Wound infection is defined as the presence of multiplying organisms which overwhelm the
body’s immune system resulting in spreading cellulitis (inflammation of the tissues). This
definition indicates that wound infection results in active disease that is likely to delay the wound
healing process and is determined by clinical diagnosis. Cuts, grazes, and other skin breaks can
become infected when bacteria enter the wound and begin to multiply. The bacteria may come
from the surrounding skin, the external environment, or the object that caused the injury.
Wound infections occur when bacteria enter and multiply within a wound, leading to tissue
damage and delayed healing. Signs and symptoms include increased pain, swelling, redness, and
potentially fever, depending on the severity. Prevention involves prompt cleaning and dressing of
wounds, and seeking professional care for larger or more serious injuries. Treatment typically
involves cleansing the wound, removing debris, and potentially antibiotics.
Wound contamination is the presence of organisms on the surface of a wound, the type and
quantity of organisms vary from one wound to another. Contamination can occur in a variety of
ways often arising through the transfer of normal body bacteria
Wound colonization is defined as the presence of multiplying micro-organisms on the surface of
a wound, but with no immune response from the host and with no associated clinical signs and
symptoms. This indicates that wound colonization, similar to wound contamination, is a normal
state and is not associated with active disease,
If bacteria or other pathogens enter a wound, an infection can occur. Symptoms or signs of
wound infection include increasing pain, swelling, and redness. More severe infections may
cause nausea, chills, or fever.
Treatment will depend on the wound type and the infection’s extent. A person may be able to
treat minor wound infections at home. However, people with more severe or persistent wound
infections should seek medical attention.
ETIOLOGY OF WOUND INFECTION
Microbial Pathogens including bacteria and fungi can cause wound infection. Common bacteria
that may cause a wound infection include: Gram-positive (e.g., Staphylococcus aureus,
Streptococcus pyogenes), Gram-negative (e.g., Pseudomonas aeruginosa, Proteus mirabilis, and
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Escherichia coli), and anaerobic bacteria (e.g., Bacteroides fragilis and Clostridium
perfringens). Fungi such as Yeast and molds (e.g., Candida albicans , Aspergillus spp.) can also
be found in an infected wound.
Risk Factors:
A number of factors can result in wound infection, these factors include;
1. Local invasion of pathogens: Bacteria can enter the wound from the environment or the
patient's own body.
2. Dirty environments: Wounds sustained in unclean environments involving a dirty, rusty,
or germ-containing object have a higher risk of infection.
3. Preexisting conditions: Certain medical conditions (like diabetes) can increase
susceptibility to infection. A weakened immune system, such as in people living
with HIV or those taking immunosuppressant medications
4. Duration of operation: Surgical wounds that take longer to close are at higher risk.
Other factors include:
A large, deep, or a jagged edge wound.
A dirt or foreign particles entering the wound
Wound caused by a bite from an animal or another person
lack of mobility, for example, in people who spend most of their time in bed
advancing age : older adults are more at risk of wound infection
nutrient and vitamin deficiencies
Pathogenesis of wound infection (Development of Infection)
1. Entry and Contamination: refers to the presence of non-replicating microbes on the
wound surface. Microorganisms often enter the wound from external sources or
endogenous flora.
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2. Colonization: At this stage, microorganisms begin to replicate without causing tissue
damage.
3. Proliferation: this is characterized by multiplication of bacteria potentially exceeding the
host's ability to defend itself.
4. Inflammation: The body initiates an inflammatory response to combat the infection,
characterized by redness, swelling, pain, and heat.
5. Tissue Damage: Inflammatory cells and bacterial toxins can damage surrounding tissues,
leading to tissue necrosis and further infection.
6. Systemic Effects: In severe cases, infection can spread systemically, causing sepsis and
other complications.
Management and Prevention
1. People can minimize the risk of infections by treating wounds effectively. Doing so will
include:
2. Thoroughly wash the hands with soap and warm water, then rinse and dry them. If there
is active bleeding, hold a clean bandage or gauze to the wound and apply pressure until it
stops.
3. Clean the wound by running warm water over it for several minutes. Use warm, soapy
water to clean the surrounding skin, but avoid getting soap in the wound.
4. Make sure that the wound is free of dirt or debris, such as grass or gravel.
5. If desired, apply a thin layer of antiseptic ointment or petroleum jelly to the cut or scrape.
6. Allow the skin to air dry before covering it with gauze or a bandage.
Diagnosis and Treatment
More severe wound infections require prompt medical attention, particularly those with other
symptoms such as fever, feeling unwell, or discharge and skin streaks from the wound.
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Some wounds may require further treatment in addition to cleaning. The doctor may recommend
wound cleansing solutions, specific wound dressings, or procedures to remove infected or dead
tissue.
Wound swab culture and sensitivity should be carried out to establish the actual microorganisms
in the infection and the specific antibiotics to be used. To fully treat the infection and prevent the
bacteria from becoming resistant to the drug, a person must complete the course of antibiotics.
People with animal bites or wounds from dirty or rusty objects may be at risk of tetanus and need
to get a tetanus shot.
Blood test to determine the presence of sepsis
Complications
If a person does not receive treatment for a wound infection, the infection can spread to other
parts of the body, which may lead to serious complications, including:
Cellulitis is an infection of the deeper layers and tissues of the skin, and it can cause swelling,
redness, and pain in the affected area. Other symptoms can include fever, dizziness, nausea, and
vomiting.
Osteomyelitis is a bacterial infection of the bone. Symptoms include pain, redness, and swelling
around the infected area. Fatigue and fever are other symptoms that may affect those with
osteomyelitis.
Sepsis is an extreme immune reaction that sometimes occurs when an infection enters the
bloodstream. Sepsis can lead to multiple organ failures and is life threatening.
Necrotizing fasciitis is rare, but it occurs when a bacterial infection spreads into a tissue called
the fascial lining that lies deep beneath the skin. It is a medical emergency.
