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Podiatry Yr1 Dressings > Wound Infection > Flashcards

Wound Infection Flashcards

1
Q

What are the signs of infection

A

Erythema, warmth, swelling, purulent discharge, malodour, new increasing pain.

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2
Q

5 methods of debriding wounds

A

Surgical - scalpel
chemical - silver dressing
mechanical - wet to dry dressing
Laval- maggots
Hydro - pulse lavage with saline

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3
Q

Name some things you would look at when assessing a wound.

A

*Site
*Length, width, depth in cm.
*Appearance - start at the centre and then work your way out eg, 70% red 30% black
*Edges/margins- are they fixed around the wound or separated, are edges rolled under, is there new skin growth
*Exudate - colour, amount, consistency, odour
*Peri-wound - the condition of intact skin around tissue.

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4
Q

What is a bio film

A

A cluster of bacterial cells enclosed in a matrix attached to the surface. facilitates the survival of bacterial pathogens. increase tolerance to antibiotics.

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5
Q

How would we evaluate if treatment of a wound is working?

A

If the wound is healing, reduction in the size of the wound.

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6
Q

What are the main nutrients important for wound healing

A

Vit A
Zinc
Protein
Iron

Poor nutrition can be a result of
Deficiency of intake
non-availability
Inability to adequately absorb nutrients

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7
Q

Why is protein important for wound healing

A

Inadequate intake inhibits normal protein synthesis and wound healing. The immune resonse is diminished and there is a delay in matrix formation

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8
Q

Why is Vit A important in wound healing?

A

Vit A promotes epithelialisation and granulation of healing wounds

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9
Q

Why is zinc important in wound healing

A

Deficiency in zinc is associated with poor wound healing because it plays an essential role in collagen synthesis, epithelialisation and cell proliferation

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10
Q

Why is iron important in wound healing?

A

Anaemia will result in decreased of o2 to damaged tissue and may delay wound healing. Iron is also required for collagen formation

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11
Q

What is hyperglycemia

A

High levels of glucose,blood sugar in the blood

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12
Q

How does hyperglycemia affect wound healing

A

excess glucose sticks to cells and makes cell walls rigid, impairing the blood flow through the small vessels. This reduces the amount of nutrients to the wound.
Prolonged inflammatory stage due to the delayed macrophage introduction and diminished leukocyte migration

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13
Q

How does infection of a wound delay the healing process

A

Prolongs the inflammatory phase
depletes the components of the comlement cascade
Disrupts the normal clotting mechanism

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14
Q

5 stages of the wound infection continuum

A

Contamination
Colonisation
Local Infection
Spreading Infection
Systemic infection

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15
Q

Contamination stage of wound healing?

A

Open wound are contaminated with non-proliferating microbes

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16
Q

Colonisation stage of wound infection

A

Limited proliferation of microbes within the wound, host defences keep these in check– no harm

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17
Q

Local infection stage of wound infection

A

Further proliferation of microbes host defence can no longer tolerate bioburden

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18
Q

Spreading infection stage of wound infection

A

Microbes proliferate and spread to surrounding tissue

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19
Q

Systemic infection stage

A

Microbes spread throughout the body via the vascular or lymphatic systems

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20
Q

At stage of the wound continuum would bio film occur

A

Local infection, Spreading infection and Systemic infection

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21
Q

What type of microorganism is gram positive cocci pathogen

A

*Staphylococci aureas (MRSA)
*beta-hemolytic Streptococcus pyogenes
*enterococci
*Corynebacterium

22
Q

What type of organism are from the gram negative aerobic rods pathogen

A

Pseudomonas aeruginosa

23
Q

What type of organism are from the gram negative faculatative rods

A

*Escherichia coli
*Eterobactar species
*Proteus species

24
Q

What type of organism are anaerobes pathogen

A

Bacteroides
Clostridium

25
Q

What type of organism are from the fungi pathogen

A

Yeasts (candida)
Aspergillus

26
Q

What type of bacteria are generally present in wounds

A

Mixed flora of Gram -ve and gram +ve, aerobic or anaerobic bacteria

27
Q

Which bacteria is present in high percentage of wounds that are less than 1 month

