# Surgical wound class (Mangram 1999)

Wound class

Status: LIVE
Price: $0.005 USDC
`GET /api/calc/wound_class`
HTML: https://magentlab.com/docs/wound-class
Markdown: https://magentlab.com/docs/wound-class.md

Not a medical device. Not a diagnosis, dose, or listing recommendation.

## What it computes

Return the caller-assigned CDC/HICPAC surgical wound class 1-4 with the published class label and Table 7 description (Mangram 1999). magent does not inspect the wound. Not SSI rates. Not AMP selection.

## When to use

When an agent already has a CDC/HICPAC surgical wound class 1-4 as assigned by the caller and needs the canonical label (e.g. I/Clean) and Mangram 1999 Table 7 wording. magent does not inspect the wound or assign the class. Not a diagnosis of infection and not antimicrobial prophylaxis selection.

## When not to use

- Not a medical device. Not a diagnosis of infection. Not antimicrobial prophylaxis (AMP) selection.
- The caller assigns wound_class 1-4. magent does not inspect the wound.
- Mangram 1999 Table 7 CDC/HICPAC surgical wound classification only. Does not invent SSI percentage rates (not in Table 7).

## Formula

```
wound_class in {1, 2, 3, 4} as assigned by the caller (Mangram 1999 CDC/HICPAC Table 7 Class I-IV). magent does not inspect the wound. Not SSI rates. Not AMP selection.
```

## Citation

[Guideline for Prevention of Surgical Site Infection, 1999](https://doi.org/10.1086/501620)
Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR, Hospital Infection Control Practices Advisory Committee
Infect Control Hosp Epidemiol. 1999;20(4):250-278
DOI: [10.1086/501620](https://doi.org/10.1086/501620)

## Worked example

### Class I/Clean

Given: `wound_class=1`

1. wound_class 1 as assigned by the caller
2. class_label I/Clean
3. An uninfected operative wound in which no inflammation is encountered


### Class IV/Dirty-Infected

Given: `wound_class=4`

1. wound_class 4 as assigned by the caller
2. class_label IV/Dirty-Infected
3. old traumatic wounds with retained devitalized tissue, existing clinical infection, or perforated viscera


## Also searched as

- CDC wound class
- surgical wound classification
- Class I clean
- clean-contaminated
- contaminated wound
- dirty-infected
- HICPAC wound class
- Mangram 1999
- CDC Class I-IV
- NNIS wound class

## Parameters

- `wound_class` (integer, required): CDC/HICPAC surgical wound class 1-4 as assigned by the caller (Mangram 1999 Table 7: 1 Class I/Clean, uninfected operative wound, no inflammation, respiratory/alimentary/genital/uninfected urinary tract not entered; 2 Class II/Clean-Contaminated, those tracts entered under controlled conditions without unusual contamination; 3 Class III/Contaminated, open fresh accidental wounds, major break in technique, GI spillage, or acute nonpurulent inflammation; 4 Class IV/Dirty-Infected, old traumatic wounds with retained devitalized tissue, existing clinical infection, or perforated viscera). Integer 1-4 only; reject 0, 5, 1.5, and roman I. magent does not inspect the wound. Not SSI rates. Not AMP selection.

## Bulk (POST)

POST the same path with a JSON items array. The first item is the GET unit; each additional item is $0.002. Invalid items return HTTP 400 before settlement.

Method: `POST /api/calc/wound_class`
Max items: 25
Price: unit_amount + extra_item_amount * (n - 1) (unit 5000 atomic, extra 2000 atomic)
Status: PREVIEW

- 1 to 25 items. Each item uses the same keys as the GET query parameters.
- POST of 1 item costs the same as GET. Lists longer than 25: chunk into multiple POSTs. Extra items still execute; do not pad dummy rows.
- The first invalid item fails the whole request (index in the 400 JSON). You are not charged.
- HTTP 200 is {count, path, items}. Each items[i] is the GET 200 body for that row.
- Catalog misses (empty matches, found=false) stay paid 200s inside that slot.
- x402 resource URL is this path plus n and body_sha256. Browsers that prefer text/html get the same paywall as GET; Pay retries POST with the same items.

