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Managing wound infection

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Wound infection can delay wound healing. The severity of the infection depends upon the immune status of the host and the virulence of the micro-organism and infection may remain localised or develop into a spreading infection that induces a systemic response.

The presence of specific local and systemic signs and symptoms help nurses and other clinicians to make a clinical diagnosis of wound infection. Treatment of wound infection involves optimising the host immune system, wound cleansing and debridement, and applying antimicrobial dressings that lower the bioburden in the wound bed.

Definition of infection

Infection is defined as: 'The presence of multiplying organisms that overwhelm the body's immune system'.1

Bacteria, viruses or fungi may enter the body through a break in the skin. Once the organisms become established in a wound bed, they form colonies, which increase in number and release enzymes and toxins that initiate infection. However, many chronic wounds contain bacteria and do not go on to develop a wound infection; these wounds are described as 'contaminated'.2

Wound infection is a dynamic continuum, with the wound starting in a state of contamination in which bacteria are present but do not increase in number.

The next stage is colonisation, in which the bacteria multiply but do not cause a clinical problem.

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