Wound Infection

What is a wound infection?

A wound is damage to body tissues that may be caused by pressure, injury, or surgery. Wounds may include bruises, scrapes, scratches, cuts, burns, pressure sores (pressure ulcers), or surgery incisions. Wounds that cause an opening in the skin, called open wounds, may easily become infected with bacteria. Signs of a wound infection include redness, pain, warmth, pus or foul-smelling fluid draining from the wound, or a fever higher than 101.5° F (38.6° C).

Major risk factors that can complicate wound infection include diabetes, skin infections, or problems with the blood vessels and circulation.

What can I expect in the hospital?

You may need to stay in the hospital because the infection is severe or if you have a medical condition that is making your infection worse or puts you at risk for it getting worse. You may need surgery to treat your wound infection.

Several things may be done while you are in the hospital to monitor, test, and treat your condition. They include:

Monitoring

• You will be checked often by the hospital staff.
• Your heart rate, blood pressure, and temperature will be checked regularly.
• If you have diabetes, you may have fingersticks to make sure your blood glucose (sugar) is in good control.

Testing

Testing may include:

• Blood tests to check for your body’s response to the infection
• Cultures, which means that cells and fluid are gently collected from your wound and sent to the lab and tested for growth of bacteria or other germs. If you have an infection, it may take several days to find out what is causing it. Knowing what is causing the infection helps your provider choose the right medicine to treat it.
• Tests to look for abnormalities in the tissue or bone under your wound, which may include:
  • Computed tomography (CT) scan, which is a series of X-rays taken from different angles and arranged by a computer to show thin cross sections of the tissues and bone under the wound
  • Magnetic resonance imaging (MRI), which uses a powerful magnetic field and radio waves to take pictures from different angles to show thin cross sections of the tissues under the wound
  • X-rays of the bone under the wound to check for infection and bone damage
  • Nuclear scan, which uses a small amount of radioactive material injected into your blood to find a deep wound or bone infection

Treatment

The treatment for a wound infection depends on its cause, your symptoms, how well you respond to treatment, your overall health, and any complications you may have.

• You will have a small tube (IV catheter) inserted into a vein in your hand or arm. This will allow medicine to be given directly into your blood and to give you fluids, if needed.
• Antibiotics are commonly given for wound infections based on the results of wound cultures.
• If needed, your provider will choose the best way to remove the infected wound tissue, called wound debridement. Wound debridement can be done in the following ways:
  • Surgical: The damaged tissue is removed with a sharp tool or laser.
  • Chemical: Medicine, usually an ointment, is put on the wound and covered with a dressing to keep the ointment off of healthy tissue. The medicine helps remove the damaged tissue.
  • Mechanical:
    • Wet to dry dressings: A wet dressing is put on the wound and allowed to dry. Damaged tissue attaches to the dressing as it dries and is removed when the dressing is changed.
    • Hydrotherapy: Pressure from a stream of water is used to remove the damaged tissue.
  • Autolytic: A wet or moist dressing is put on the damaged tissue to keep the tissue moist and allow your body to get rid of the damaged tissue on its own as it grows new, healthy tissue underneath it.
  • Maggot debridement: Disinfected fly larvae are put in the wound to remove infected tissue, kill bacteria, and encourage healing.
• In serious cases, the infection may result in a wound that does not heal. The infection from the wound may cause a skin infection around the wound or may spread through your body to cause infection in bones or other areas.
• Hyperbaric oxygen therapy: High levels of oxygen are delivered in a pressurized chamber to treat serious infections.
• Your provider may prescribe medicine to:
  • Treat pain
• Your provider may recommend other types of therapy to help relieve pain, other symptoms, or side effects of treatment.
• You may need additional treatment to help you adjust to tissue, bone, or limb loss. This may include:
  • Physical therapy to help you regain muscle strength and teach you ways to move safely
  • Occupational therapy to help you relearn ways to do the tasks that you previously did

What can I do to help?

• You will need to tell your healthcare team if you have new or worsening:
  • Bluish color of the skin on your leg or toes below the area of the wound
  • Pain in the area around your wound
• Ask questions about any medicine, treatment, or information that you do not understand.

How long will I be in the hospital?

How long you stay in the hospital depends on many things, such as your general health, why you are in the hospital, and the treatment you need. Talk with your provider about how long your stay may be.

If your wound is severe and you have complications, you may stay in the hospital longer. Wound healing may take many weeks or months. You may need to continue a wound care or rehabilitation (rehab) program after you leave the hospital to continue treating your wound or to help you adjust to tissue, bone, or limb loss.