Example request:

```json
{
  "items": [
    {
      "wound_class": "1"
    },
    {
      "wound_class": "1"
    }
  ]
}
```

Human paywall (two-item fixture): https://api.magentlab.com/paywall/bulk/wound-class

Example 200:

```json
{
  "count": 2,
  "path": "/api/calc/wound_class",
  "items": [
    {
      "description": "An uninfected operative wound in which no inflammation is encountered and the respiratory, alimentary, genital, or uninfected urinary tract is not entered. In addition, clean wounds are primarily closed and, if necessary, drained with closed drainage. Operative incisional wounds that follow nonpenetrating (blunt) trauma should be included in this category if they meet the criteria.",
      "components": [
        {
          "factor": "class_i_clean",
          "met": true
        },
        {
          "factor": "class_ii_clean_contaminated",
          "met": false
        },
        {
          "factor": "class_iii_contaminated",
          "met": false
        },
        {
          "factor": "class_iv_dirty",
          "met": false
        }
      ],
      "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
      "citation": {
        "authors": "Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR, Hospital Infection Control Practices Advisory Committee",
        "doi": "10.1086/501620",
        "id": "mangram-1999",
        "pmid": "10219875",
        "source": "Infect Control Hosp Epidemiol. 1999;20(4):250-278",
        "title": "Guideline for Prevention of Surgical Site Infection, 1999"
      },
      "formula": "wound_class",
      "formula_expression": "wound_class in {1, 2, 3, 4} as assigned by the caller (Mangram 1999 CDC/HICPAC Table 7 Class I-IV). magent does not inspect the wound. Not SSI rates. Not AMP selection.",
      "class_label": "I/Clean",
      "wound_class": 1
    },
    {
      "description": "An uninfected operative wound in which no inflammation is encountered and the respiratory, alimentary, genital, or uninfected urinary tract is not entered. In addition, clean wounds are primarily closed and, if necessary, drained with closed drainage. Operative incisional wounds that follow nonpenetrating (blunt) trauma should be included in this category if they meet the criteria.",
      "components": [
        {
          "factor": "class_i_clean",
          "met": true
        },
        {
          "factor": "class_ii_clean_contaminated",
          "met": false
        },
        {
          "factor": "class_iii_contaminated",
          "met": false
        },
        {
          "factor": "class_iv_dirty",
          "met": false
        }
      ],
      "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
      "citation": {
        "authors": "Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR, Hospital Infection Control Practices Advisory Committee",
        "doi": "10.1086/501620",
        "id": "mangram-1999",
        "pmid": "10219875",
        "source": "Infect Control Hosp Epidemiol. 1999;20(4):250-278",
        "title": "Guideline for Prevention of Surgical Site Infection, 1999"
      },
      "formula": "wound_class",
      "formula_expression": "wound_class in {1, 2, 3, 4} as assigned by the caller (Mangram 1999 CDC/HICPAC Table 7 Class I-IV). magent does not inspect the wound. Not SSI rates. Not AMP selection.",
      "class_label": "I/Clean",
      "wound_class": 1
    }
  ]
}
```

## Response fields

- `formula` (string): wound_class
- `formula_expression` (string): Published Mangram 1999 Table 7 class rule
- `wound_class` (integer): Caller-assigned CDC/HICPAC class 1-4
- `class_label` (string): Roman class plus name (e.g. I/Clean)
- `description` (string): Mangram 1999 Table 7 wording for that class
- `components` (array): Per-class Tree rows class_i_clean, class_ii_clean_contaminated, class_iii_contaminated, class_iv_dirty with factor and met; exactly one is met
- `citation` (object): Mangram 1999 Infect Control Hosp Epidemiol citation
- `disclaimer` (string): Not-a-device notice

## Example JSON

Frozen fixture. Not a live lookup.

```json
{
  "description": "An uninfected operative wound in which no inflammation is encountered and the respiratory, alimentary, genital, or uninfected urinary tract is not entered. In addition, clean wounds are primarily closed and, if necessary, drained with closed drainage. Operative incisional wounds that follow nonpenetrating (blunt) trauma should be included in this category if they meet the criteria.",
  "components": [
    {
      "factor": "class_i_clean",
      "met": true
    },
    {
      "factor": "class_ii_clean_contaminated",
      "met": false
    },
    {
      "factor": "class_iii_contaminated",
      "met": false
    },
    {
      "factor": "class_iv_dirty",
      "met": false
    }
  ],
  "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
  "citation": {
    "authors": "Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR, Hospital Infection Control Practices Advisory Committee",
    "doi": "10.1086/501620",
    "id": "mangram-1999",
    "pmid": "10219875",
    "source": "Infect Control Hosp Epidemiol. 1999;20(4):250-278",
    "title": "Guideline for Prevention of Surgical Site Infection, 1999"
  },
  "formula": "wound_class",
  "formula_expression": "wound_class in {1, 2, 3, 4} as assigned by the caller (Mangram 1999 CDC/HICPAC Table 7 Class I-IV). magent does not inspect the wound. Not SSI rates. Not AMP selection.",
  "class_label": "I/Clean",
  "wound_class": 1
}
```

