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Diagnosing wound infection is a clinical judgement. Micro-organisms are contained in all wounds however the majority do not become infected.
An increased level of suspicion for the likelihood of wound infection should be maintained in patients with:
Wound management strategies must aim to provide optimal wound healing conditions:
Topical antibiotic preparations are used to reduce levels of bacteria within the wound bed and in burns to prevent infection. They are frequent sensitisers, can encourage the development of resistant bacteria and have no effect on healing. Therefore, their use should be carefully restricted.
Please see 13.10.1 Antibacterial preparations
Wound swabs should be taken following wound cleansing (and debridement if appropriate) from wounds which are critically colonised or clinically infected. The following wound types should be swabbed:
The swab result is to confirm that the antibiotic regime is the appropriate one. If indicated, change antibiotics in response to swab.
For suspected critically colonised wounds a two-week anti-microbial dressing challenge without microbiological swabbing is appropriate.
Systemic antibiotics should be used in the presence of systemic and spreading infection.
Antibiotics should be prescribed in line with local antibiotic prescribing policies. A swab should also be sent, and antibiotic changed if indicated by result.
Anti-microbial dressings should be considered to reduce bio burden in acute and chronic wounds that are infected or are being prevented from healing by microorganisms.
Please see 17.3 Antimicrobial dressings
If a wound is malodorous: