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Podiatry - Podiatric Theory 1 > Wound Infection > Flashcards

Wound Infection Flashcards

1
Q

What is an Acute Wound?

A

A wound with an aetiology that occurs suddenly, but then heals in a timely manner

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2
Q

What is a Chronic wound?

A

A wound that has a slow progression through the wound healing stages due to intrinsic or extrinsic factors

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3
Q

Which stages of wound healing are the main points of disruption for chronic wounds?

A
  • Inflammation
  • Proliferation
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4
Q

True or false: Chronic wounds occur most with primary intention wounds.

A

False - Secondary Intention

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5
Q

What Intrinsic Factors influence wound healing?

A
  • Nutrition - Calories / Nutrients needed for cell proliferation
  • Concurrent Disease
  • PAD
  • Age
  • Immunosuppresion / Drugs
  • Systemic Infection
  • Substance Abuse
  • Hydration - resulting in imbalance of electrolytes which impairs cell function
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6
Q

What extrinsic factors influence wound healing?

A
  • Pressure / Mechanical Stress
  • Micro-environment
  • Bacterial burden / Foreign bodies
  • Size of wound
  • Presence of necrotic tissue / slough
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7
Q

What main nutrients are important for wound healing?

A
  • Protein
  • Vitamin A
  • Zinc
  • Iron
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8
Q

Why is Protein important for wound healing?

A

Protein deficiency inhibits normal protein synthesis and wound healing. Immune response is diminished and matrix formation is delayed

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9
Q

Why is Vitamin A important for wound healing?

A

Promotes epithelialisation and granulation of healing wounds

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10
Q

Why is Zinc important for wound healing?

A

Plays an important role in the synthesis of collagen formatoin, epithelialisation ann cell proliferation

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11
Q

Why is Iron important for wound healing?

A
  • Essential for collagen formation
  • Anaemia results in decreased transportation of oxygen to damaged tissue
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12
Q

What is Hyperglycaemia?

A

High levels of sugar or glucose in the blood

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13
Q

How can Hyperglycaemia affect wound healing?

A
  • Impairs cell wall rigidity, meaning decreased blood flow through vessels, meaning less nutrients and oxygen are transported to wound site
  • This leads to prolonged inflammatory stage due to delayed macrophage introduction, and diminished leukocyte migration to wound.
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14
Q

How does infection of a wound delay the healing process?

A
  • Prolonged inflammatory stage
  • Depleting the components of the complement cascade
  • Disrupting the clotting mechanism
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15
Q

What are the five stages of the Wound Infection Continuum?

A
  1. Contamination
  2. Colonisation
  3. Local Infection
  4. Spreading Infection
  5. Systemic Infection
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16
Q

What is the Contamination stage of wound infection?

A
  • Open wound is contaminated with non-proliferating microbes
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17
Q

What is the Colonisation stage of wound infection?

A
  • Limited Proliferation of microbes within the wound
  • Host defence keeps these in check - no harm done
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18
Q

What is the Local Infection stage of wound healing?

A
  • Proliferation of microbes increases to extent that host defences cannot tolerate the bioburden
19
Q

What is the Spreading Infection stage of wound infection?

A
  • Microbes have proliferated and spread to surrounding tissue outside of the wound
20
Q

What is the Systemic Infection stage of wound infection?

A
  • Microbes have spread throughout the body via the vascular or lymphatic systems
21
Q

Through what stages of the Wound Infection Continuum would a biofilm occur?

A
  • Local Infection -> Systemic Infection
22
Q

What is a Biofilm?

A
  • Structured clusters of bacterial cells enclosed in a matrix attached to the surface of a wound
  • Appear to facilitate the survival of bacterial pathogens - there is an increasing tolerance to antibiotics
23
Q

Are Biofilms visible to the naked eye?

A

No

24
Q

What types or organisms are from the Gram Positive cocci Pathogen?

A
  • Staphylococci Aureus / MRSA
  • Beta Haemolytic Streptococci
  • Enterococci Corynebacterium
25
Q

What types of organisms are from the Gram Negative Aerobic rods Pathogen?

A
  • Pseudomonas
  • Aeruginosa
26
Q

What types of organisms are from the Gram Negative Facultative rods Pathogen?

A
  • Escherichia Coli
  • Enterobacter Species
  • Proteus Species
27
Q

What types are organisms are from the Anaerobes pathogen?

A
  • Bacteroides
  • Clostridium
28
Q

What types of organisms are from the Fungi pathogen?

A
  • Yeasts
  • Aspergillus
29
Q

What types of bacteria are normally present of wounds?

A
  • A flora of Gram +ve and -ve aerobic, or anaerobic bacteria
30
Q

What bacteria is found in higher percentage of wounds under a month old?

A

Gram +ve bacteria

31
Q

What bacteria is found in higher percentages in wounds older than a month old?

A

Gram -ve and anaerobes

32
Q

Golden-yellow purulent discharge is a clinical sympton of which bacteria?

A

Staphylococcus aureus

33
Q

Beefy red, friable and painful wounds are a clinical symptom of which type of bacteria?

A
  • Streptococcus
34
Q

Bright green wound with strong sweet malodour is a clinical symtom of which bacteria?

A
  • Pseudomonas aeruginosa
35
Q

How are wound infections diagnosed?

A
  • Clinical Observations / Presentation of wound
  • Swab only to be used to determine TYPE of infection to determine treatment - NOT FOR ASSESSING WHETHER INFECTION IS PRESENT
36
Q

What are the classic signs and symptoms of Infection?

A
  • Erythema
  • Local warmth
  • Swelling
  • Purulent discharge
  • New / Increasing pain
  • Increasing malodour
  • Delayed wound healing beyond normal expectations
37
Q

What are signs of spreading infections?

A
  • Patient attitude - change in appetite, focus etc.
  • Sepsis
  • Cellulitis
  • Osteomyelitis
38
Q

What is Cellulitis?

A
  • Bacteria (or their products) have invaded surrounding tissue to a wound causing acute, diffuse inflammation and infection of skin and underlying subcutaneous tissue
39
Q

What is Osteomyelitis?

A
  • Bone infection
  • Clinical presentation usually ‘sausage toe’
40
Q

What factors need to be taken into account for Infection Control?

A
  • ANTT is essential
  • Regular and effective hand hygeine
  • Appropriate use of sterile / non-sterile gloves
  • PPE
  • Clean Environment
  • Effective waste / sharp disposal
41
Q

How are wound infections best managed?

A
  • Minimising factors that increase infection risk
  • Infection control procedures
  • Improve bed/margins of the wound (managing exudate, removal of slough/necrotic tissue)
  • Provide education to patient / carers
  • Regular re-assessment
42
Q

What are the key anti-microbial dressings used for dressing infected wounds?

A
  • Iodene
  • Silver
  • Honey
  • PMBH (Polyhexamethylene biguanide
43
Q
A

Podiatry - Podiatric Theory 1 (14 decks)

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