Signs and Symptoms of Wound Infection

Health Teaching: Signs and Symptoms of Wound Infection

Wound care is an important part of nursing. When a patient develops a wound, it is important the wound does not get infected. In this post, we discuss the common signs and symptoms of the infected wounds. If you are a nurse performing wound care, you can educate the patient on signs and symptoms of wound care using this nurse teaching. It can also be added to nursing visit notes as patient education example for documentation purpose. Signs and symptoms of wound infection include:

1. Chills & Fever: Individuals with infected wounds could present with chills and elevated body temperature. During infection, human body tends to display a natural immune response of elevated temperature, as infecting microorganisms multiply poorly at higher body temperature. Once the new higher temperature set point is decided, individuals start shivering and chilling, which leads to extensive muscle contractions and relaxation. This muscle contraction and relaxation generates the needed heat to raise the body temperature from where it is to the new higher set point, resulting in fever.
2. Increasing pain: Wound that is healing well presents with progressively subsiding pain levels. The microorganisms in an infected wound increasingly trigger the nerve cells at the wound site causing increased pain. Progressively increasing pain in a wound site can be a clear sign for infection and need to be investigated further.
3. Increasing erythema: Wounds usually have some associated inflammation and consequently, present with some redness or erythema around the wound. The erythema should progressively reduce in a wound that is healing on schedule, without any complications. An infected wound can present with furthering/worsening of the inflammatory process, resulting in deepening and expanding of redness around the wound site. Keeping track of the erythema at a wound site, by taking picture of the wound every time the dressing is changed, can help an easy comparison.
4. Increasing swelling: Wounds usually have some associated inflammation and consequently, present with some swelling of the wound site. The swelling should progressively reduce in a wound that is healing on schedule, without any complications. An infected wound can present with furthering/worsening of the inflammatory process, resulting in persistent and increasing swelling of the wound site. Keeping track of the swelling at a wound site, by measuring the swelling of the involved body part using a tape, every time the dressing is changed, can help an easy comparison.
5. Unduly warm skin around the wound site: Wounds usually have some associated inflammation and consequently, present with some warmth of skin around the wound site. The warmth should progressively reduce in a wound that is healing on schedule, without any complications. An infected wound can present with furthering/worsening of the warmth, resulting in persistent and increasing warmth of the wound site.
6. Increasing drainage from the wound site: Wounds can present with serous (drainage that is thin and clear), serosanguineous (thin and clear drainage mixed with some blood, pink in color), or sanguineous (frank red blood) drainage. The drainage should progressively reduce and contain in a wound that is consistent with healing. An infected wound can present with furthering/worsening of the drainage, resulting in persistent and increasing drainage from the wound site.
7. Changes in the nature of drainage from the wound site: Change in the nature of drainage from serous to other forms (serosanguineous or sanguineous or purulent (yellow or brown colored thick fluid, often with foul odor) can be a sign of worsening wound condition & infection and requires appropriate medical attention.
8. Foul odor or worsening of odor from the wound site: A clean wound should usually not emit any unpleasant odor. If a wound continues to emit unpleasant odor, despite regular cleansing and irrigation, it could be a sign of infection and requires further investigation.
9. Increasing size or depth of the wound: The size of a wound should progressively reduce in a wound that is healing on schedule, without any complications. An infected wound can present with worsening of the local wound conditions, resulting in extension of wound borders, increase in the wound size, and further deepening of the wound. Keeping track of the wound measurements, by measuring the wound site on every dressing change, can help an easy comparison.
10. Change in color of the wound bed and surrounding wound environment: A normally healing wound should display a healthy pinkish – bright red color to the wound bed and surrounding environment inside the wound. This color is due to the growth of healthy granulation tissue, which is the tissue helping for wound healing. Any appearance of yellow brown color to the wound bed and surrounding wound environment in the wound could be a sign of infection. Keep close watch with appearance of wound bed and surrounding wound environment during every dressing change.