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Wound Infection
HEALTH INSIGHTS

Wound Infection

By David A. Thompson, M.D. 
 | 
March 22, 2017

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Wound Infection

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Impetigo of Elbow

Lymphangitis - Left Forearm

Wound Infection - Suture Site

Definition

  • Traumatic wound (break in the skin) shows signs of infection

  • Includes sutured wounds, puncture wounds, scrapes

  • Most contaminated wounds become infected 24 to 72 hours after the initial break in the skin

Signs of Wound Infection

  • Pus or cloudy fluid draining from the wound

  • Pimple or yellow crust formed on the wound (impetigo)

  • Scab has increased in size

  • Increasing redness around the wound (cellulitis)

  • Red streak is spreading from the wound toward the heart (lymphangitis)

  • Wound has become extremely tender

  • Pain or swelling increasing after 48 hours since the wound occurred 

  • Wound has developed blisters or black dead tissue (gangrene and myonecrosis)

  • Lymph node draining that area of skin may become large and tender (lymphadenitis)

  • Onset of widespread bright red sunburn-like rash

  • Onset of fever

  • Wound hasn't healed within 10 days after the injury

CA-MRSA: Community Acquired Methicillin-Resistant Staphylococcus aureus

  • Staphylococcus aureus is a bacteria that can cause a variety of skin infections including pimples, boils, abscesses, cellulitis, wound infections, and impetigo.

  • In the 1960's strains of Staphylococcus aureus that were resistant to penicillin-type antibiotics started appearing in hospitals and health care settings. These were referred to as Methicillin-Resistant Staphylococcus aureus (MRSA) Infections.

  • More recently, strains of penicillin-resistant Staphylococcus aureus have increasingly become the cause of skin infections in healthy individuals in the community. These are now being referred to as Community Acquired Methicillin-Resistant Staphylococcus aureus (CA-MRSA) Infections. There have been outbreaks in athletes (e.g., wrestling teams) and in prison populations.

  • CA-MRSA requires treatment with specific types of antibiotics.

  • More information about CA-MRSA is available at http://www.cdc.gov/ncidod/dhqp/ar_mrsa_ca_public.html.

If not, see these topics

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When to Call Your Doctor

call now

Call Your Doctor Now (night or day) If

  • You feel weak or very sick

  • Bright red, sunburn-like rash on your body

  • Fever

  • Red streak runs from the wound

  • Increasing redness around the wound

  • Severe pain in the wound

  • Face wound with signs of infection

  • Finger wound, where finger has sausage shaped swelling and pain

call within 24 hours

Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If

  • You think you need to be seen

  • Pus or cloudy drainage from the wound

  • Pimple where a stitch comes through the skin

  • Wound becomes more tender after the second day

  • Taking an antibiotic for more than 3 days and wound infection not improved

call within 24 hours

Call Your Doctor During Weekday Office Hours If

  • You have other questions or concerns

home care

Self Care at Home If

  • Wound doesn't look infected and you don't think you need to be seen

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HOME CARE ADVICE FOR MILD REDNESS OF WOUND

  1. Warm Soaks or Local Heat: If the wound is open, soak it in warm water or put a warm wet cloth on the wound for 20 minutes 3 times per day. Use a warm saltwater solution containing 2 teaspoons of table salt per quart of water. If the wound is closed, apply a heating pad or warm, moist washcloth to the reddened area for 20 minutes 3 times per day.

  2. Antibiotic Ointment: Apply an antibiotic ointment 3 times a day. If the area could become dirty, cover with a Band-Aid or a clean gauze dressing.

  3. Pain Medicines:

    • For pain relief, take acetaminophen, ibuprofen, or naproxen.

    Acetaminophen (e.g., Tylenol):

    • Take 650 mg by mouth every 4-6 hours. Each Regular Strength Tylenol pill has 325 mg of acetaminophen.

    • Another choice is to take 1,000 mg every 8 hours. Each Extra Strength Tylenol pill has 500 mg of acetaminophen.

    • The most you should take each day is 3,000 mg.

    Ibuprofen (e.g., Motrin, Advil):

    • Take 400 mg by mouth every 6 hours.

    • Another choice is to take 600 mg by mouth every 8 hours.

    • Use the lowest amount that makes your pain feel better.

    Naproxen (e.g., Aleve):

    • Take 250-500 mg by mouth every 12 hours.

    • Use the lowest amount that makes your pain feel better.

    Extra Notes:

    • Acetaminophen is thought to be safer than ibuprofen or naproxen in people over 65 years old. Acetaminophen is in many OTC and prescription medicines. It might be in more than one medicine that you are taking. You need to be careful and not take an overdose. An acetaminophen overdose can hurt the liver.

    • Caution: Do not take acetaminophen if you have liver disease.

    • Caution: Do not take ibuprofen or naproxen if you have stomach problems, kidney disease, are pregnant, or have been told by your doctor to avoid this type of medicine. Do not take ibuprofen or naproxen for more than 7 days without consulting your doctor.

    • Before taking any medicine, read all the instructions on the package

  4. Expected Course: Pain and swelling normally peak on day 2. Any redness should go away by day 3 or 4. Complete healing should occur by day 10.

  5. Contagiousness: For true wound infections, you can return to work or school after any fever is gone and you have received antibiotics for 24 hours.

  6. Call Your Doctor If:

    • Wound becomes more tender

    • Redness starts to spread

    • Pus, drainage or fever occurs

    • You become worse

And remember, contact your doctor if you develop any of the "Call Your Doctor" symptoms.

Updated:  

March 22, 2017