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Wound Management

Critically colonized/infected

Authors: Hasan Gökcer Tekin, MD, Christian Kaare Paaskesen, Med. Stud, Magnus Avnstorp, MD, Bjørn Thomas Crewe, MD and Consultant wound specialist

Definition: Critical bacterial colonization resulting in tissue damage

Description: Malodor. Yellow/green slough or thick exudate that can be wiped off wound bed. Breakdown of vital and non-vital tissue. Periwound skin with swelling, pain and spreading erythema.

Treatment aim:  Manage bacterial colonization and reduce bacterial load. Debridement of infected tissue and consider systemic antibiotic treatment according to the microbial strains.

Wound dressing (dry wounds): Hypotonic-moistened gauzes, antimicrobial ointments/crèmes, impregnanted tulles

Wound dressing (wet wounds): Hypotonic-moistened gauzes, alginates, medical honey dressings, composite silver dressings

Wound exampels:

Malignant wound on the scalp

View of malignant wound on the scalp with secondary pseudomonas aeruginosa infection. Wound bed covered in green slough and malodourous suppuration.
In this case wound dressing with alginate was used as primary contact layer.
foam bandage as a secondary dressing.

Pubic region abscess cavity

Frontal view of pubic region – Cavity wound exuding thick yellow pus and critical colonization/infection.
Frontal view of pubic region – Incision of abscess cavity due to a pressure sore associated with massive abdominal obesity.
Wound bed treated with hypotonic-moistened gauzes and mechanical debridement.
2 months post-operative with granulation tissue imbedded in fatty tissue.

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