4.3 Wound Infection and Risk of Wound Infection

Critical Thinking Exercises: Questions, Answers, and Sources / References

Critical thinking questions are in bold type, and the answers are italicized. Additional resources or references are provided below.

1. Gerry, 58 years old. History of smoking and hypertension. Has been in a motorcycle accident resulting in significant abrasions to his arms and legs. What factors increase Gerry’s  risk of wound infection?

• Smoking: Results in vasoconstriction and arterial damage = potential ↓ oxygen to the tissues = ↓ potential for healing.
• Hypertension: Is sometimes associated with atherosclerosis which can mean potential impaired circulation and ↓ oxygen to the tissues.
• Nature of his injury: Abrasions from a motorcycle accident likely mean the wounds were contaminated with dirt and debris, which increases risk of infection.

Source:

Any pathology textbook.

2. JT, 38 years old. Has paraplegia and had a wound on the right ischium for 18 months. What factors increase JT’s risk of wound infection?

• Chronicity: What phase of wound healing is this wound in?
• Potential infection / biofilm: Is the wound infected, and is this preventing the wound from healing?
• Location and risk of infection: The ischium is near the rectum; has the wound been contaminated with stool?
• Continued pressure: Is JT able to off-load pressure to allow blood flow and oxygen to the site to promote healing?
• Nutrition status: What is JT’s nutrition status. Is it affecting his healing and risk of infection negatively or positively?
• Lifestyle: Does JT use cigarettes, alcohol, or drugs? Smoking, alcohol, and drug abuse can affect circulation, nutrition, and ability to care for one’s self. Lifestyle can have negative effects on healing or risk of infection.
• Medications: does JT use medications that interfere with wound healing?

3. What are the commonalities in relation to risk of wound infection and risk of impaired wound healing?

• Answer…they are similar.

Source:

International Wound Infection Institute (IWII). (2016). Wound infection in clinical practice: Principles of best practice. Wounds International. http://www.woundinfection-institute.com/wp-content/uploads/2017/07/IWII-Consensus_Final-2017.pdf

Sample Quiz Questions

1. What are the classic S&S of wound infection? Select all that apply.

• Pain Correct
• Swelling at the site Correct
• Redness to the wound and surrounding area (erythema) Correct
• Delayed healing Correct
• Elevated WBC count Correct
• Foul odor from the wound Correct
• Fever chills Correct
• Purulent (pus) discharge Correct, but to note purulent discharge does not ALWAYS suggest wound infection. Other factors must be considered too.

Source:

Potter, P., Perry, A., et al (2019). Canadian fundamentals of nursing (6th ed.). Elsevier; Mosby.