Unstagable wound presentation - ANSWER Cannot confirm depth or bed due to
slough/eschar
stage 3 or 4
Incontinence associated dermatitis - ANSWER Most common form of MAD
Inflammation of the skin that occurs when urine/stool come in contact with skin
Bioburden - ANSWER degree or load of organisms that create contamination in a
wound. TErm used to justify use of antimocrobial dressings
Factors that affect bioburden - ANSWER Numbers, activity, mix of different bacteria
and host resistance
bacteria shape - ANSWER Three common:
Round (cocci)
Cylinder (Rod)
Spiral (Spirillum)
Can be more than one name
gram positive/negative - ANSWER Take the organism and see if they retain (positive)
or lose (Negative) the staining
1
,Aerobic/Anaerobic - ANSWER Needs oxygen/Doesn't need oxygen
Biofilms - ANSWER Complex microbial communities.
Have multiple types of bacteria in them
Form as bacteria presence increases and bonding occurs
As they cluster, become more resistant to immune system
Can form on or under wounds
Contamination - ANSWER Presence of non-replicating bacteria on wound surface. All
wounds are contaminated
Colonized wound - ANSWER Once a contaminated wound begins to have bacterial
replication
Local infection - ANSWER Point at which colonization begins to affect wound healing.
Doesn't invoke host immune reaction
Clinical indicators of local infection - ANSWER Wound healing slows or stops
hypergranulation, bleeding, friable, breakdown, enlargement
pathology of local infection - ANSWER Bacteria and cells fight for oxygen and nutrients
exotoxins affecting wound
increasing bacterial loads increasing macrophage and neutrophil response
Spreading wound infection - ANSWER presence of microbes that cause a
local/systemic reaction
Systemic infection - ANSWER Spread via the lymph or vascular system
2
, Severe sepsis + shock
Most common wound infector - ANSWER Stap aureus, Psuedo aeruginosa and
Streptococci
local factors that affect host immune response - ANSWER Size and location
Necrotic tissue/ foreign bodies
Scar presence
Previous radiation
Poor treatment
Systemic factors that affect immune response - ANSWER DM
Bad perfusion
edema
Medication
Malnutrition
Drug use
Biopsy guidelines for suspected infected wounds - ANSWER Maybe required after 1.
suspicion of infection
2. poor healing after 2 weeks
If you have old cultures from a wound - ANSWER Use those reccomended abx first,
reculture and wait for new results
Culture swab reccomended technique - ANSWER Cleanse wound with normal saline
Debried beforehand
Take from clean healthy appearing tissue
3
slough/eschar
stage 3 or 4
Incontinence associated dermatitis - ANSWER Most common form of MAD
Inflammation of the skin that occurs when urine/stool come in contact with skin
Bioburden - ANSWER degree or load of organisms that create contamination in a
wound. TErm used to justify use of antimocrobial dressings
Factors that affect bioburden - ANSWER Numbers, activity, mix of different bacteria
and host resistance
bacteria shape - ANSWER Three common:
Round (cocci)
Cylinder (Rod)
Spiral (Spirillum)
Can be more than one name
gram positive/negative - ANSWER Take the organism and see if they retain (positive)
or lose (Negative) the staining
1
,Aerobic/Anaerobic - ANSWER Needs oxygen/Doesn't need oxygen
Biofilms - ANSWER Complex microbial communities.
Have multiple types of bacteria in them
Form as bacteria presence increases and bonding occurs
As they cluster, become more resistant to immune system
Can form on or under wounds
Contamination - ANSWER Presence of non-replicating bacteria on wound surface. All
wounds are contaminated
Colonized wound - ANSWER Once a contaminated wound begins to have bacterial
replication
Local infection - ANSWER Point at which colonization begins to affect wound healing.
Doesn't invoke host immune reaction
Clinical indicators of local infection - ANSWER Wound healing slows or stops
hypergranulation, bleeding, friable, breakdown, enlargement
pathology of local infection - ANSWER Bacteria and cells fight for oxygen and nutrients
exotoxins affecting wound
increasing bacterial loads increasing macrophage and neutrophil response
Spreading wound infection - ANSWER presence of microbes that cause a
local/systemic reaction
Systemic infection - ANSWER Spread via the lymph or vascular system
2
, Severe sepsis + shock
Most common wound infector - ANSWER Stap aureus, Psuedo aeruginosa and
Streptococci
local factors that affect host immune response - ANSWER Size and location
Necrotic tissue/ foreign bodies
Scar presence
Previous radiation
Poor treatment
Systemic factors that affect immune response - ANSWER DM
Bad perfusion
edema
Medication
Malnutrition
Drug use
Biopsy guidelines for suspected infected wounds - ANSWER Maybe required after 1.
suspicion of infection
2. poor healing after 2 weeks
If you have old cultures from a wound - ANSWER Use those reccomended abx first,
reculture and wait for new results
Culture swab reccomended technique - ANSWER Cleanse wound with normal saline
Debried beforehand
Take from clean healthy appearing tissue
3
