Brief overview
- Symptoms: Inflamed wounds are red, swollen and painful. In addition, they are often purulent and smell bad. In severe cases, surrounding tissue dies or blood poisoning occurs, which is manifested by fever, chills and rapid pulse, among other symptoms.
- Description: A wound infection is an inflammation of a wound caused by pathogens (usually bacteria).
- Causes: Microorganisms such as bacteria, less commonly viruses, fungi, and parasites invade the wound, causing it to become infected.
- Diagnosis: Discussion with the doctor, physical examinations (e.g. examination of the wound, blood test, taking tissue samples).
- Prevention: Ensure sufficient hygiene, clean wounds carefully and keep them clean, change dressings regularly.
How do you recognize a wound infection?
In severe cases, blood poisoning (sepsis) occurs, in which the immune system not only attacks the pathogens. The body is also severely affected – up to the failure of one or more organs. In addition, in rare cases it is possible for the pathogens to reach the bones directly from the inflamed wound or via the blood and inflame them (osteomyelitis).
Signs of infection directly in the wound area are:
- The wound is reddened.
- The affected skin area feels warmer (overheating).
- The infected wound hurts and is sensitive to touch.
- The surrounding tissue is hardened.
- Pus leaks from the wound.
- Increased wound secretion escapes from the wound (“weeping wound”).
- Sensations are present in the inflamed wound area
Other signs that indicate advanced or severe infection as well as blood poisoning (sepsis) are:
- Affected person develops fever and chills.
- The wound heals very slowly.
- The wound smells foul or putrid (putrefactive odor).
- Pockets and cavities form at the base of the wound.
- Abscesses (cavities filled with pus) develop.
- The wound becomes discolored (e.g., a greenish color indicates a Pseudomonas infection).
- Pain becomes more severe.
- Function of the affected limb is impaired.
- Heart rate is increased.
- Respiration accelerates.
What can be done for an infected wound?
Wound care
In the case of heavily oozing wounds, the doctor also carries out wound drainage. This involves draining the wound fluid to the outside with the aid of a plastic tube that is inserted into the wound.
The doctor then dresses the wound with sterile dressing material (e.g. wound dressings, gauze bandages, compresses). This should be changed daily if possible.
With any wound, it is important to keep it clean and protect it from contamination!
Antibiotics
If the wound infection penetrates into deeper tissue layers, inflames large areas or there is a risk of blood poisoning, the doctor administers antibiotics immediately. Targeted therapy with antibiotics is essential here to prevent serious, sometimes life-threatening complications (e.g. organ failure).
During surgery, it is not uncommon for the doctor to prescribe antibiotics to prevent infections before, during or after surgery.
If you are allergic to a particular antibiotic, be sure to inform your doctor!
Passive tetanus vaccination
Home remedies
Some home remedies are also said to help support wound healing. For example, ointments made from echinacea, chamomile, St. John’s wort oil or calendula, which are applied thinly to the wound edges, are said to have positive effects on the healing process.
Cod liver oil can be applied to burn wounds, which is said to reduce scarring. However, wound care and healing should always be accompanied by a doctor.
Other herbal remedies for infected wounds are: Balloon vine herb, propolis, sage, hops, arnica and horsetail herb.
Home remedies have their limitations. If the symptoms persist for a long period of time, do not improve or even get worse, you should always consult a doctor.
What is a wound infection?
What triggers a wound infection?
The most common cause of wound infection is the penetration of bacteria into a wound. This causes inflammation. In addition, in a few cases viruses, fungi or parasites trigger a wound infection. In most cases, the pathogens are transmitted by contact or smear infection (e.g., when the wound comes into contact with contaminated surfaces such as door handles, computer keyboards or toilet seats).
Contaminated wounds
If contaminated water gets into open wounds, this also promotes wound infections caused by bacteria such as the Vibrio vulnificus bacterium. It occurs, for example, at river mouths or in brackish water and triggers rapid skin inflammations that can even lead to blood poisoning.
