Wound Infections

 

 

Antibiotic prophylaxis

It has been strongly suggested that prophylactic antibiotics are overused, (Shanson 1988). This overuse has contributed to the development and spread of  bacterial antibiotic resistance as well as some incidences of nosocomial cross infection. If prophylaxis is to be used the drugs chosen should have as narrow a spectrum as possible to prevent undue disruption of normal flora and to reduce the risk of superinfection. The patient may also suffer unnecessary toxic effects of the drugs and there is always a slight risk of allergic reactions. These factors mean that each time prophylactic antibiotics are given the risk from possible infective complications should outweigh the potential risks of the drugs to the individual patient. In addition there should be reason to suppose that the antibiotic given is effective against the potentially infective bacterial strain.

 

Prophylactic antibiotics used in trauma and surgery are most effective if the antibiotic is given within three hours of the initial traumatic or surgical tissue insult. Preferably the antibiotics will be given as early as possible and in the case of surgery before the start of the operation. This will mean that there is theraputic tissul levels of antibiotic when bacterail contamination occurs. Such prophylaxis should usually be continued after 72 hours, (Westaby, 19  )

 

 

Terms

Nosocomial

Prophylaxis

Superinfection

 

References

Shanson DC (1988) Microbiology in Clinical Practice, Third edition, Wright, London

Westaby S. 19  , Wound Care, Heinemann, London

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Wound infection

 

 

An infected wound does not heal.

Any poorly healing wound should be swabbed for culture.

 

Types of wound

 

Clean

Surgical wounds not involving opening potentially infecting cavities

 

Clean-contaminated

Operative wounds in which the gut respiratory or GU tract is entered, usually without contamination

 

Contaminated wound

Fresh traumatic wounds

Wounds coming into contact with non-purulent infection eg. cholecystitis

Wounds entering the colon

 

Dirty and infected wounds

Wounds infected from the outside or inside the patient

 

What are the clinical features of wound infection?

 

Local                                                         Systemic

Inflammation                                                     Malaise

Heat                                                                 Pyrexia ------ dehydration

Pain                                                                  Tachycardia proportional to pyrexia

Redness                                                           Pyrexia/ febrile/rigours               

Swelling                                                            Metastatic infection

Loss of function                                                 Risk of bacteraemia, septicaemia and death

Pus, eg. from suiture sites or wound drain            Leucocytosis

Purulent discharge                                             Anorexia

Non-healing                                                       Enlarged lymph nodes

Cellulitis                                                            Lymphatic streaking

Necrotic tissue                                                             

Smell                                       

Wound breakdown

Dehiscencs

Wound enlargement

Tender to palpation

Green appearance indicates pseudomonas

 

Fever alone may have many other causes, deep seated infection may give rise to systemic signs first. Learn to distinguish between normal redness in granulation tissue and inflammatory redness.

 

Depressed cardiac function from toxins with  clostridia

 

Peripheral vasodilation - low BP

 

Renal and respiratory complications

 

 

 

Distinguish between wound Infection and wound colonisation.

 

Infection  -  A wound with clinical features of infection. In this situation there is clinical evidence of infection and the wound will usually grow the infective agent on culture.

 

Colonisation  -  A colonised wound may grow bacteria on culture but has no clinical features of infection. Bacterial culture may produce laboratory evidence of the presence of bacteria in the absence of the clinical features of infection. Most chronic wounds are colonised whereas most surgical wounds are not.

 

 

 

Give clinical applications of the above differentiation

 

Infection -  Infection inhibits or prevents healing. Cultures should be taken from clinically infected wounds to optimise treatment.

 

Colonisation -  Colonisation does not significantly inhibit healing. Cultures should not normally be taken from wounds in the absence of clinical features of infection, "to find out what is there", this is a waste of resources and has no clinical application.

 

 

 

Which wounds are in danger of becoming infected?

All wounds may potentially become infected due to disruption of the bodies protective barrier. Westaby claims that wounds effecting the abdomen, thigh, calf and buttock are especially susceptible while the face, scalp and thorax are affected less frequently.

 

 

 

What factors influence the likelihood of a wound becoming infected?