A

gram +ve bactera

28
Q

Which bacteria is present in high percentage of wounds that are over a month old

A

gram -ve and anaerobes

29
Q

What are the clinical signs of Staphylococcus aureus

A

Golden yellow purulent discharge

30
Q

If a wound is beefy red, friable and painful which bacteria is the causative pathogen

A

Streptococcus

31
Q

Clincal signs of bacteria Psuedomonas aeruginosa

A

Bright green- very strong sweet odour

32
Q

How are wound infections diagnosed

A

clinical observations, presentation of wounds is key to diagose wound infection
Microbiological investigation could be used to establish the specific pathogen to assist course of treatment
Clinical documentation essential for monitoring wound staus

33
Q

What are the signs and symptoms of a spreading/systemic infection

A

Cellulitis

34
Q

What is cellultis

A

Occurs when bacteria or its products have invaded surrounding tissue causing diffuse acute inflammation and infection of skin or subcutaneous tissues

35
Q

What to look for in chronic wounds

A

*Hypergranulation
*Bleeding/friable/bright red granulation
*Epithelial bridging and pocketing in granulation tissue
*Delayed wound healing beyond expectations
*Increasing malodour
*New or increased pain/change in sensation
*New ulceration of the peri-wound

36
Q

What factors need to be taken into account for infection control

A

ANTT is essential during dressing changes
*regular and effective hand hygiene
*appropriate use of sterile/non sterile gloves
*PPE
*clean environment
Effective waste/sharp disposal

37
Q

How are wound infections best managed

A

*minimise risk factors that increase infection risk where possible
*infection control procedures
*improve bed margins of the wound (manage exudate, removal of necrotic/slough)
*provide education to patient/carers
*regular reassessment

38
Q

Which antibiotic is used for gram +ve staph and strep infections

A

Penicillin

39
Q

How does penicillin work

A

Interferes with synthesis of bacterial cell wall

40
Q

name some examples of penicillin used on skin and soft tissues

A

Amoxicillin
Flucloxicillin

41
Q

Which antibiotic is used for gram +ve and -ve bacteria

A

Cephalosporin

42
Q

How does cephalosporin work

A

It alters formation of cell wall

43
Q

Name a cephalosporin used on skin and soft tissues

A

Cefalexin

44
Q

Name the type of antibiotic, its action and an example used on skin and soft tissues for anaerobes infection

A

Nitroimidazoles
Damages DNA
Metronidazole

45
Q

Name the type of antibiotic, its action and an example used on skin and soft tissues for staph and strep infection

A

Macrolides,
blocks protein synthesis-preventing reproduction of bacteria
Erythromycin
Clarithromycin

46
Q

Name the type of antibiotic, its action and an example used on skin and soft tissues for Gram -ve , gram +ve including Pseudmonasinfection

A

Fluroquinolone
Stops DNA being repaired/replicated
Ciprofloxacin

47
Q

Antimicrobial dressings can be used to …….

A

kill microorganisms and thereby reduce bacterial burden. no use on dry wounds

48
Q

What are the key anti-microbial dressings used to dress infected wounds

A

Iodene
Silver
Honey
PMBH (Polyhexamethylene biguanide)

(Idoflex, Atruman Ag, Activon tulle

49
Q

Things to know when assessing a wound

A

*how long wound been there
*What medication patient is on
*Size, Site, length, width and depth
*take a photo with patient’s details and date
*levels of exudate, low/moderate/high
*is an infection present, take a swab and send for microscopy
*start the patient on antibiotics and refer to GP
*level of pain

50
Q

What is the time principle of wound healing

A

Tissue debridement, remove non-viable tissue
Infection/inflammation- remove infected tissue via topical systemic antibiotics
Moisture - apply moisture balancing dressing
Edge of wound non-advanced or undermined, reassess cause, debridement , peri-wound

Podiatry Yr1 Dressings (3 decks)

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