controlled entry into these tracts without unusual contamination; Class III (contaminated) wounds include open, fresh accidental wounds or surgical wounds with major breaks in sterile technique or gross spillage; and Class IV (dirty-infected) wounds are those with existing infection or perforated viscera.

Healing an open surgical wound involves maintaining a clean environment to prevent infection, controlling inflammation, and promoting tissue repair through proper wound care. This includes regular cleaning, appropriate dressing changes, and monitoring for signs of infection.

The healing process progresses through stages of hemostasis, inflammation, proliferation (including collagen deposition and epithelialization), and remodeling, which can be supported by adequate nutrition, hydration, and sometimes medical interventions such as antibiotics or advanced wound therapies if complications arise.