Identifying Wound Infection

All wounds, whether resulting from physical injury or idiopathic causes, are susceptible to infection. Identifying wound infection is one of the most important roles of the wound care specialist, as an unmanaged infection can lead to chronic non-healing wounds and a wide range of complications.

The Five Signs of Wound Infection

Most wound care professionals are taught to recognize the five signs of wound infection. These are classically known as:

  • rubor
  • calor
  • tumor
  • dolor
  • functio laesa

Inflammation & Slow Wound Healing

Unfortunately, these signs are very similar to the physical manifestation of inflammation, which is an important stage in the wound healing cascade. Differentiating the normal, inflammatory signs of wound healing from warning signals of infection can prove difficult, and is most readily learned through direct clinical experience. In general, however, these signs tend to be excessive or disproportionate to the size and extent of the integumentary damage in case of a wound infection. Another warning of infection is a plateau in wound healing or a decline in wound status. A declining wound status can often be recognized by changes in the granulation tissue, including a decrease in the amount of granulation tissue present, a change in its color, or the formation of a more friable texture. If any of these signs are observed, with or without the classic signs of infection, a possible wound infection should be investigated.

Microbiological Assessment

If a wound infection is suspected, a wound culture and microbiological assessment is often performed to confirm the infection and identify the pathogen or pathogens involved. Because all wounds contain a certain background level of bacterial contamination, culturing in wounds not already suspected of harboring an infection is unnecessary and probably meaningless. With improvements in laboratory techniques, a range of pathological services are now available to give a wider picture of clinical wounds and possible causes of indolence and non-healing. The accurate identification of immunological changes in patients that modern specialist pathologists are able to offer can help to direct treatment and management strategies for infected wounds.

Wound infection is one of the most important areas of wound management and a subject in which all wound care specialists should be confident. To refresh your knowledge of wound infection, and to learn more about current evidence-based techniques for the identification and management of wound infection, consider gaining a certification in wound care. Studying for wound certification is the perfect opportunity to renew your skills and knowledge and to demonstrate your commitment to wound management.

Learn More With Our Wound Care Education Options

Interested in learning more about wound care and certification? Browse through our wound care certification courses for information on our comprehensive range of education options to suit healthcare professionals across the full spectrum of qualifications and experience.


  1. Fleck CA. Identifying Infection in Chronic Wounds. Adv Skin & Wound Care. 2006; 19(1): 20-21.
  2. Kingsley A. The wound infection continuum and its application to clinical practice. Ostomy Wound Manage. 2003 Jul;49(7A Suppl):1-7.
  3. Lansdown AB. The role of the pathologist in wound management. Br J Nurs. 2007 Nov 8-21;16(20):S24-33.

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