Infection management

 

 

"All wounds contain
micro-organisms, yet the
majority are not infected." 1

All wounds, even postoperative wounds, are colonised by a variety of aerobic and anaerobic bacteria.2 However, the presence of bacteria in a wound is not inherently harmful - infection only occurs when the bioburden exceeds the level manageable by the host.3

Wound bioburden refers to the presence of bacteria in the wound competing for a limited supply of oxygen and nutrients, which creates a burden on the wound-healing process.

Bioburden is more than just a quantitative assessment of the number of bacteria present in the wound; diversity, virulence, and interaction of organisms are also key factors of the negative impact of micro-organisms on the wound.

Toxins released from certain bacteria, such as Pseudomonas aeruginosa, are known to affect progression toward healing.1

Delayed wound healing manifests as a prolonged or extended inflammatory response, an alteration in collagen synthesis and deposition, delayed epithelialisation, and alteration in wound contraction.4

As wound infection results in an impeded wound-healing process, consideration of healing rate of the wound combined with assessment of the signs of infection can help with the decision to intervene.1


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