Treatment of wound infections

Postoperative wound infections and infections linked to various traumatic and thermal injuries all contribute to patient morbidity and mortality, as well as to increased hospital costs. Standard practices of wound management include debridement of devitalized tissue, drainage, irrigation, and loose packing of the open wound. Antibiotics are usually effective as adjuncts to these procedures and to host resistance. Their choice, whenever possible, should be based on cultures of fresh pus (anaerobes must be obtained by airless syringe) to select an agent active against implicated pathogens. In rapidly developing infections, the choice must often be based on known probabilities until culture results are available. Specific management techniques are indicated for postoperative wounds, where brief prophylactic treatment may be needed. Traumatic wounds may require combination antibiotic therapy, and possible lack of immunity to tetanus should be considered. Most burn wound infections tend to be nosocomial; topical antiseptic agents often control burn infections while preventing the emergence of resistant bacteria.