Practice development: Ensuring that the correct antimicrobial dressing is selected ?????????????????????????????????????
????????????????????
antiseptic/antimicrobial dressing to prevent the biofilm from reoccurring.
Cleansing Some issues have focused on which cleansing
Table 2: Bioburden checklist Group Signs and symptoms A
agents are appropriate. Only minor and contradictory differences in the related prevalence of infections between tap water and saline cleansing have been reported[11]
. Antiseptic cleansers were at one time considered toxic and
Date (year/month/day)
n Stalled healing n Friable and bright red granulation tissue
n Increasing or altered exudate n Increasing malodour n Localised oedema n Increased pain
B
n Increasing induration plus erythema extending well beyond wound borders
n Wound breakdown and/or satellite areas of breakdown
n Lymphangitis n General malaise
C
n Fever n Rigors n Chills n Hypotension n Organ failure
Category: I, II, III, IV Clinician initial
Table 3: Clinical interpretation of bioburden checklist Level of risk
Colonised: at risk
Localised infection (Critically colonised)
Spreading infection Systemic infection
Category Definition I
II III IV
No signs or symptoms from any group. Clinical decision based on location of wound and co-morbid conditions
Presence of two or more signs or symptoms from Group A (SeeTable 2)
Presence of two or more signs or symptoms from Group A PLUS one or more from Group B
Presence of any sign or symptom from Groups A and B PLUS one or more from Group C
References
6. James GA, Swogger E, Wolcott R et al. Biofilms in chronic wounds. Wound Repair Regen 2008; 16(1): 37–44.
7. Wolcott RD, Rhoads DD, Bennett ME, et al. Chronic wounds and the medical paradigm, J Wound Care 2010; 19(2): 45–53.
8. Cutting KF, Harding KG. Criteria for identifying wound infection. J Wound Care 1994; 5(4): 198–201.
9. Gardner SE, Frantz RA, Doebbeling BN. The validity of the clinical signs and symptoms used to identify localized chronic wound infection. Wound Repair Regen 2001; 9: 178–86.
www.woundsinternational.com
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Practice Development
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