Infection Evidence

Despite increased awareness of the need to prevent infection, surgical and traumatic wound infections still account for a significant amount of additional costs, increased lengths of stay in hospital facilities and in occasional instances patient mortality.

Sources of Infection

Sources of infection are either endogenous, when the patient's own bacterial flora overwhelm the host, or exogenous, when the infecting organism is acquired from a source outside the patient. Cross-infection, or the transfer of the infecting organism from staff, other patients, or contaminated equipment, is responsible for exogenous or nosocomial infection.

Resistance to Infection

Resistance of the patient or host is the key factor. If resistance is sufficient, colonization, or growth of organisms in the wound, can occur without a host response. The greater the number of organisms, the more likely an infection is to develop; however, the host's ability to fight off the attack plays a role in whether colonization evolves into an infection.

Some groups of patients are less able to mount a defense against the threat of infection and are at higher risk. The elderly, those who are immunosuppressed and patients with certain nutritional and metabolic states are at particularly high risk. For example, diabetes, chronic inflammatory bowel disease, and anaemia will all increase the risk of wound infection.



Monitoring for Infection

Acute wounds, particularly surgical wounds, must be monitored carefully for any signs of infection. If there is undue inflammation, redness, or any purulent drainage, a culture is taken and appropriate antibiotics are begun.

All chronic wounds are considered contaminated, as many organisms can be present. The wound is infected only when true signs and symptoms of infection are present.

Classic signs of infection include: Redness, Heat, Pain, and Swelling.

Cultures should be taken when these signs are present. A typical picture would be an incision or wound that is inflamed, painful and tender, with accompanying fever and leukocytosis.



Prevention is Key

Prevention of infection is a key element in wound care. Good aseptic technique, and in particular hand washing, is the basis for infection prevention. For surgical wounds, strict sterile technique is required. For chronic wounds, since contamination is present, a clean, or 'no touch' technique is acceptable.

For further comprehensive information on the use of Antimicrobials in wound care, pls refer to:

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