Managing and Treating Wound Infection: Taking a Holistic Approach

Bacterial control is accomplished through wound cleansing and debridement. Debridement is the single most important action to reduce the level of bacterial contamination in chronic wounds. Bacteria thrive in devitalized tissue and exudate. (Rodeheaver, 2001) The choice of debridement must match the needs of the patient and the wound, the skill and practice ability of the clinicians, and available resources.

Cleansing solutions should not be toxic to healthy tissue. Enough mechanical force should be used to remove necrotic tissue, exudate, metabolic waste and dressing residue from the wound surface, but not enough to traumatize. (Campton-Johnston, 2001; White et al., 2001)

When treating and managing wound infection a team approach is the best response to bring together clinical expertise, including the specialized skills, training, and experience of CWOCNs. Through collaboration, significant savings in cost and time may be achieved, while providing prompt and appropriate treatment for the patient.

For more information, contact the Wound, Ostomy and Continence Nurses Society at www.wocn.org.

Kathleen Ozella is a member of the Wound, Ostomy and Continence Nurses’ Society (WOCN). She practices at St. Vincent Hospital in Worcester, Mass.

References:

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Peacock and Van Winkel. Wound Repair. WB Saunders, 1976.

Ratliff CR and Rodeheaver GT. Correlation of semi-quantitative swab cultures to quantitative swab cultures from chronic wounds. Wounds. 2002.

Gardner SE, et al. Diagnostic validity of semiquantitative swab cultures. Wounds. 19(2):31-38. 2007.

Segerstrom SC and Miller GE. Psychological stress and the human immune system: A meta-analytic study of 30 years of inquiry. Psychol Bull. 2004 July; 130(4): 601-630.

Rodeheaver GT. Pressure ulcer debridement and cleansing: a review of current literature. Ostomy Wound Manage. Jan; 45 (1A Suppl.): 80S-85S;2001.

Campton-Johnston SM and Wilson, JA. Infected wound management: Advanced technologies, moisture-retentive dressings, and die-hard methods. Crit Care Nurs Q. Vol. 24, No. 2. Pages 64-77. August 200.

White RJ, Cooper RA, Kingsley A. Wound infection and microbiology: the role of topical antimicrobials. Br J Nurs 2001; 10(9): 563-78.