Do you remember the last time you fell on the playground and injured your skin? Or accidently slashed your fingertip while using a knife? Maybe it was not very long ago. You might also remember what happened after that. The injury might have oozed some blood, which stopped soon after to reveal reddish, damaged skin. If the injury was deep, you may have visited the doctor.
The doctor would have cleaned the damaged skin and covered it with a bandage. Over the next few days, you may have observed the injured skin change colors from bright red to bluish-black, and finally, the injury would have been replaced with fresh skin. After the damaged skin has healed, you may see a flesh-colored scar at the location of the injury.
If this sounds familiar, it means that your accidental injury resulted in what is called a wound, which was followed by the normal steps of recovery known as wound healing. It is likely that your wound eventually healed without any problems.
The skin is the largest organ of the body and it acts as a protective covering shielding the body from the outer environment.
The epidermis is the outermost layer of the skin, consisting of cells known as keratinocytes. The middle layer, or dermis , contains another type of skin cell known as fibroblasts, and blood vessels that carry blood to and from the skin.
The dermis also has tissue fibers that provide support to cells within the skin. Superficial wounds are injuries to only the epidermis.
Deep wounds extend all the way into the dermis, causing greater damage to skin cells and tissue fibers, resulting in a gap in the skin. In deep wounds, the blood vessels also get damaged, leading to leaks, which is why these wounds bleed. So, what happens after we get hurt and how does the body respond to a wound? After an injury, the body starts repairing damaged skin through the process of wound healing, which involves a set of four well-coordinated steps Figure 1 [ 1 ].
The first step involves stopping the blood flow by formation of a blood clot at the wound, and this happens almost immediately after an injury. To form a clot, blood components interact to form a loose plug of protein strands and blood cells at the wound site.
Next, large numbers of immune cells arrive at the wound site through blood vessels, releasing chemicals that start to build new tissue in the wound. In the third stage, the wound is gradually filled with new skin tissue that replaces the gap created by the injury.
This works somewhat like building blocks, in which different types of skin proteins act as a solid, sticky surface on which many layers of skin cells can attach and grow. In the final stage of wound healing, this new skin tissue gets strengthened and completely fills the wound. This step replaces the damaged tissue with scar tissue that closely resembles normal skin. This completes the process of wound healing. The entire process of wound healing starts immediately after injury and usually takes a few weeks.
However, in certain situations, wounds do not follow this coordinated repair process, taking a long time to heal or not healing at all. Other common signs include:. Treatment will depend on how severe the wound is, its location, and whether other areas are affected. It may also depend on your health and the length of time you have had the wound. If you are concerned about possible wound infection contact your local Coastal Urgent Care and speak with one of our doctors today.
No Comments. Common causes for infected wounds include: Bites — Wound infections due to bites tend to reflect the microorganisms present in the saliva and oral cavity of the animal that created it. They may also become infected by exposure to microorganisms in the hospital environment. Burns — Burns may be caused by scalding or flammable liquids, fires and other sources of heat, chemicals, sunlight, or electricity.
Signs of an infected wound: As wounds are healing, there are often some distinct changes that occur to the skin both around and near the wound.
Here are a few things that you can expect — and the things to watch out for: Fluid Normal: This is one of the ways our bodies naturally heal themselves. Drainage can either be clear or slightly yellow in color. Redness Normal: A small amount of redness and inflammation around the tissue that has been altered. Raised Skin Normal: Most surgical procedures produce some type of scar, which is completely normal.
Other common signs include: An unpleasant odor coming from the wound Generalized chills or a fever Excessive swelling or increasing redness around the wound Increasing tenderness or throbbing of the wound Swelling lymph nodes in your neck, groin, or armpit Red streaks within the skin progressing away from the wound Pus or drainage Warmth near or on the wound Treatment of Infected wounds: Treatment will depend on how severe the wound is, its location, and whether other areas are affected.
Patient Case: A patient with a surgical wound later developed an abscess infection. The culture of the abscess revealed CRE and the patient was isolated. This patient had been in the facility for many months. The patient was identified as very high risk as a result of the additional treatments being received: dependency on ventilator; a catheter for urinary retention; and plus, the patient was on long-term IV antibiotics. There was difficulty placing the patient into another facility related to the infection because of the need to continue with isolation.
Clostridium difficile C. This bacteria and the toxins it produce can cause a number of intestinal conditions including pseudomembranous colitis, toxic megacolon and perforations of the colon. Sepsis may also occur and on rare occasion, death.
If toxins A and B enter the colon, they cause breakdown of the muscle and mucosa. Toxin B contributes to the major damage in the intestine. There is a difference between C. A patient with symptoms of the disease considered to have the infection. According to the CDC, the symptoms include: appetite loss, nausea, watery diarrhea, fever and abdominal pain with tenderness.
Patient will also test positive for the organisms or toxins in cases of C. Patient case: A patient had continued upper respiratory infections related to trach. The patient was transferred after a car accident to an extended care facility to have continued physical therapy and hour care by nursing , trach was finally discontinued and he was able to speak, and a decrease in infections was noted.
After the last hospitalization, the patient developed diarrhea, which was diagnosed later as C. All known medications were tried and the patient continued to weaken without colonization of the C. This patient died within three months after the diarrhea had started. MDRO has become prevalent in different types of health care facilities as well as different levels of care.
When patients are located in long-term care facilities, there is an increased incidence as well as an increased mortality rate associated with MDROs.
The residents that are colonized become the vehicle for the infection in acute care facilities. The CDC states there is also an increase in the number of pediatric patients infected. A good program to help assure the patient progresses back to health is to focus on eliminating or reducing the risk factors. Some research suggests that a multidisciplinary approach is the best way to base a decision as to whether to use or not use antibiotics to reduce the number of patients that become colonized or contact MDRO.
Patient case: A patient in a skilled nursing facility who has been in bed for several months with a large wound caused by an insect bite, has had several surgical debridements.
The patient was cultured because the wound had not shown signs of healing. The culture result showed that MDRO had become colonized within the patient, so the patient was placed in isolation for treatment in an effort to reduce the spread of the bacteria to other patients. Approaching the treatment of the patient's infection from a holistic, multidisciplinary way may help a someone who is having issues such as anxiety as a result of treatment protocol, and may impact decisions of care.
VRE Vancomycin-resistant Enterococci is a bacteria that is normally located in the intestines and female genital tract. Unless a patient becomes compromised, this bacteria's presence is normal and colonization does not cause disease.
The difference between the two levels is determined when the minimum inhibitory concentration MIC is available. Individuals at risk for developing a treatable VRE infection include: patients that have a lengthy history of antibiotic treatment; patients that are hospitalized; surgical patients; patients with medical devices; patients with a past history of colonized VRE; and patients with weakened immune systems.
The best steps to take in treating VRE is to remove the medical device, if possible, that is the source the infection, and provide further treatment only if there are symptoms. A treatment example is a patient who has a urinary tract infection and currently has a catheter. If there is no medical reason for the catheter, then it should be removed and the patient treated only for the length of symptom relief or if this patient becomes colonized. Patient case: A patient who had a catheter related to a stage IV pressure ulcer showed signs of infection in the wound and urine.
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