You may have thought of several however you may wish to take the factors you have considered and try to fit them into the following classifications

 

 

 

Contamination    Bacterial Environment     Patient resistance

 

The more contamination     Prolonged treatment procedures          Immune status 

the greater the infection     Presence/absence of oxygen               Age     

risk                                   Presence of medium/substrates          Nutritional status

                                        Extent and nature of the wound           Anergy

                                        Haematoma                                      Inflammatory bowel disease                                    Tissue damage by crushing                Diabetes

                                       Presence of foreign material, (big factor)   Anaemia

                                                                                                     Dehydration

                                                                                                     Shock

 

           

Lowest incidence of infection is in late teens and early 20s. Children have a slightly higher incidence of infection. After the 20 the incidence progresses with increasing age.

 

Wound infection  =   number or organisms x virulence

                                             host resistance

 

 

 

Where may bacteria which contaminate a wound come from?

You may have thought of several possibilities, try to classify your ideas under the following headings. Endogenous means from the patient themselves, exogenous means from without the patient.

 

Endogenous                                                     Exogenous

Patents normal bacterial flora, becoming pathogenic                    Cross infection

in the wound.                                                                             From Staphylococcal carrier

 

 

 

The most common bacteria to cause wound infection are from the skin and gut. Staphylococcus aureus and Staphylococcus epidermis are found on the skin. Staphylococcus aureus is also found in the upper respiratory tract

 

 

 

Might these organisms also be found in the air? If so why?

Yes - dead skin cells are always flaking off into the air. Also Staphylococcus and Streptococcus may be exhaled passed on through coughing and sneezing and by touch.

 

 

 

Give a clinical application from your answer

Do not open wounds to dusty air, eg. after hospital bed making

 

 

 

What does virulence mean?

The organisms ability to create infection despite the body's defence mechanisms

Is nosocomial wound infection a problem?

About 10% of patients acquire some kind of infection while in hospital, about a quarter of these are wound infections

 

 

What is the relationship between area of superficial skin loss and wound infection? Give a rationale for your answer.

The more skin loss the greater the risk due to the increased opportunity for wound colonisation

 

 

What is the relationship between debilitation and risk of wound infection? Give a rationale for your answer.

Debility predisposes to infection risk. Lack of mobility reduces blood circulation and also leads to an impaired immune response.

 

 

What are aerobic and anaerobic bacteria?

Aerobic                         - need oxygen to live

Anaerobic                     - are killed by the presence of oxygen

Eg.       Clostridium tetani           - often in the soil in spore form

            Clostridium welchii         - from soil or gut, infection causes gas gangrene

 

 

How may the risks of anaerobic infection be reduced?

Usually these infections gain access to the wound from dirt in the environment, therefore wound exploration and cleaning are vital. Also debridment and follow up wound cleaning may help. Sometimes allow to heal by secondary intention. Ensure all foreign bodies are removed.

 

So infection may be airborne, auto, cross or from contaminated equipment

 

 

List nursing measures to prevent these forms of wound contamination.

 

Airborne infection

Dressing to cover wound

Short exposure of wound to ward air - collection of bacteria on wound is proportional to time of exposure.

 

Auto-infection

Skin cleaning

Prevent outside contamination, eg urine, faeces

 

Cross infection

Cross infection between patients or vectored by staff.

Isolation if indicated.

Correct waste disposal, isolation of soiled and contaminated linen.

Barrier nursing / reverse barrier nursing, protective clothing etc.

Treat infected wounds after clinically normal wounds

Generally clean environment

Good staff personal hygiene, hand washing etc.

Avoid hand contact with eyes, nose, mouth and genitalia

 

Combinations of the above modes of contamination

Avoid interference with dressing

Prevent moist pathways, eg from exudate

Asepsis of dressings and any instruments uses

Early recognition of infections

Remove source of infection

Extra care when using invasive devices

 

 

When and how should necrotic material be removed from a wound?

Basically dead tissue is no good and should be removed unless it forms an inert protective layer, with no fluid collected beneath it. Normally wounds are debrided using topical debriding agents or surgical excision

 

Always check perfusion of a wound.

 

 

How may wound perfusion be assessed?

Colour, capillary refill, pulses distal to the wound, level of pain.

 

 

Why is necrotic tissue a problem?