## Errors

- HTTP 400 `invalid_wound_class`: wound_class must be 1, 2, 3, or 4 (Mangram 1999 CDC/HICPAC Table 7 Class I-IV). Returned before settlement; you are not charged.
- HTTP 400 `invalid_items`: POST body must be a JSON object with only an items array Returned before settlement; you are not charged.
- HTTP 400 `invalid_item_count`: items must be an array of 1 to 25 objects Returned before settlement; you are not charged.
- HTTP 400 `invalid_item`: each items entry must be a JSON object Returned before settlement; you are not charged.

Shared HTTP 402 and 503: https://magentlab.com/docs/payments

## Related tools

- [MESS](https://magentlab.com/docs/mess) — Compute the Johansen 1990 Mangled Extremity Severity Score from caller-assigned skeletal/soft-tissue, limb ischemia, shock, and age integers, doubling ischemia when time exceeds 6 hours, and return the published 0-6 / ≥7 band.
- [Surgical Apgar](https://magentlab.com/docs/surgical-apgar) — Compute the Gawande 2007 intraoperative Surgical Apgar score from estimated blood loss, lowest mean arterial pressure, and lowest heart rate.

## Payment

Unpaid requests return HTTP 402 even if query parameters or POST items are missing or invalid, so CDP and agents can index the path. After a PAYMENT-SIGNATURE, invalid params return HTTP 400 JSON before settlement. magent does not charge. Fix the params, then request a new 402 quote for that complete URL. Catalog misses (empty matches, found=false) are valid paid 200s.

- GET the tool with Accept: application/json (do not send Accept: text/html unless you want the human paywall).
- HTTP 402 means you have not paid. Decode the base64 PAYMENT-REQUIRED header. HTTP 503 is not a new quote.
- Sign accepts[0] (exact, EIP-3009) with validBefore = now + maxTimeoutSeconds (600 seconds), or accepts[1] (batch-settlement deposit/voucher) on product GET. Ping and POST {items} stay exact. Magent retries transient facilitator 429/5xx before answering.
- Retry the same URL with PAYMENT-SIGNATURE (base64 JSON of accepted and payload). Magent attaches canonical extensions.bazaar on CDP verify/settle; echoing 402 bazaar is optional.
- Success is HTTP 200 JSON plus PAYMENT-RESPONSE. exact settles before the tool. batch-settlement verifies (and deposit-settles) before the tool and commits the charge after HTTP 2xx. HTTP 503: retry the same PAYMENT-SIGNATURE. Mint a new exact nonce only after a new HTTP 402.

- offered `exact` on eip155:8453: Fixed-price USDC on Base. The buyer authorizes the advertised amount (EIP-3009). magent settles before the tool runs (paymentFlow upfront). extra.assetTransferMethod=eip3009 extra.paymentFlow=upfront.
- offered `batch-settlement` on eip155:8453: Payment-channel vouchers claimed later in batches. Exact stays accepts[0]. Same-path POST {items} is still exact. extra.assetTransferMethod=eip3009 extra.paymentFlow=authorization.

- not offered `upto`: Not offered. Usage-based: buyer authorizes a ceiling, seller settles the actual amount after work. Reserved for a future metered tool. Not for current calculators or code search.

Same-path POST {items} is still scheme exact: one EIP-3009 authorization for GET unit plus $0.002 per extra item. That is not x402 batch-settlement (payment channels / vouchers).

Shared HTTP 402 and 503 table: https://magentlab.com/docs/payments

Stdio MCP (one process per host): https://magentlab.com/docs/mcp

## Guarantees

- HTTP 402 is unpaid, including a missing query. After PAYMENT-SIGNATURE, invalid parameters return HTTP 400 before settlement. You are not charged. HTTP 402 never includes the tool JSON.
- exact: settlement finishes before the tool (paymentFlow upfront). batch-settlement: verify/deposit before the tool; chargedCumulativeAmount commits after HTTP 2xx. Uncertain or failed settlement fails closed (HTTP 503). Retry the same PAYMENT-SIGNATURE.
- HTTP 402 is unpaid only. Do not sign a second authorization because of a 503.
- Execution is timeout-bounded and concurrency-capped.
- Calculator inputs are stored encrypted for allowlisted operators (Magent Console). They are not in public logs, SSH lookups, catalog, or rollups. Request logs store path without query.