Wound Care Infection

In wound care we often think of a open wound infection as being a yes or a no. Is the wound infected, or is it not infected? And for us, that would be great if it were always that clear, but it’s really not. Infection is actually a spectrum that goes from simply having bacteria there to truly being embedded within the tissue and invading the tissue itself. And even within that spectrum, we divide it up into different categories. But the reality is there’s some crossing over from each of those categories. But for the purposes of today, we’re going to divide the wound infections up into four categories so that we can kind of get a picture of what’s happening.

And first of all is simply contamination. And that just means that bacteria is present within the wound, but there’s not any reaction by the host. Okay? So, simply having something that grows there doesn’t mean that it’s causing any harm to the host. There’s no response from the host. It’s just there.

A step beyond that is colonization. So, now the bacteria is within the wound, and it’s multiplying. But again, sometimes it will not produce a host reaction. Now, it can initiate a host reaction. But with colonization, the bacteria is there, it’s growing, and it’s multiplying. So, it’s setting up shop. It’s colonizing.

There’s this fine line that occurs between when it’s just colonizing and when it becomes tissue infection. And that’s kind of the critical point that we call critical colonization. So, it’s multiplication of bacteria causing a delay in wound healing. It’s usually associated with an exacerbation of pain not previously reported, but still no overt host reaction.