Infection Management

By Luis Fernandez, M.D., KHS, KCOEG, FACS, FASAS, FCCP, FCCM, FICS

Complex wounds have plagued humankind for thousands of years, and the search for methods to combat infectious agents has been met with limited success. Although silver, iodine, and honey still hold a place in a long list of treatments employed today, in general, these and other antimicrobials have at least one thing in common: unlike pure hypochlorous acid (HOCL), none of them are native to humans (iodine is not present in humans in an antimicrobial role).

By Cathy Wogamon, DPN, MSN, FNP-BC, CWON

From the first announcement to the current screening, closings, and practice modifications, the novel coronavirus (severe acute respiratory syndrome coronavirus 2, which is the cause of coronavirus disease 2019 [COVID-19]) has increasingly created panic among the general public. For those of us in the health care profession, it has been an ongoing battle to keep up with the changing guidelines while helping the public and patients understand the virus, how it is spread, and why appointments are being rescheduled or modified in some fashion. Although the practices listed here are "preaching to the choir," it's always a good idea to review the basics.

By Thomas E. Serena, MD, and Khristina Harrell, RN

With apologies to Nietzsche: "What kills you makes you dead." The slow painful death of large and expensive in-person conferences has begun. Technological evolution has selected against these lumbering dinosaurs, but, rather than a massive asteroid, the parlous event came as a microscopic virus. Lockdowns and social distancing enacted in response to COVID-19 pushed us all deeper into a virtual world, a world that will persist long after COVID resolves.

By the WoundSource Editors

Antifungal cream is a broad term used to describe a range of products containing antifungal agents that are topically applied to the skin to control and manage fungal infections. These products may be formulated with a moisture barrier to protect and condition the skin. Antifungal creams are used both as a palliative treatment for existing fungal infections and as a prophylactic measure in cases where there is a risk of fungal infection.

By the WoundSource Editors

Wound healing is a complex biological process that involves a sequence of molecular and cellular events to restore damaged tissue. These events occur within the extracellular matrix, a complex three-dimensional acellular environment that is present within all tissue and essential for life. Remodeling within this extracellular matrix is necessary for tissue repair throughout the wound healing process, including during the inflammatory phase.

By the WoundSource Editors

The venous leg ulcer (VLU) is the most common type of chronic leg wound, and it can be challenging to manage. VLUs account for up to 90% of all chronic leg ulcers. Proper diagnosis and treatment planning are key to wound healing outcomes. This fact is particularly true for older adults, who have an annual VLU prevalence of 1.7%.

By the WoundSource Editors

Antimicrobial resistance is one of the greatest health threats of the 21st century. The current number of deaths attributed to drug-resistant infections is 700,000, yet this figure is expected to grow more than 10-fold by 2050. Although the rapid administration of antibiotics to treat infections often reduces morbidity and saves the lives of many patients each year, it has also been shown that up to 40% of all antibiotics prescribed are either unnecessary or inappropriate, which contributes to the growing problem of antibiotic resistance.

By the WoundSource Editors

All wounds are complex non-sterile environments, often requiring a succession of intersecting phases of wound healing to repair completely. When epithelial tissue is compromised by a wound, contamination by common skin surface microbes may result in infection or the formation of a biofilm that impedes healing. Although systemic antibiotics are necessary for treating clinically infected wounds, the use of antibiotics and antiseptics in non-healing, non-infected wounds is debated.

By The WoundSource Editors

Antimicrobial stewardship is becoming an increasing concern for nearly all clinical professionals. Antimicrobial resistance is often considered one of the most serious health threats of the 21st century. It is estimated that currently approximately 700,000 people die each year of drug-resistant infections, and experts predict that this figure could increase to 10 million deaths each year by 2050. On a global scale, antimicrobial resistance compromises the ability of clinicians to treat infectious diseases and thereby undermines many of the recent advances in modern medicine.

By the WoundSource Editors

Antimicrobial dressings: Dressings that contain substances with antimicrobial properties, such as silver, chlorhexidine, honey, or iodine. These dressings can be effective in reducing bioburden and promoting healing.

Antimicrobial stewardship: Collective measures that are taken to slow the evolution of multidrug-resistant organisms.

Bacterial resistance: The capacity of bacteria to withstand the effects of antibiotics that are meant to kill them; this term is commonly used interchangeably with antibiotic resistance.