As healthcare professionals, pharmacists play a vital role in supporting patients with wound care management.
One crucial aspect to consider in wound care is the presence of bacteria. Bacteria can significantly impact the healing process, and pharmacists must have a comprehensive understanding of bacteria's role in wound infections. Here we look at different types of bacteria, their effects on wound healing, and appropriate interventions to ensure optimal wound care.
"Given increasing antimicrobial resistance and microbial emergence related to antibiotic overuse and misuse, there’s compelling evidence that antiseptics are an integral part of antimicrobial stewardship strategies for open wound infections"
TYPES OF BACTERIA FOUND IN WOUNDS:
Wounds provide an ideal environment for bacteria
to thrive due to the compromised skin barrier.
Common bacteria found in wounds, including:
- Staphylococcus aureus: A leading cause of wound infections, often resistantto antibiotics.1
- Streptococcus pyogenes: Known for causing strep throat, it can also infect wounds.2
- Pseudomonas aeruginosa: Commonly found in burns and produces toxins that hinder wound healing.3
- Escherichia coli: Typically associated withurinary tract infections but can infect wounds in certain cases.4,5
IMPACT OF BACTERIA ON WOUND HEALING:
Bacterial colonisation in wounds can impede the healing process through various mechanisms:
- Biofilm formation: Bacteria can form protective biofilms that make them resistant to antibiotics and host defences.6
- Delayed inflammation resolution: Chronic bacterial presence can prolong the inflammatory phase, hindering tissue repair.7
- Toxin production: Bacteria like Staphylococcus aureus can produce toxins that damage healthy tissue and delay healing.8
- Impaired angiogenesis: Some bacteria can disrupt the formation of new blood vessels, essential for wound healing.7
STRATEGIES TO MANAGE BACTERIAL INFECTIONS:9
- Assessment and classification: Evaluate wounds for signs of infection, such as erythema, increased warmth, purulent discharge, or delayed healing.10
- Antimicrobial selection: Collaborate with healthcare providers to select appropriate antimicrobial therapies based on bacterial culture and sensitivity results.10
- Topical antiseptics: Recommend appropriate topical antiseptic therapy. Given increasing antimicrobial resistance and microbial emergence related to antibiotic overuse and misuse, there’s compelling evidence that antiseptics are an integral part of antimicrobial stewardship strategies for open wound infections.10,11
- Wound dressings: Advise on appropriate dressings, such as antimicrobial dressings, that can help control bacterial growth.12
Patient education: Educate patients on proper wound care techniques, including hand hygiene, dressing changes, and recognising signs of infection.13,14
MULTIDISCIPLINARY COLLABORATION:
Pharmacists should actively collaborate with other healthcare professionals to optimise wound care outcomes:
- Infection control teams: Work closely with infection control specialists to implement best practices and guidelines.
- Wound care nurses: Engage with wound care nurses to ensure proper dressing selection, application, and patient education.
- Surgeons and physicians: Consult with surgeons and physicians to discuss wound management strategies and antimicrobial therapy.
By staying updated on the latest research and guidelines, collaborating with healthcare teams, and educating patients, pharmacists can play a vital role in preventing and managing bacterial infections in wounds. Together, we can ensure optimal wound care outcomes and contribute to patients' overall well-being.
*References available on request
WHY PROTECT WOUNDS?
Keeping a wound safely protected is the key to an undisturbed healing process. When exposed, the wound is left defenceless against elements that can cause infection, swelling, or other complications.
- Bacteria: If left uncovered, bacteria have the potential to enter the wound, possibly cause infections and delay healing.
- Water: Waterproof wound protection is essential to prevent the wound from getting in contact with water. Indeed, water may be contaminated with bacteria or contain harmful elements such as chlorine, which can significantly increase the risk of infection and delay wound healing. In addition, contact with water will swell the skin and can lead to delay in wound closure. Bacteria and germs can then more easily enter the wound, creating an even greater risk of infection.
- Moist Healing: Protecting wounds using principles of moist wound healing will support the natural healing process. This is used in hospitals for the treatment of chronic wounds and is proven to heal wounds more safely, completely, and quickly, with less likelihood of scarring than if the wound was allowed to dry out.
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