All Pathways
Plastic SurgeryManagement
Wound Classification and Closure Selection
Wound Classification and Closure Selection: Wound Requiring Closure → Wound Classification → Clean (Class I) → Reconstructive Ladder → Primary Closure.
Pathway Overview
12 steps
Algorithm Steps
12 total
01Start 02Decision Wound Classification
- Clean (Class I)
- Clean-contaminated (Class II)
- Contaminated (Class III)
- Dirty/Infected (Class IV)
03Action Clean (Class I)
Primary closure appropriate
04Decision Reconstructive Ladder
Simplest effective option
05End Primary Closure
Direct suture approximation
06End Skin Graft
STSG or FTSG based on location
07End Local Flap
Advancement, rotation, transposition
08End Free Tissue Transfer
Microvascular anastomosis required
09Action Clean-Contaminated (II)
Primary closure with caution
- Path rejoins step 04Shared downstream outcome
10Action Contaminated (III)
Delayed primary or secondary
11End Secondary Intention
Allow granulation, wound care
12Action Dirty/Infected (IV)
Secondary intention or delayed
- Path rejoins step 11Shared downstream outcome
Guideline Source
CDC Surgical Wound Classification / Reconstructive Ladder
Clinical Safety Information
Clinical Decision Support — Not a Substitute for Clinical Judgment
Individual patient factors may require deviation from these recommendations.
Known Limitations
- Closure timing depends on contamination level
- Patient factors (nutrition, comorbidities) affect healing
- Reconstructive elevator may replace ladder in some cases
Applicable Regions
USAUUKEU
UK: NICE wound management guidelines
US: CDC wound classification for SSI risk
Version 1Next review: 2028-01-01
Next steps
Finish the workflow by opening the most relevant calculator, then convert the session into a live account when you are ready.
Related Resources
Frequently Asked Questions
What is the Wound Classification and Closure Selection?
The Wound Classification and Closure Selection is a management clinical algorithm for Plastic Surgery. It provides a structured decision tree to guide clinical decision-making, based on CDC Surgical Wound Classification / Reconstructive Ladder.
What guideline is the Wound Classification and Closure Selection based on?
This algorithm is based on CDC Surgical Wound Classification / Reconstructive Ladder (DOI: 10.1097/PRS.0000000000008276).
What are the limitations of the Wound Classification and Closure Selection?
Known limitations include: Closure timing depends on contamination level; Patient factors (nutrition, comorbidities) affect healing; Reconstructive elevator may replace ladder in some cases. Individual patient factors may require deviation from these recommendations.
Get AI-Powered Analysis Alongside This Algorithm
In AttendMe.ai, the Wound Classification and Closure Selection appears automatically when your clinical question matches — alongside evidence from 3M+ peer-reviewed articles.
Try AttendMe Free