Table 3. Factors Associated with Noncompliance with Hand Cleansing at PACU Admission, Univariate Analysis
Clean sites (wounds): Surgical sites in which no inflammation is encountered and the respiratory, alimentary, genital, and urinary tracts are not entered. In addition, clean wounds are primarily closed and, if necessary, drained with closed drainage. Surgical sites for operations that follow nonpenetrating (blunt) trauma should be included in this category if they meet these criteria. Clean–contaminated sites (wounds): Operative sites in which the respiratory, alimentary, genital, or urinary tract is entered under controlled conditions and without unusual contamination. Specifically, operations involving the biliary tract, appendix, vagina, and oropharynx are included in this category, provided no evidence of infection or major break in technique is encountered. Contaminated sites (wounds): Including open, fresh accidental wounds or operations with major breaks in sterile technique or gross spillage from the gastrointestinal tract. Surgical sites through which there is entry into the genitourinary tract with infected urine or biliary tract with infected bile, and surgical sites in which acute, nonpurulent inflammation is encountered, fall into this category. Dirty–infected sites (wounds): Including old traumatic wounds with retained devitalized tissue, foreign bodies, or fecal contamination. Surgical sites where a perforated viscus or pus is encountered during the operation are in this category.
* Altemeier class refers to the system to classify surgical operative sites by the degree of contamination as follows:ASA = American Society of Anesthesiology; PACU = postanesthesia care unit.