Infected Wound Management: Advanced Technologies, Moisture-Retentive Dressings, and Die-Hard Methods

Wound infection is a significant problem for the complicated,
critically ill patient. A critical care patient's plan of care can be
challenging enough without complicating it with the additional
comorbidity of a wound infection. Wound infection delays wound
closure, disrupts wound tensile strength; increases hospital length of
stay and costs; and escalates the patient's risk of bacteremia,
sepsis, multisystem organ failure, and death. 1 The goal is to reduce
and eliminate the wound infection before it leads to such drastic
consequences, especially in the age of antibiotic-resistant organisms.
It is paramount to identify classic and not-so-obvious signs and
symptoms of wound infections, correctly collect a wound specimen, and
assist in appropriate systemic and topical wound management.
Techniques to prevent wound infection and reduce bioburden include
nontoxic wound cleansing, debridement of necrotic tissue, proper
antibiotic management, and appropriate use of moisture-retentive
dressings. Advanced technologies in moisture-retentive dressings
include sustained-release silver and cadexomer iodine antimicrobial
dressings and negative-pressure wound therapy. Accurate wound
assessment, knowledge of new technologies, and applying current wound
care standards to clinical practice will assist the critical care
nurse in treating and preventing wound infections.