I was doing a lap chole with a trauma surgeon last month. He was quizzing the med student on the function of bile. When we started taking down the gallbladder from the liver, the gallbladder was nicked and bile started to leak. When this happens, we as nurses must then classify the wound as "clean contaminated". While listening to the surgeon lecture, he asked the med student why we saw bubbles when we irrigated. No response from the student. The surgeon went on to say that bile is actually a detergent.
Now I am a self admitted airhead. I know that detergent doesn't always mean "scrubbing bubbles". However, upon further pondering of his statement, I researched further on the detergent properties of bile. So my question is this:
If bile is spilled into the abdominal contents during surgery, why is it considered clean-contaminated? I am surmising that since bile is a protein and can denature if the gallbladder ruptures well BEFORE surgery, it can be considered contaminated at that point. But DURING surgery?
