Tag: Infection Management

Clinical Challenges in Diagnosing Infected Wounds

Given the impact of infection on delayed wound healing, determining the presence of colonization and infection is imperative to achieving healed outcomes. Chronic wounds are always contaminated, and timely implementation of management and treatment interventions is a key component of the plan of care.

 

Diagnosis of infection can be a very challenging task to say the least, and it is further complicated by the presence of biofilms for which no diagnostic tool is currently available. If not addressed in a timely manner, these local infections can become systemic, leading to sepsis, multiple organ failure, and death. The first steps are a complete and thorough history and a physical examination of the whole patient, not just the patient’s wound, while taking into account both primary and secondary findings to understand the host response.

 

Having a thorough understanding of the principles of chronic wound care and of the current diagnostic modalities available is essential to the improvement of clinical outcomes and cost reduction related to the complication of wound infection. Our focus is on the challenges to diagnosing wound infection, including accurately determining risk factors, differentiating colonization from infection, and understanding the gold standard for diagnosing wound infection … read more

Multidrug-Resistant Organisms in Wound Management

Among the greatest triumphs of modern medicine were the identification and naming of the Penicillium mold by Alexander Fleming in 1928, and its ability to inhibit bacteria growth on culture medium. Penicillin was then developed by the team of Heatley, Chain, and Florey in England during the Second World War.1 This miracle brought about the ability to cure previously untreatable diseases and devastating infections that had high morbidity and mortality rates. Along with the great efficacy of penicillin was the added benefit of very few side effects. This area of research brought about the era of antibiotic production, which began in the 1950s.

 

Mechanisms of Antibiotic Resistance and Implications for Health Care
Antibiotics target one or multiple modes of cellular communication which allow microorganisms to proliferate. These include cell wall, membrane transport, RNA function, DNA synthesis, protein function, or enzyme activity.2 Interrupting cellular communication and thus proliferation has made antibiotics very effective against a broad range of microoganisms. In looking at the history of multidrug-resistant organisms (MDROs) we must remember that there are two sides to every coin, and with the positive side of clinical efficacy against microoganisms there is also a downside. To ensure their survival, it has become necessary for microorganisms to evolve and genetically mutate. These processes have caused the organisms of today to be much different from the organisms of yesterday, much more virulent, and more multidrug resistant … read more

Clinical Challenges in Diagnosing Infected Wounds

Given the impact of infection on delayed wound healing, determining the presence of colonization and infection is imperative to achieving healed outcomes. Chronic wounds are always contaminated, and timely implementation of management and treatment interventions is a key component of the plan of care.

 

Diagnosis of infection can be a very challenging task to say the least, and it is further complicated by the presence of biofilms for which no diagnostic tool is currently available. If not addressed in a timely manner, these local infections can become systemic, leading to sepsis, multiple organ failure, and death. The first steps are a complete and thorough history and a physical examination of the whole patient, not just the patient’s wound, while taking into account both primary and secondary findings to understand the host response.

 

Having a thorough understanding of the principles of chronic wound care and … read more

The Role of Hypochlorous Acid in Managing Wounds

Reduction in Antibiotic Usage

 

by Martha Kelso, RN, HBOT

Numerous brands of hypochlorous acid have emerged in the last few years and have been marketed as “ideal” products for use in wound cleansing. These statements, of course, should draw speculation because it is rare for a single product to be used on all wounds, all clients, in all care settings, all the time, thus making it “ideal.” Let’s explore the role of hypochlorous acid in wound management and wound healing and see how it assists with reduction in antibiotic usage.

 

In its true native natural state, hypochlorous acid is a biocide produced naturally by the human body through the process of phagocytosis during the oxidative burst pathway. Because hypochlorous acid is an oxidant, it leaves nothing behind for bacteria and viruses to create resistance to and therefore does not contribute to the superbug (multidrug-resistant organisms) dilemma. Manufacturers have found a way to create hypochlorous acid outside the human body and bottle it for commercial use. These products are non-cytotoxic when concentrations (parts per million) and pH levels are acceptable for human use … read more