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Published on: August 30, 2018
Healthcare practitioners' perspectives on infection management, antimicrobial resistance and stewardship in wound
Astrid Probst1, Bodo Günther2, Emma Woodmansey3
1Wound Care Nurse; Lead of Wounds/Ostomy/Continence team, Kreiskliniken Reutlingen gGmbH, Reutlingen, Germany.
Objective:
Antimicrobial resistance (AMR) poses a significant global health threat, particularly in wound care, where non-healing wounds often harbour pathogens that complicate healing and reduce treatment efficacy. Despite available guidance, antimicrobial use remains inconsistent and often lacks alignment with antimicrobial stewardship (AMS) principles. This study aimed to assess global practices in, and awareness of, infection prevention, management and AMS in wound care.
Method:
A cross-sectional survey was distributed to a global database of more than 66,000 healthcare professionals. A total of 712 responses were collected between August and September 2025. The survey contained 27 questions, exploring infection management, the use of antiseptic cleansing solutions, topical and systemic antimicrobial use and AMS implementation from across a wide range of healthcare professions globally, with a focus on wound care.
Results:
Participants represented diverse clinical roles and settings, with most identifying as specialist wound nurses. While 59.4% followed formal infection protocols, 37.2% reported not following AMS guidelines. Antimicrobial dressings such as silver, iodine, polyhexamethylene biguanide, chlorhexidine gluconate and honey were reported to be used by 88.2% of participants, with 41% reporting 'just in case' use of antimicrobial dressings. Antiseptic cleansers were also widely used. AMS leadership structures varied. Key support needs for decision-making included clinical evidence (77.9%), treatment pathways (71.6%) and guideline development (71.6%).
Conclusion:
Findings highlight both strengths and gaps in infection prevention, management and AMS implementation. High use of antimicrobial dressings in general and as a precautionary measure may indicate a lack of adherence to AMS principles. The lack of consistency in AMS leadership reported within clinical settings may indicate a variation in protocols and practice across wound care. Greater integration of evidence-based guidance, education and leadership as part of wider AMS structures and teams are needed to support consistent antimicrobial use and mitigate AMR in wound care.
Insights
Antimicrobial resistance (AMR) is a major threat in wound care. Many healthcare professionals use antimicrobial dressings without clear guidelines, highlighting a need for better antimicrobial stewardship (AMS) practices globally.
Area of Science:
- Global health
- Infectious diseases
- Wound care
Background:
- Antimicrobial resistance (AMR) is a critical global health challenge, especially in wound care.
- Non-healing wounds often harbor pathogens, complicating treatment and reducing efficacy.
- Current antimicrobial use in wound care is inconsistent and often lacks alignment with antimicrobial stewardship (AMS) principles.
Purpose of the Study:
- To assess global practices and awareness regarding infection prevention, management, and AMS in wound care.
- To identify gaps and strengths in current approaches to infection control and antimicrobial use in wound management.
- To inform strategies for improving AMS adherence and mitigating AMR in wound care settings.
Main Methods:
- A cross-sectional survey was distributed to over 66,000 healthcare professionals globally.
- 712 responses were collected between August and September 2025, focusing on wound care practices.
- The survey included 27 questions on infection management, antiseptic use, antimicrobial agents, and AMS implementation.
Main Results:
- 59.4% of participants followed formal infection protocols, but 37.2% did not adhere to AMS guidelines.
- Antimicrobial dressings were used by 88.2%, with 41% using them 'just in case'.
- Key support needs identified were clinical evidence, treatment pathways, and guideline development for decision-making.
Conclusions:
- Significant gaps exist in the consistent implementation of AMS principles in wound care globally.
- Widespread use of antimicrobial dressings, including precautionary use, suggests suboptimal adherence to AMS.
- Enhanced evidence-based guidance, education, and leadership are crucial for consistent antimicrobial use and AMR mitigation in wound care.
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