Diabetic patient with sinus on left foot

Abstract

Infection Wounds do not exist in isolation and it is important that the clinician can confidently distinguish between the signs and symptoms of the normal physiological inflammatory response in healing and those related to infection or underlying aetiologies, such as rheumatoid arthritis or vasculitis (Figure 16). The mere presence or multiplication of microorganisms on the wound surface does not necessarily equate to wound infection. Wound bacteria can be acquired from the patient’s own endogenous flora or from exogenous microbial contamination (European Wound Management Association (EWMA), 2005). The notion of a continuum in the development of wound infection was described by Kingsley (2001), naming the increasingly severe forms of wound bioburden as contamination, colonisation, critical colonisation and wound infection (Figure 17). Contamination is the presence of organisms on the wound surface in low numbers. Often these microbes are harmless Classic criteria Additional criteria