Preventing Wound Infection - An Overview

Introduction

A wound occurs when there is a break in the body tissue. An injury may occur either externally or internally. Everyone experiences wounds at some point in their lives. Most of them are considered minor and can be treated easily. However, wounds may become complicated due to the invasion of pathogens. Preventive measures are to be taken to avoid these complications.

What Is a Wound Infection?

A wound is an injury. It can be caused by falls, accidents with sharp objects, or car accidents. Serious accidents require medical help. Simple wounds can be managed at home. In serious accidents, medical care must be taken immediately, especially when the bleeding occurs for more than 20 minutes.

Open wounds are classified into four types based on their causes.

These include:

• Abrasion: This type of wound occurs when the skin gets rubbed against a rough or hard surface.

• Laceration: It is a deep cut caused by skin tearing. It occurs in accidents with sharp objects like knives, tools, and machines. Bleeding occurs rapidly and extensively with deep lacerations.

• Puncture: A small hole caused by long and pointed objects. A nail or needle causes an injury or a hole. An injury caused by a bullet may be considered a puncture wound. These wounds may not bleed, but they are deep wounds.

• Avulsion: A type of wound in which partial or complete tearing of the skin or tissue may be observed. Avulsions occur during violent accidents like body-crushing accidents, explosions, and gunshots.

Wound infections are common, as thousands of microorganisms are present on the skin. They invade easily into a wound or a burn where the skin is broken or cut. Microorganisms or germs can enter the wound through soil or water during trauma or because of a human or animal bite. A surgical procedure may be the route to the infection.

Some conditions can cause the wound to get infected. These include

• If a person is affected by type 1 or type 2 diabetes.

• If the object causing the wound is dirty and contaminated with germs.

• If the person is old.

• If the person is obese or overweight.

• If the person has the habit of smoking.

• If the person‘s immune system does not work properly because of medications like steroids or chemotherapy, and if the person is affected by AIDS (acquired immunodeficiency syndrome).

What Are the Symptoms of Wound Infection?

The symptoms of wound infection include

• The wound may be more painful instead of gradually improving.

• There is redness around the wound, and this red area may become warm or hot.

• Swelling can be observed.

• Discharge yellow material or pus from the wound. It may be smelly.

The infection starts when the skin is broken or has a cut. If the wound infection is neglected and not treated early, it spreads. The skin may become red, swollen, and sore. The infection invades deeper tissues of the skin. This type of infection is called cellulitis. When the infection starts spreading, it may spread through the blood and enter the system. This leaves the person unwell by increasing the body temperature and leading to a severe sepsis infection.

How to Treat and Prevent Wound Infection?

Bacteria can seriously infect open wounds, leading to gastric gangrene and tetanus. These infections may lead to chronic wound or bone infections and death. These complications are observed when the person seeks help very late or when the person cannot be treated due to a lack of trauma care, like in disasters where the affected person will need more than the trauma care available. Hence, the appropriate treatment of injuries is important to avoid wound infection and its complications.

Appropriate management of injuries can be done by following core principles and protocols.

When a wound is infected, healthcare professionals must be consulted for help. They will examine and confirm the infection. If the infection is present in the wound, a swab or discharge is taken and sent to the lab to learn about the bacteria causing the infection. This helps treat the infection with precise antibiotics. In the case of severe infections, blood tests and scans may have to be done.

Treatment for infected wounds includes:

• No Treatment: If the infected wound is minor and mild, the body can fight naturally. Sometimes, it can get better on its own.

• Wound Care: The infected wound should be cleaned every few days, and a sterile wound dressing should be applied. Nurses provide these antibacterial dressings.

• Antibiotic Creams: Minor wound infections can be treated with antibacterial creams.

• Antibiotic Capsules or Tablets: This treatment is given to large, infected wounds, which may become worse without treatment. Severe wounds may need treatment at the hospital. They may require antibiotics administered intravenously.

Serious wounds may have to be operated on to remove infected and dead tissue from the wound.

The core principles to be followed regarding infected wounds include:

• Not to close the infected wounds. Wounds should be cleaned with surgical debridement using saline. This should be repeated until the wound is clean.

• The wounds should not be closed when contaminated; those clean wounds should be six hours old. These should be treated with a surgical toilet. Then, they should be left open for 48 hours. After this, they should be closed. This is called delayed primary closure.

Prevention of wound infection can be done by

• Restoring of breathing and blood circulation is to be done after the injury.

• The victim must be warmed, and high-energy nutrition must be given. Pain relief has to be done.

• Tourniquets (a device like a cloth strip or a rubber band) should not be used.

• Wound toileting and surgical debridement are to be done within eight hours of the injury.

• Universal precautions are to be followed to avoid transmission of infections.

• Antibiotic prophylaxis must be administered to victims with deep wounds and other indications.

Antibiotics cannot reach infected wounds, but they can reach the area around the wound. Antibiotics alone are not sufficient. They should be combined with wound toilets and surgical debridement.

It is advised not to use topical antibiotics or antibiotic solutions to clean.

• Wound Washing: To do this, use a large quantity of soap and boiled water for 10 minutes. After this, irrigation with saline is to be done.
• Debridement: All dirt and foreign particles will be removed mechanically, and damaged tissue will be removed using surgical techniques. After this, irrigation is done.
• Leave the Wound Open: The wound should be damped with saline, disinfected, or cleaned with gauze. It should then be covered with a dry dressing. The packing and dressing need to be changed daily. When the wound is tetanus-prone, a tetanus injection should be given.

Conclusion

Wounds and injuries are part of everyday life. Most of them do not require any treatment and heal themselves. Some wounds may get infected by germs and, if not treated promptly, may lead to life-threatening complications. Severe wound infections may require medical attention at hospitals. Hence, knowing about wound infections, symptoms, prevention, and management is important.