wound infection. wound infection has a significant impact on economic and patient outcomes (iwj...
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Wound infection
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• Wound infection has a significant impact on economic and Patient outcomes (IWJ 2008), However it is often misdiagnosed and mistreated.
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“Wound infection scares me on a daily basis. It is one of the most challenging aspects of wound management today - a major contributor to healthcare costs around the world, and the cause of significant distress to patients and carers.”
Professor Keith Harding
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Statistics associated with HAIs
• 10% of patients get a HAI• 5000 patients every year die of HAI– 5000 patients die every year of “superbug”
infection• Deaths due to MRSA are increasing• Costs £1 billion per year• 15% of HAI are preventable
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How does infection occur?
• This depends on the type of bacteria.• The number of bacteria • The host reaction (ie the patients ability to
fight infection).
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• All individuals are covered with a range of bacteria known as normal body flora, these are usually not harmful.
• When a wound occurs bacteria enters the skin and may cause an infection.
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The presence of bacteria
• Contamination– Presence of bacteria, without multiplication
• Colonisation– Multiplication, but no host reaction
• Infection– Deposition and multiplication of organisms in tissue, with an associated host
reaction( Ayton, 1985)
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Bacteria Causing Wound Infection Prolong Healing
• By destroying cells by competing for available oxygen supplies
• By releasing toxins that damage tissue causing necrosis & pus formation
• By releasing toxins into the blood stream.
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Why do wounds become infected?
Conditions for bacterial growth• time• temperature• food• moisture• A wonderful culture medium
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Who is at risk of infection?
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Is Patient at risk of Infection?• Reduced resistance• Malignancy• Medical condition -
Diabetes• Medication• Psychological• Position of Wound• Type of tissue
present• Chronic wound• Size of wound(Cutting et al 1994)• Reduced tissue
perfusion
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Tissue typesNecrosis Slough
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• How do we recognise of wound infection?
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Signs of infection
•Erythema•Heat•Swelling•Pain•Loss of function•Patient may have a temperature or be generally unwell – these patients need fast assessment!!
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Signs of infection•SUPERFICIAL BRIDGING
•FRIABLE TISSUE
•BLEEDS EASILY
•PAIN IN WOUND
•DELAY IN HEALING
•ODOUR
•Increase in exudate and colour
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You may be asked to perform a wound swab
• Clean wound first to remove surface debris.• Using gentle pressure rub the swab in a zig zag
motion over the wound bed• This is known as the levine technique• Ensure that the form has been filled in with
correct clinical information
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Prevention is better than cure
• How can we help in preventing wound infection?• Remember your patient is watching
you!!!
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Infection control is paramount• Handwashing
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Gloves and ApronsProtects you and your patient!!!
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Infection control is paramount• Clean non touch technique for dressing
change =chronic wounds• or aseptic technique = acute wounds
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What treatments might your patient be prescribed?
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Using antimicrobialsAntimicrobials are agents that either kill or inhibit the growth and division of micro – organisms. They include antibiotics (which act on specific cellular target sites) antiseptics, disinfectants and other agents (which act on multiple cellular target sites).
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Antibiotics act on ….
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Antiseptics act on ...
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Types of treatments available
• Systemic• Topical– Debridement (WBP)– Antibiotic– Antimicrobial
• Iodine• Silver• Honey• PHMB• Chlorhexidine
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• Your patient may be displaying signs of infection
• If you have identified some of the above symptoms please get the patient assessed ASAP by a GP or Nurse in charge.
• Failure to identify and treat wound infection may have serious consequences for your patient.
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Are these wound infections?
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