Acts a nutrient culture medium for bacteria. Poor blood supply means white cells can not readily get to the area.

 

 

Which patients are at increased risk of infection for intrinsic reasons?

The following factors may lead to immuno-compromise, HIV AIDS, steroids, very old and very young, immuno-suppressants, malignancies, those with other infections.

 

 

What are the longer term effects of wound infection

Longer hospital stay/need for more medical/nursing intervention

More time off work

Formation of more scar tissue

Change in body image,               eg. facial scaring

Loss of function of part of body   eg. hand

Amputation

Chronic infections,                     eg. osteomylitis

 

 

 

 

 

Antibiotic use/prophylaxis

 

Most wounds do not need routine antibiotic prophylaxis.

 

 

Which wounds will need prophylactic antibiotics?

Those involving known infection or opening of the gut

 

 

What factors and procedures will determine antibiotic choice?

Culture and sensitivity to give a narrow spectrum, effective antibiotic

 

 

What is meant by the following terms

 

Resistance

The ability of a bacterial strain not to be killed in the presence of an antibiotic

 

Broad spectrum       

An antibiotic which is effective against a wide range of bacterial types

 

Narrow spectrum

An antibiotic which is effective against a narrow range of bacterial types

 

 

Multiple resistance strains may emerge from the indiscriminate use of topical antibiotics

 

 

Bacterial cultures

 

 

What is the ideal material to send for culture?

Pus, exudate or tissue is more useful than a swab. In deep wounds check with the lab re. type of specimen, storage and transportation.

 

 

What may cause a false positive culture result?

A superficial swab may identify bacteria colonising the wound but not causing the infection.

 

 

What may cause a false negative culture result?

A swab which fails to culture bacteria which are in fact causing infection, perhaps deeper in the wound. Anaerobes are often difficult to culture from routine swabs.

 

 

 

What is the difference between a qualitative and a quantitative culture?

Qualitative analysis will only identify the organisms present not the number or organisms. Biopsy will identify numbers, infection is defined as 105 organisms per gram of tissue or per ml of wound fluid.

 

 

 

Leg Ulcers

 

In some chronic wounds such a leg ulcers heat pain and redness may be a part of the normal healing process so infection needs to be assessed using other criteria

 

Chronic wounds may have high numbers of bacteria per gram of tissue, with no signs of infection and still go on to heal

 

Subsequent culture of leg ulcers reveals changes in the type of bacterial cultured (82% of ulcers), so it seems than the colonising bacteria change over time.

 

Healing in leg ulcers in independent of bacteria cultured on surface swabs.

 

It seems likely that Staphylococcus aureus, B - haemolytic streptococcus and pseudomonas have a detrimental effect on ulcer healing.

 

The following criteria are useful in determining infection or otherwise in leg ulcers

 

*           lack of progress towards healing

*           very friable granulation tissue with an unhealthy red colour

*           increased pain

*           increased exudate

 

 

Principles of treatment

 

Systemic

Reassurance and encouragement

Nutrition

Hydration

Correct other conditions eg. diabetes

Antibiotics

Metronidazole

 

Local

Keep wounds open

Open surgical infected wounds

Ensure good wound drainage

Pack if not drained by surgical drains

Intermittent topical irrigation

Debridement

Drainage of abscesses

Allow wounds to close by contraction

Keep dressings changed to keep dry

Avoid adhesive tapes on excoriated skin

Local moist heat may improve circulation and lymph flow

Possible topical antibiotics

 

 

Septicaemia

Specific intravenous antibiotics

 

Cellulitis

Intravenous or oral antibiotics for long enough to establish resolution of symptoms

 

Local infections causing delays in healing

There should not be widespread, indiscriminate use of topical antiseptics as these do not seem to be positively correlated with improved healing, and  there is some evidence that they may adversely effect healing in certain circumstances

 

 

 

Examples of treatment options

 

Indicate how you would manage the examples below

 

 

Infected pressure sore - Escherichia coli, Bacteroides, Staphylococcus aureus, (75 year old woman)

Irrigation with 0.9% saline to remove debris and faecal contamination

Oral flucloxacillin - prevent spreading of local infection

Topical metronidazole

Hydrogel - (to control odour)

Possible use of hydrocolloids and topical antiseptics

 

 

Non-healing post operative pilonidal sinus (23 year old man) with unhealthy coloured, friable granulation tissue.

