Lecture 2 - Infection

Question 1

What is contamination?

Answer 1

normal non-replicating resident bacterial and fungi on/in skin and GI tract

count of 10^3 of microbes

Question 2

What is colonization?

Answer 2

When microflora adhere to the body’s surface and replicate but do not adversely affect the individual or cause a host response

Question 3

What is critical colonization?

Answer 3

increasing wound bioburden reaches critical point and begins to adversely affect host; however the person’s body does not mount a defense

Question 4

What is infection?

Answer 4

Microorganisms multiply and invade viable body tissues, body should mount a defense

Question 5

At what point is there so much bacteria that there is a decline in wound status?

Answer 5

Critical colonization

Question 6

What may be the only indication of infection?

Answer 6

Decline in wound status with no other explanation

Question 7

How will drainage change with infection?

Answer 7

Increase - look for need to change to more absorptive dressing OR more frequent changes

Question 8

What is the texture and color of infection drainage?

Answer 8

Purulent (thicker) drainage

Yellow, white, green or blue

Question 9

What infection has an ammonia-like smell?

Answer 9

Proseus

Question 10

What infection has a “sickly sweet” smell sometimes accompanied by a bluish wound bed?

Answer 10

Pseudomonas

Question 11

What is biofilm?

Answer 11

Polymicrobial with diverse species in thick slimy barrier made of proteins and sugars that make and secrete protective matrix that attaches to the wound base

attaches during critical colonization

Question 12

Signs of infection

Answer 12

Rubor - redness

Calor - heat

Tumor - swelling

Dolor - pain

Functio Lasea - loss of function

Question 13

When is biofilm most likely to happen?

Answer 13

Decreased immunity, poor circulation/tissue ischemia, poor nutrition

Question 14

T/F Antibiotics help to decrease biofilm.

Answer 14

False, they don’t work.

Question 15

Biofilm leads to increased inflammation which leads to _____

Answer 15

Increased exudate and slough = more neutrophils, macrophages, and MMPs in the wound bed

Question 16

T or F, the only indication of an infection could potentially be a decline in wound status with no other explanation

Answer 16

T

Question 17

During an infection, drainage may change to _______ thicker drainage that is _____ (what color)

Answer 17

purulent

yellow/white/green/blue

Question 18

What is the gold standard for wound culturing?

Answer 18

Tissue biopsy

Question 19

What is the benefit of a swab culture?

Answer 19

Less painful
Can be done bedside

Question 20

What is the disadvantage of a swab culture?

Answer 20

Can only tell you what is on the surface

Question 21

What are the 2 types of swab cultures?

Answer 21

1. Aerobic
2. Anaerobic

Question 22

T or F : Odor and drainage is a sign of infection

Answer 22

F

Question 23

Which swab culture is more common?

Answer 23

Aerobic bacteria are more common, anaerobic are typically in undermining or sinus tracts (because of lack of O2)

Question 24

What’s the difference between antibiotic and antimicrobial?

Answer 24

Antibiotic - use more systemic (IV or oral)

Antimicrobial - use more local (topicals or dressings)

Question 25

How will infection affect drainage?

Answer 25

Most likely will increase drainage

Question 26

What is biofilm?

Answer 26

Bacteria forms thick slimey barrier that attaches to wound base and affects healing

Question 27

When does biofilm happen?

Answer 27

During critical colonization

most likely happens with decreased immunity, poor circulation, tissue ischemia, poor nutrition

Question 28

Biofilm causes an increase in ____________ which increases exudate and ________

This calls more neutrophils, macrophages, and MMPs to the wound bed. These end up __________ the wound bed more

Answer 28

Inflammation

Slough

Damaging

Question 29

What is a caution with antiseptics?

Answer 29

They are cytotoxic = good at killing microbes in wound BUT also kill keratinocytes and other cells needed to heal

Question 30

T or F: you can test for a biofilm with a culture and use antibiotics to help it

Answer 30

False

Question 31

WASH YOUR HANDS

Answer 31

10-15 seconds
anti-microbial soap
wrist, hands, fingers, nails
wash before and after treatments

PREVENT NOSOCOMIAL INFECTION

Question 32

How to remove biofilm?

Answer 32

Debridement

Apply antimicrobial treatment

Question 33

What is the gold standard for wound culturing?

What kind of wound culture only tells you whats on the surface, but is les painful?

Answer 33

Tissue biopsy

Swab Culture

Question 34

Aerobic vs anaerobic swab culture

when should you use each?

Answer 34

aerobic- swabbing an area exposed to air

anerobic- swabbing areas not exposed to air (different bacteria grow here)

All wounds - Aerobic

Anaeorbic - Inside of undermining and sinus tracts

Question 35

What are the pros and cons of using antiseptics in wounds?

Answer 35

Effective at killing microbes

but also kill keratinocytes and other cells needed to heal

They’re being used less frequently in woundcare, but still have a place and time for use

Question 36

Handwashing guidelines?

Answer 36

Wash hands atleast 10-15 seconds using antimicrobial soap, include wrist, hands, fingers, nails

or use alcohol hand rub before and after treatments

Question 37

What is a nosocomial infection

Answer 37

An infection from the hospital/developed at the hospital

note: depending on severity can be a sentinel event (serious injury or harm)

PAYMENT MAY BE WITHHELD FROM INSURANCE FOR THESE :(

Question 38

Standard woundcare precautions

Answer 38

Universal precautions

Handwashing + PPE

Gloves worn entire treatment, change gloves between different procedures on the same patient

Question 39

Knock knock

Answer 39

Steven is here to say you’re doing great!

Question 40

Sterile technique

Answer 40

Meticulously make sure u dont touch anything that isnt sterile besides the wound

signficant prep and set up required

discard all contaminated items

Research shows that sterile technique doesnt make a big difference unless dealing with burns