Coping With Wound Infection

Surgical site infections are a common complication of surgery, occurring in around 2–5% of all surgical procedures, and extending a patient’s length of stay by an average of 9.7 days. Including readmissions, this accounts for close to 1 million additional inpatient-days nationally, and a staggering $1.6 billion in excess costs. Wound infection is clearly a problem which needs to be addressed.

Identification & Management

Any wound can become infected if not managed correctly. Unfortunately, it can be notoriously difficult to identify and diagnose localized wound infection, particularly in chronic wounds. The classic signs and symptoms of wound infection are pain, erythema, edema, heat, and purulent exudate. However, in chronic wounds or in patients who are immunosuppressed, delayed healing may be the only sign of infection in some cases.

Once a wound infection has been identified, it must be dealt with quickly and confidently. Treatment options include topical antimicrobial therapy, systemic antibiotic therapy, and the use of antiseptic agents. There are more and more topical antimicrobial therapies appearing on the market every year, and many are extremely effective. Silver dressings are particularly popular, although their cost can sometimes be inhibitive. Other effective topical agents include cadexomer iodine, polyhexamethylene biguanide and hydrofera blue.

Although wound infections can be managed, the time and resources required and the distress caused to the patient mean that by far the best approach is to prevent a wound becoming infected in the first place. Regular debridement of necrotic tissue and exudate can help reduce bacterial bioburden, while standard clean practices should be adopted at all times, including thorough hand washing and the use of antimicrobial cleaners before and after wound care. In wound infection, as in many things, prevention is certainly better than cure.

Prevention

To learn more about effective strategies in the prevention and management of wound infection, you may consider becoming certified in wound care. A wound care certification ensures that your knowledge is refreshed and that you are kept up to date with developments in all areas of wound care, including wound infection.

References:
1. Chattopadhyay R, Zaroukian S, Potvin E. Surgical site infection rates at the Pontiac Health Care Centre, a rural community hospital. Can J Rural Med. 2006;11:41-8.
2. de Lissovoy G, Fraeman K, Hutchins V, et al. Surgical site infection: incidence and impact on hospital utilization and treatment costs. Am J Infect Control. 2009;37:387-97.
3. Gargener SE, Frantz RA. Wound bioburden. In: Baranoski S, Ayello E, editors. Wound care essentials. Practice principles. 2nd ed. Ambler PA: Lippincott Williams & Wilkins; 2008. p. 93-118.
4. Stotts NA. Wound Infection: Diagnosis and Management. In: Bryant RA, Nix DP, editors. Acute and chronic wounds. Current management and concepts. 3rd ed. St Louis, MO: Mosby Elsevier; 2007. p. 161-175.