Wound Infection - Causes, Symptoms, and Treatment

Introduction

A wound is developed when there is an injury to the skin and tissues of the human body. The human body has a natural healing system that repairs broken skin and tissues after an injury. However, when the wound's damaged or broken skin and tissues come into contact with harmful microorganisms such as bacteria, fungi, or viruses - present in the surrounding environment, such as the atmosphere or commonly touched surfaces - the wound becomes infected. These harmful microorganisms get a favorable condition inside the wound to multiply or replicate and spread within.

Globally, 20 percent of deaths are caused by sepsis - a dysfunction of the human body's response to infection. Response against infection depends on various factors. A microorganism alone cannot develop an infection in the human body. The patient's age, immune system, smoking habit, etc., are various factors that play an important role in wound infection.

What Is a Wound?

A wound is a tear or damage in the skin or tissues because of a cut or injury.

What Is Infection?

Infection is the point of entry of harmful germs or bacteria in the body that multiplies in number and causes a reaction in the body. Initially, the bacteria cause damage to the layers of the skin - dermis and epidermis layers and, in later stages, may get into the blood circulation of the human body.

What Is Wound Infection?

It is an infection that develops in the wound or injury. The bacteria enter the wound at the injury site and replicate or multiply in number. This causes problems in the wound by hampering the healing process.

Which Pathogens Cause Wound Infection?

Bacteria, fungi, or viruses can cause an infection. The most common infection-causing pathogens are Pseudomonas aeruginosa, Staphylococcus aureus, Klebsiella pneumoniae, Enterococcus faecalis, etc.

What Are the Types of Wound Infections?

An infection can occur in any wound. Therefore, it is important to understand the types of wounds that may develop an infection: Based on cause or etiology, wounds are of two types:

1. Acute Wounds: They are caused by physical damage to the skin, such as abrasion, cuts, surgical wounds, etc. For example, surgical wounds, traumatic wounds, or burns.

2. Chronic Wounds: They are caused by internal factors of the human body, such as pathophysiological abnormalities like foot ulcers, diabetes, aging, etc.

Based on the condition of the wound, wounds are of four types:

1. Class 1: Clean wounds that are bacteria or germ-free.

2. Class 2: Clean wounds with bacteria or other microorganisms that cause infection.

3. Class 3: Open and contaminated because of the mishandling of sterile instruments.

4. Class 4: Dirty and infected because of the unclean environment in the operating room.

Based on the exposure of injured tissue, wounds are of two types:

1. Open Wounds: The skin is damaged or broken, and the underlying tissue is exposed.

2. Closed Wounds: The damaged skin remains intact, and the underlying tissue is damaged but unexposed.

Based on the onset of infection or time duration, wound infections are of three types:

1. Early Infection: It occurs within two weeks of injury or wound.

2. Delayed Infection: It occurs two to ten weeks after injury or wound.

3. Chronic Infection: It occurs after ten weeks of injury or wound.

What Causes Infection in a Wound?

There are two schools of thought about wound infection-causing factors: the number of microorganisms present in the wound and the type of microorganism in developing an infection. In general, several factors cause wound infection apart from the microorganisms, such as:

1. Patient-related factors include conditions like diabetes, poor nutritional status, poor immunity, increased weight, etc.

2. Medications such as corticosteroids, immunosuppressants, etc.

3. Psychosocial factors such as poor personal hygiene, unhealthy lifestyle, etc.

4. Hospital-related factors such as unclean environment, non-sterile instruments, etc.

More commonly, people who are immunocompromised, diabetic, obese, malnourished, and have smoking habits are at higher risk for developing a wound infection.

What Are the Signs and Symptoms of Wound Infection?

Different types of wounds show different signs and symptoms. But, in general, it includes:

• Swelling at the wound site.

• Increased pain at the wound site.

• Heat or increased temperature at the wound site.

• Redness in the wound area.

• Purulent discharge or pus.

• Delayed wound healing.

• Unpleasant odor or smell.

• Loss of appetite.

• Fever.

How to Treat Wound Infection?

Managing wound infection involves a holistic approach:

1. Improve the patient's ability to fight against the infection. Systemic factors such as diabetes or sugar levels must be considered and brought to normal. Other factors, such as medications that may interfere with wound healing and infection, must be stopped or altered.

2. Good hygiene should be maintained to reduce bacterial load, such as hand washing, personal hygiene, etc.

3. If there is pus formation in the wound, then wound drainage should be done. Cleansing and irrigating the wound should be done regularly with an antiseptic solution.

4. Antiseptics may help when applied locally on the wound site. Acetic acid, chlorhexidine, honey, and hydrogen peroxide are commonly used antiseptics for wound infection management.

5. Antibiotics can be given orally or applied locally on the wound site. The unnecessary use of antimicrobial therapy should be avoided because it may develop antibiotic resistance in the patient’s body.

Which Antibiotic Is Best for Wound Infection?

Different microorganisms are treated with different classes of antibiotics. For example, commonly used antibiotics to treat wound infection are amoxicillin-clavulanate, dicloxacillin, doxycycline, cephalexin, clindamycin, etc.

How Long Do Antibiotics Take to Heal Wound Infection?

Typically, treating a wound infection takes a minimum of one week.

How to Treat Wound Infection Naturally?

Various natural agents are antibacterial and regenerative as they aid the healing process as mentioned below:

• Essential Oil: It is synthesized from plants such as leaves, roots, etc. It is anti-inflammatory, anti-allergic, anti-viral, etc. For example, tea tree oil.

• Honey: It is a natural healing agent applied topically or over the wound.

• Nanoparticles: They are considered a good substitute for antibiotics. For example, zinc oxide.

What Happens When a Wound Infection Is Left Untreated?

Generally, an infection begins in the superficial or outermost layer of the skin. However, with time, it can get into the other deeper layers of skin and, in serious cases, may get into the patient's bloodstream. This leads to the development of a different condition called cellulitis.

How to Prevent Wound Infection?

• Wash the wound immediately after the injury. Generally, within eight hours of injury.

• Do not immediately cover the wound and surrounding skin, and let it dry.

• Apply antiseptic to the wound.

• Cover the wound with a gauge or antiseptic dressing.

• Restore breathing and circulation of blood as early as possible.

• Give the patient high-energy food and pain relief medications.

• Maintain hygiene to avoid contamination of wounds.

What Are the Complications of Wound Infection?

• Delayed healing.

• Cellulitis.

• Abscess.

• Bacteremia - the presence of bacteria in the blood.

• In severe cases, intensive care units and life support.

• Sepsis.

Conclusion

Timely management of wound infection is important to avoid further complications. If there is an injury, a cut, or a burn, it is advisable to follow preventive measures such as personal hygiene, hand hygiene, wound cleansing, etc., as early as possible. Preventing the wound from infection is the key to quick healing and recovery.