What represents the greatest risk for infection complications arising from surgery on a dirty wound?

• A. Immediate primary closure of the wound
• B. Delayed closure until the wound is clean
• C. Closure with drainage
• D. Use of prophylactic antibiotics

Answer: (A)

Closing a dirty wound right away carries the greatest infection risk because it traps contaminated tissue and bacteria inside a closed space. When you suture a wound that is dirty, you remove the natural route for drainage and create an environment with limited oxygen and poor ability to clear contaminants, which promotes bacterial growth, abscess formation, and delayed healing. The safer approach is to clean and debride to reduce bacterial load and either delay closure until the wound is clean or establish proper drainage, allowing the wound to be evaluated and cleaned further if needed. Antibiotics can help reduce risk, but they don’t compensate for leaving contamination in place or preventing drainage.