March 2006, Volume 36 Number 3 , p 76 - 77
CALIANNO, CAROL RN, CWOCN, MSN; JAKUBEK, PAMELA RN, CWOCN, MSN
IN OUR FEBRUARY COLUMN, we described assessing a patient with a chronic wound, relieving pain, and debriding the wound. Now let's look at managing infection and choosing a dressing.
Managing the bacterial load
All chronic wounds contain bacteria, and that's not necessarily bad; low levels of bacteria can stimulate the inflammatory phase of wound healing. But higher levels impair healing. The level of bacteria determines whether the wound is truly infected.
If the patient has decreased resistance because of immunosuppression, diabetes, or malnourishment, even low levels of bacteria can cause serious infection.
Wounds containing bacteria are categorized as follows:
* Contaminated: Bacteria are present on the wound surface, but haven't multiplied. * Colonized: Bacteria have multiplied on the wound surface but haven't invaded the wound tissue. Contamination ...