During surgery, an inflamed appendix is removed after laparotomy. The procedure should be documented as which level of contamination?

• A. Clean
• B. Clean-contaminated
• C. Contaminated
• D. Dirty

Answer: (C)

Entering a hollow viscus with active inflammation places the wound in the contaminated category. The appendix is part of the digestive tract, and removing an inflamed appendix means the abdominal cavity is opened to GI contents and inflammatory tissue. This exposure increases bacterial contamination and infection risk, even if there isn’t a rupture or visible pus. If there were gross spillage or purulent infection, it would be dirty; if the GI tract were entered under controlled conditions with no inflammation, it would be clean-contaminated. If no tract was entered and there was no inflammation, it would be clean. So, this inflamed appendectomy is categorized as contaminated.