Management of

Wound Infection
Dr. Mgs. Roni Saleh, SpB-SpBP(K)
Definition
Wound Infection after trauma is a clinical one :
Wound erythema
Induration
Disproportionate pain
Discharge of pus
Severe cellulitis and / or necrosis of the wound edge
is evidence of severe evidence
Culture are commonly helpful in treatment
Necrotizing fasciitis may be a consequence of an initial
traumatic injury.
The diagnosis of necrotizing fasciitis should be
suspected when there is rapidly developing skin
necrosis, blestering, and bullae formation about the
wound.
The microbiology : group A streptococci, or a
polymicrobial microflora of aerobic and anaerobic
species
Deep penetration of clostridium perfingens
from puncture wound or other traumatic injuries
can result in the rapid emergene of gas gangrene.
Infection due to clostridial myonecrosis is
commonly associated with fairly mild signs of
inflamation at the site of pucture wound, but the
patients have severe toxemia.
The management of traumatic wound infection
is to open the wound, drain pus and
mechanically remove fibrin and other infected
debris.
Systemic antibiotics may not be necessary in
simple wound abscess, but when cellulitis or
advancing necrosis is present they are warranted.
Wound Dressings
Wound dressings can be broken down into several
groups which include gauze, semipermiable film
dressing, foam dressing, alginate and hydrocolloid.
A number of solution (acetic acid, sodium hypochlorite,
etc.) have been added to the basic gauze dressing in an
attempt to minimize bacterial growth, but
unfortunately, almost all of them impair wound healing
by damaging host tissues.
Hydrocolloid dressing are also attractively easy
to manage for wound that are closed primary.
Although their simple application cost is higher,
both hydrocolloid and alginate dressing much
less frequent change than wet - to - dry dressing,
which may make them cost effective.