Infections

The concept of wound hygiene has grown traction recently as clinicians increasingly adopt an antibiofilm-oriented approach to wound care. Despite the increase in recognition of wound hygiene as a four-step protocol, many definitions for wound care terminology evolve as clinical understanding grows and new wound care protocols continue to emerge.

Staphylococcus aureus, or "staph" bacteria normally reside on the skin and nose and is usually harmless. Most individuals do not manifest any symptoms of illness; however due to its prevalence, this pathogen is a common culprit of hospital-acquired infection. Acute skin infection may even develop due to drug resistance. Methicillin-resistant Staphylococcus aureus, more commonly referred to as MRSA, is a bacterial organism resistant to many antibiotics, in particular the -cillins. The overuse and misuse of antibiotics in the past several decades has contributed to its resistance to certain antibiotics.

Emily Greenstein, APRN, CNP, CWON-AP, FACCWS Pseudomonas aeruginosa (PA) is a common gram-negative aerobic bacilli bacterial infection in chronic wounds. PA is often present in soil, water, humans, and on the surface of medical devices, plants, and animals. PA is an opportunistic infection that can cause serious disease. Patients with an immunocompromised state will often have PA infections.

Laura Swoboda, DNP, APNP, FNP-C, FNP-BC, CWOCN-AP Due to factors including the lack of affordable housing and the retrenchment of social programs, the prevalence of homeless people experiencing homelessness in the United States and those residing in homeless encampments and tent cities has increased. People experiencing homelessness have their own markedly increased health care disease burdens, in addition to issues with complex health care access.

On September 1, the Centers for Disease Control and Prevention (CDC) issued a health advisory regarding the pathogen Vibrio vulnificus. V. vulnificus is a rare but aggressive species of Vibrio bacteria commonly found in warm coastal waters, usually on the Gulf Coast.

In Part 1 of this series on recalcitrant wounds, we started our discussion on some factors on why wounds may seem to stall or stop healing. It can be very difficult in trying to treat a wound that seems to resist all efforts to get it to heal. In Part 1, we discussed some signs of a recalcitrant wound, exploring alternative etiologies behind a wound and how dressings can impact a wound’s ability to heal. In Part 2, we will discuss other possible factors that can cause a recalcitrant wound, including, infection, prolonged or chronic inflammation, the presence of necrotic tissue, the edge effect, nutrition as well as socio-economic factors. We must also bring up the fact that, due to underlying comorbidities or complications, some wounds may never heal and how to start a conversation about this.