Oral metronidazole and erythromycin

Possible alginate dressings

 

 

Post operative removal of metastatic malignant melanoma, (62 year old woman). Swab revealed MRSA. Wound showing signs of healing.

Because wound is healing the MRSA is probably only colonising the wound

Apply topical mupirocin to prevent spread of MRSA

Change dressing frequently

Possible iodine impregnated dressings, ( eg. inadine)

Possible intravenous vancomycin, topical iodine or silver sulphadiazine

 

 

Four month history of foot ulcers from ill fitting shoes in a patient with IDDM, (57 year old man)

Oral flucloxacillin

X Ray to identify bony involvement

Surgery for removal of dead infected soft tissue and bone - for osteomyelitis

Wound drainage

 

 

Patient with recurrent soft tissue infections in the thigh, green appearance to wound, (49 year old woman)

Green = pseudomonas infection

Antiseptics

Possible Silver sulphadiazine, Acetic acid, Tea-tree oils

 

 

Particular problems

 

Necrotising fasciitis

A serious spreading infection involving the fascial planes

Haemolytic streptococci or Staphylocci

Causes tissue necrosis and gangrene

Treated with excision of the whole area of fascial involvement and Penicillin

 

Gas gangrene

Anaerobic infection of muscle

Toxaema

Local oedema and gas bubbles

Swelling

Discharges of foul brown fluid

Blotchy and purple overlying skin becoming purple/black

Amputation may prevent death

Large doses of penicillin

Mortality of 25 - 40%

 

Human bites

Streptococci staphyloccocci and spirochetes

Debridement required

Cleaning and immobilisation

Systemic antibiotics often penicillin

 

References and reading

Shanson DC (1988) Microbiology in Clinical Practice, Third edition, Wright, London

Westaby S. 19  , Wound Care, Heinemann, London

Gilchrist B (1996) Wound Infection, Journal of Wound Care, vol. 5 no. 8 Sept.

Harding KG  (1996) Wound Infection, Journal of Wound Care, vol. 5 no. 8 Sept.

David JA  (1987)  Wound Management, Martin Dunitz

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Wound infection

 

An infected wound does not heal.

Any poorly healing wound should be swabbed for culture.

 

Types of wound

 

Clean

Surgical wounds not involving opening potentially infecting cavities

 

Clean-contaminated

Operative wounds in which the gut respiratory or GU tract is entered, usually without contamination

 

Contaminated wound

Fresh traumatic wounds

Wounds coming into contact with non-purulent infection eg. cholecystitis

Wounds entering the colon

 

Dirty and infected wounds

Wounds infected from the outside or inside the patient

 

What are the clinical features of wound infection?

 

Local                                                         Systemic

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Fever alone may have many other causes, deep seated infection may give rise to systemic signs first. Learn to distinguish between normal redness in granulation tissue and inflammatory redness.

 

Depressed cardiac function from toxins with  clostridia

 

Peripheral vasodilation - low BP

 

Renal and respiratory complications

 

Distinguish between wound Infection and wound colonisation.

 

Infection  - 

 

 

Colonisation  - 

 

 

Give clinical applications of the above differentiation

 

Infection -  .

 

 

Colonisation - 

 

Which wounds are in danger of becoming infected?

 

 

 

What factors influence the likelihood of a wound becoming infected?

 

 

 

Contamination    Bacterial Environment     Patient resistance

 

 

           

 

 

 

Wound infection  =   number or organisms x virulence

                                             host resistance

 

Where may bacteria which contaminate a wound come from?

 

 

Endogenous                                                     Exogenous

 

 

 

 

 

 

 

The most common bacteria to cause wound infection are from the skin and gut. Staphylococcus aureus and Staphylococcus epidermis are found on the skin. Staphylococcus aureus is also found in the upper respiratory tract

 

 

 

Might these organisms also be found in the air? If so why?

 

 

 

 

Give a clinical application from your answer

 

 

 

 

What does virulence mean?

 

 

 

Is nosocomial wound infection a problem?

 

 

 

What is the relationship between area of superficial skin loss and wound infection? Give a rationale for your answer.

