Overview
A wound infection occurs when microorganisms colonize tissue at levels that overwhelm local host defenses, typically defined as ≥10⁵ organisms per gram of tissue or any beta hem...
A wound infection occurs when microorganisms colonize tissue at levels that overwhelm local host defenses, typically defined as ≥10⁵ organisms per gram of tissue or any beta-hemolytic Streptococcus, causing impaired healing, systemic spread risk, and potential sepsis. Missed wound infection is a leading driver of surgical site infection (SSI) morbidity in Canadian hospitals, with progression from local cellulitis to necrotizing fasciitis occurring within 24–72 hours in high-risk patients. Top 3 Nursing Priorities: 1. Assess wound characteristics at every dressing change — erythema beyond wound margin >2 cm, warmth, induration, purulent exudate, or odour mandate immediate escalation. 2. Obtain wound culture BEFORE initiating or changing antibiotics — swab the wound base (Levine technique: rotate swab over 1 cm² for 5 seconds with sufficient pressure to express fluid). 3. Monitor systemic signs: temperature >38°C or <36°C, HR >90 bpm, RR >20, WBC >12 × 10⁹/L — two or more = SIRS; notify physician immediately. NCLEX Trap: Students select wound irrigation or dressing change first — the priority is always culture BEFORE antibiotics, then wound management. Never initiate antibiotics without culture in a...
