How to effectively manage an infected wound
Abstract
The use of antibiotics alone does not overcome the issues associated with infected wounds. Wound infection will delay healing, increase the time and effort involved in management, while potentially leading to significant complications and an increase in costs associated with treatment. The modern approach is one that focuses on reducing the microbial and organic burden within the wound, and treating infection systemically only when absolutely necessary to avoid increasing episodes of bacterial resistance.
Inflammation is a crucial and normal part of the healing process and is characterized by redness, production of exudate, swelling and pain (Table 1). Inflammation delivers neutrophils and macrophages to the wound site and enables clearing and natural debridement of debris, bacteria, and devitalized tissue (Shultz, 2007).
Powerful enzymes called proteases are used during this process to break down large proteins into a more liquid form for easy digestion by macrophages. As a result the wound takes on a more goey, sloughy appearance as inflammation peaks at around 2 to 3 days after injury (Collier, 2003; Shultz, 2007).
Production of slough and exudate during the inflammatory phase is the reason a fresh wound will often look ‘worse’ before it starts to look better. However, it is possible to confuse these symptoms with infection (Figure 1).
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