 

 

What is the relationship between debilitation and risk of wound infection? Give a rationale for your answer.

 

 

 

What are aerobic and anaerobic bacteria?

 

 

 

 

How may the risks of anaerobic infection be reduced?

 

 

 

So infection may be airborne, auto, cross or from contaminated equipment

 

 

List nursing measures to prevent these forms of wound contamination.

 

 

Airborne infection

 

Auto-infection

 

Cross infection

 

Combinations of the above modes of contamination

 

When and how should necrotic material be removed from a wound?

 

 

Always check perfusion of a wound.

 

How may wound perfusion be assessed?

 

 

Why is necrotic tissue a problem?

 

 

 

Which patients are at increased risk of infection for intrinsic reasons?

 

 

What are the longer term effects of wound infection

 

 

 

Antibiotic use/prophylaxis

 

Most wounds do not need routine antibiotic prophylaxis.

 

 

Which wounds will need prophylactic antibiotics?

 

 

 

 

What factors and procedures will determine antibiotic choice?

 

 

 

 

What is meant by the following terms

 

 

Resistance

 

Broad spectrum       

 

Narrow spectrum

 

Multiple resistance strains may emerge from the indiscriminate use of topical antibiotics

 

 

Bacterial cultures

 

 

What is the ideal material to send for culture?

 

 

What may cause a false positive culture result?

 

 

What may cause a false negative culture result?

 

 

What is the difference between a qualitative and a quantitative culture?

 

 

 

Leg Ulcers

 

In some chronic wounds such a leg ulcers heat pain and redness may be a part of the normal healing process so infection needs to be assessed using other criteria

 

Chronic wounds may have high numbers of bacteria per gram of tissue, with no signs of infection and still go on to heal

 

Subsequent culture of leg ulcers reveals changes in the type of bacterial cultured (82% of ulcers), so it seems than the colonising bacteria change over time.

 

Healing in leg ulcers in independent of bacteria cultured on surface swabs.

 

It seems likely that Staphylococcus aureus, B - haemolytic streptococcus and pseudomonas have a detrimental effect on ulcer healing.

 

The following criteria are useful in determining infection or otherwise in leg ulcers

 

lack of progress towards healing

very friable granulation tissue with an unhealthy red colour

increased pain

increased exudate

 

Principles of treatment

 

Give examples of the following types of treatment

 

Systemic

 

 

 

 

 

Local

 

 

 

 

 

Septicaemia

Specific intravenous antibiotics

 

Cellulitis

Intravenous or oral antibiotics for long enough to establish resolution of symptoms

 

Local infections causing delays in healing

There should not be widespread, indiscriminate use of topical antiseptics as these do not seem to be positively correlated with improved healing, and  there is some evidence that they may adversely effect healing in certain circumstances

 

Examples of treatment options

 

Indicate how you would manage the examples below

 

Infected pressure sore - Escherichia coli, Bacteroides, Staphylococcus aureus, (75 year old woman)

 

 

 

 

Non-healing post operative pilonidal sinus (23 year old man) with unhealthy coloured, friable granulation tissue.

 

 

 

 

Post operative removal of metastatic malignant melanoma, (62 year old woman). Swab revealed MRSA. Wound showing signs of healing.

 

 

 

 

Four month history of foot ulcers from ill fitting shoes in a patient with IDDM, (57 year old man)

 

 

 

 

Patient with recurrent soft tissue infections in the thigh, green appearance to wound, (49 year old woman)

 

 

Particular problems

 

Necrotising fasciitis

A serious spreading infection involving the fascial planes

Haemolytic streptococci or Staphylocci

Causes tissue necrosis and gangrene

Treated with excision of the whole area of fascial involvement and Penicillin

 

Gas gangrene

Anaerobic infection of muscle                                 Toxaema

Local oedema and gas bubbles                             Swelling

Discharges of foul brown fluid                    

Blotchy and purple overlying skin becoming purple/black

Amputation may prevent death                                Large doses of penicillin

Mortality of 25 - 40%

 

Human bites

Streptococci staphyloccocci and spirochetes                   Debridement required

Cleaning and immobilisation                                               Systemic antibiotics often penicillin