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Skin protects the body from infection. Breaks in the skin can occur
through punctures (like a nail or a thorn), abrasions (scrapes
or scratches), or lacerations (rips in the skin tissue).
Healthy individuals can develop infections through wounds in the skin. However,
it is more likely that persons with underlying immune system (the body's ability to fight infection) problems will develop wound
infections if a break in their skin occurs. The October 26, 2005, issue of JAMA includes an article about use of supplemental oxygen
to decrease the risk of surgical wound infections.
Signs of wound infections
Redness, warmth, and tenderness in the area of the wound
Pus—a foul-smelling, yellowish-white fluid coming from the
Immune system disorders, cancer, human immunodeficiency virus
infection, and malnutrition
Paralysis or other limited mobility (wheelchairs, confined to
Hospitalization, which increases risk for infection by organisms
that are resistant to antibiotics
Complications of wound infections
Death of surrounding tissue, including muscle, connective tissue,
or bones, which may require surgical debridement (removal
of dead tissue)
Spread of the infection to the bloodstream, involving other organs
Septic shock, a critical illness involving
the whole body, which may require intensive care and life support and lead
to multiple organ failure or death
Surgical wound infections
The incision (cut) in the skin performed for
an operation can become infected. Surgical wound infections can range from
redness surrounding a small portion of the incision to deeper infections involving
underlying muscles or to a severe infection spread through the bloodstream.
Doctors take precautions to prevent surgical wound infections, including use
of sterile (free from germs) procedures and instruments
and appropriate use of antibiotics. Risk factors for surgical wound infections
include diabetes, emergency procedures, smoking, severe obesity, altered immune
function, malnutrition, low body temperature, and long operation times.
Treating wound infections depends on the nature of the wound, degree
of infection, and the bacteria responsible for the infection. All wounds should
be cleaned, any foreign materials (such as dirt or splinters) removed, and
any pus drained. Prescription antibiotics may be necessary to treat the infection
and prevent its spread. A tetanus vaccine booster shot may be indicated to
prevent the occurrence of tetanus (lockjaw), a serious
illness that includes severe muscle spasms. Severe infections or infections
that occur in persons with medical problems may require hospitalization and intravenous (through a vein directly into the bloodstream)
antibiotics. In the case of sepsis or septic shock, intensive care and life
support may be needed.
For more information
Centers for Disease Control and Prevention800/311-3435http://www.cdc.gov
American College of Surgeons800/621-4111http://www.facs.org
To find this and previous JAMA Patient Pages, go to the Patient Page
link on JAMA's Web site at http://www.jama.com. Many are available in English and Spanish.
Sources: American College of Surgeons, National Institute of Allergy
and Infectious Diseases, Centers for Disease Control and Prevention
The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate
in most instances, but they are not a substitute for medical diagnosis. For
specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied
noncommercially by physicians and other health care professionals to share
with patients. To purchase bulk reprints, call 718/946-7424.
Torpy JM, Burke A, Glass RM. Wound Infections. JAMA. 2005;294(16):2122. doi:10.1001/jama.294.16.2122
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