Dead tissue, accumulations of older blood or tissue fluid as well as foreign bodies in the wound promote the proliferation of microorganisms and thus infections.
Infection of wounds also occurs after surgery (postoperative or surgical wound infection). Postoperative wound infections typically occur a few days after surgery, but are also possible several weeks after a procedure.
Infections after operations are sometimes serious, as they are not infrequently caused by hospital germs that are insensitive (resistant) to certain antibiotics (e.g. methicillin-resistant Staphylococcus aureus, or MRSA for short). They therefore do not respond or hardly respond to treatment with certain antibiotics.
Bite wounds and burns
If your tetanus vaccination was given more than ten years ago, you should quickly arrange for a booster!
How does a wound infection occur?
Wound infections caused by bacteria can be divided into the following forms:
Pyogenic wound infection
Pyogenic wound infection is often caused by cocci, a group of spherical bacteria (certain species of staphylococci and streptococci). Pus often forms in the wound. Other causative agents for pyogenic wound infections include Pseudomonas aeruginosa, Escherichia coli, Enterococcus, Proteus, and Klebsiella.
Putrid wound infection
Anaerobic wound infection
Anaerobic wound infection develops due to bacteria that (also) form without oxygen (e.g. Escherichia coli, Bacteroides fragilis, anaerobic cocci, Fusobacteria). These usually lead to foul-smelling abscesses that fester profusely. If left untreated, the inflammation progresses.
Bacterial-toxic wound infection
Specific wound infection
How does the doctor make the diagnosis?
If a wound infection is suspected, the general practitioner is the first point of contact. He examines the wound and either treats it himself, refers those affected to a specialist (e.g. dermatologist) or arranges direct admission to a hospital (e.g. if blood poisoning is suspected).
At the beginning of the diagnosis, the physician first conducts a detailed interview (anamnesis), which is followed by a physical examination.
Anamnesis
Physical examination
The doctor then examines the wound and, if necessary, palpates it carefully. By palpating it, he checks whether the underlying tissue is hardened, heated or swollen, if necessary.
Blood testing provides the physician with additional evidence of wound infection through characteristically altered blood values, e.g.:
- increase in white blood cells in the blood (leukocytosis)
- Increase in a non-specific inflammation value (C-reactive protein), by which the physician estimates the severity of an infection
- Increased erythrocyte sedimentation rate (ESR for short, indicates inflammation)
To detect the spread of inflammation and pus accumulation, the doctor sometimes uses imaging techniques such as an ultrasound examination (sonography), an X-ray examination or magnetic resonance imaging (MRI).
When to see a doctor?
If wounds do not heal on their own after a few days, or if symptoms even worsen, you should see a doctor right away. In case of fever, chills, nausea or shortness of breath, please do not hesitate to see your family doctor immediately.
Heavily soiled wounds or wounds with stuck foreign bodies should also be treated by a doctor. Wounds heal more slowly in people with chronic diseases such as diabetes mellitus. In this case, the doctor’s role in wound care is all the more important.
How long does it take for an infected wound to heal?
If the wound is and remains slightly inflamed, the body fights the infection itself. The wound then heals slowly but steadily if the wound is well cared for. In the case of heavily contaminated wounds that are not adequately cared for, the inflammation may worsen.
If the infection spreads in the body and continues to be untreated, there is a risk of life-threatening blood poisoning in the worst case.
Wound infections slow down the healing process and are triggers of life-threatening complications, such as blood poisoning. It is therefore important to recognize and treat infections early.
How can you prevent a wound infection?
Here’s what you can do yourself to prevent a wound infection:
- Wash or disinfect your hands thoroughly before treating your wound!
- If the wound is dirty, rinse it with cold, clean running water.
- Then disinfect the wound with an antiseptic solution, antiseptic cream or antiseptic spray.
- To prevent germs and bacteria from entering the wound, dress the wound with sterile dressing material. Make sure that you do not stick the wound (e.g. with plaster).
- Change the dressing regularly (every one to two days).
