Wound Infection

Symptoms

DEFINITION

• Traumatic wound (break in the skin) shows signs of infection
• Includes sutured wounds, puncture wounds, scrapes
• Most contaminated wounds become infected 24 to 72 hours after the initial break in the skin

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Signs of Wound Infection

• Pus or cloudy fluid draining from the wound
• Pimple or yellow crust formed on the wound (impetigo)
• Scab has increased in size
• Increasing redness around the wound (cellulitis)
• Red streak is spreading from the wound toward the heart (lymphangitis)
• Wound has become extremely tender
• Pain or swelling increasing after 48 hours since the wound occurred 
• Wound has developed blisters or black dead tissue (gangrene and myonecrosis)
• Lymph node draining that area of skin may become large and tender (lymphadenitis)
• Onset of widespread bright red sunburn-like rash
• Onset of fever
• Wound hasn't healed within 10 days after the injury

CA-MRSA: Community Acquired Methicillin-Resistant Staphylococcus aureus

• Staphylococcus aureus is a bacteria that can cause a variety of skin infections including pimples, boils, abscesses, cellulitis, wound infections, and impetigo.
• In the 1960's strains of Staphylococcus aureus that were resistant to penicillin-type antibiotics started appearing in hospitals and health care settings. These were referred to as Methicillin-Resistant Staphylococcus aureus (MRSA) Infections.
• More recently, strains of penicillin-resistant Staphylococcus aureus have increasingly become the cause of skin infections in healthy individuals in the community. These are now being referred to as Community Acquired Methicillin-Resistant Staphylococcus aureus (CA-MRSA) Infections. There have been outbreaks in athletes (e.g., wrestling teams) and in prison populations.
• CA-MRSA requires treatment with specific types of antibiotics.
• More information about CA-MRSA is available at http://www.cdc.gov/ncidod/dhqp/ar_mrsa_ca_public.html.

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See More Appropriate Topic (instead of this one) If

• Have stitches and wound is not infected, see SUTURE QUESTIONS

Should I Call?

WHEN TO CALL YOUR DOCTOR

Call Your Doctor Now (night or day) If

• You feel weak or very sick
• Bright red, sunburn-like rash on you body
• Fever occurs
• Red streak runs from the wound
• Increasing redness around the wound
• Severe pain in the wound
• Face wound with signs of infection
• Finger wound, where finger has sausage shaped swelling and pain

Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If

• You think you need to be seen
• Pus or cloudy drainage from the wound
• Pimple where a stitch comes through the skin
• Wound becomes more tender after the second day
• Taking an antibiotic for more than 3 days and wound infection not improved

Call Your Doctor During Weekday Office Hours If

• You have other questions or concerns

Self Care at Home If

• Wound doesn't look infected and you don't think you need to be seen

Care at Home

HOME CARE ADVICE FOR MILD REDNESS OF WOUND

1. Warm Soaks or Local Heat: If the wound is open, soak it in warm water or put a warm wet cloth on the wound for 20 minutes 3 times per day. Use a warm saltwater solution containing 2 teaspoons of table salt per quart of water. If the wound is closed, apply a heating pad or warm, moist washcloth to the reddened area for 20 minutes 3 times per day.
2. Antibiotic Ointment: Apply an antibiotic ointment 3 times a day. If the area could become dirty, cover with a Band-Aid or a clean gauze dressing.
3. Pain Medication:
   • For pain relief, take acetaminophen or ibuprofen.
   • Acetaminophen (e.g., Tylenol): The dose is 650 mg by mouth every 4 hours or 1000 mg by mouth every 6 hours. Maximum dose per day = 4000 mg.
   • Ibuprofen (e.g., Motrin, Advil): The dose is 400 mg by mouth every 6 hours or 600 mg by mouth every 8 hours.
   • People who are over 65 Years of age: Acetaminophen is generally considered safer than ibuprofen. Acetaminophen dosing interval should be increased to every 8 hours because of reduced liver metabolism. Maximum dose per day = 3000 mg.
   • CAUTION: Do not take ibuprofen if you have stomach problems, kidney disease, are pregnant, or have been told by your doctor to avoid this type of anti-inflammatory drug. Do not take ibuprofen for more than 7 days without consulting your doctor.
   • CAUTION: Do not take acetaminophen if you have liver disease.
   • Read the package instructions thoroughly on all medications that you take.
4. Expected Course: Pain and swelling normally peak on day 2. Any redness should go away by day 3 or 4. Complete healing should occur by day 10.
5. Contagiousness: For true wound infections, you can return to work or school after any fever is gone and you have received antibiotics for 24 hours.
6. Call Your Doctor If:
   • Wound becomes more tender
   • Redness starts to spread
   • Pus, drainage or fever occurs
   • You become worse

And remember, contact your doctor if you develop any of the "Call Your Doctor" symptoms.

Photo Example

Impetigo of Elbow

The photo shows an abrasion of elbow that has become infected with bacteria.

Source: Wikimedia Commons, Permission is granted to copy, distribute and/or modify this document under the terms of the GNU Free Documentation License.

Lymphangitis - Left Forearm

If you look closely at this photo, you should be able to see a red streak (lymphangitis) spreading from the hand wound up into the arm.

The presence of lymphangitis means that there is an infection that needs urgent antibiotic treatment. Admission to the hospital is sometimes required.

Wound Infection - Suture Site

There is a pimple where a stitch comes through the skin. The pimple suggests a low-grade infection.

Source: LMS Inc.

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