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Multicenter Study
. 2023 Aug;32(15-16):4730-4740.
doi: 10.1111/jocn.16527. Epub 2022 Sep 12.

Diagnosis and treatment of infected wounds: A multi-centre audit of current clinical practice across the UK, Ireland and Scandinavia

Jane Hampton  1 , Andrew Sharpe  2 , Pat McCluskey  3 , Tim Styche  4 , Jacqui Hughes  4 , Emma Woodmansey  4
Affiliations
Multicenter Study

Diagnosis and treatment of infected wounds: A multi-centre audit of current clinical practice across the UK, Ireland and Scandinavia

Jane Hampton et al. J Clin Nurs. 2023 Aug.

Abstract

Aims and objectives: Surveillance of wound infection including signs of infection alongside antimicrobial usage (types, duration, frequency) can highlight knowledge gaps and inconsistencies. This manuscript aims to highlight these, identify and inform opportunities for practice improvement and to show impact of infection management practice may be having on the issue of antimicrobial resistance.

Background: Infected wounds pose challenges to healthcare professionals. Balancing risk of wound deterioration and progression to systemic infection with appropriate use of antimicrobials is necessary to minimise development of resistance.

Methods: Analysis consisted of a practice survey of 9661 wounds across 70 community sites over a period of one week. Data were collected from projects between 2017 and 2020. The form was available to providers within the UK, Ireland, Norway, Denmark, Sweden and Finland. EQUATOR research guidelines were followed; STROBE checklist for observational research reporting was completed.

Results: Infection rates of 8.9% were reported from wounds assessed. These data indicate inconsistencies with diagnosis across practice with non-specialists more likely to be unsure of wound infection. Greater confidence in infection identification was observed as number of signs increased. Inconsistencies were also observed in appropriate treatment; antimicrobials were used in 35% of wounds considered not infected and not used in 41% of wounds that were identified as infected.

Conclusions: This investigation of infection management practice of over 9000 wounds provides an insight into diagnosis and treatment of infection. Inconsistencies in diagnosis and treatment of wound infections reported highlight the need for increased education, awareness of diagnosis and treatment of infection.

Relevance to clinical practice: Variability in management of infected wounds highlights opportunities to aid more effective diagnosis and treatment of infected wounds. Incorporation of support tools or evidence-based pathways into practice may enhance confidence in management of local infection, balanced with appropriate use, potentially minimising resistance and improving outcomes.

Keywords: antimicrobial resistance and stewardship; infection; practice improvement; topical antimicrobial dressings; wounds.

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References

REFERENCES

    1. Ayello, E. A., Carville, K., Fletcher, J., Keast, D., Leaper, D., Lindholm, C., Martínez, J. L. L., Mavanini, S., McBain, A., Moore, Z., Opasanon, S., & Pina, E. (2012). International consensus. Appropriate use of silver dressings in wounds. An expert working group consensus. Wounds International, 1-24. www.woundsinternational.com
    1. Bui, U. T., Finlayson, K., & Edwards, H. (2019). The diagnosis of infection in chronic leg ulcers: A narrative review on clinical practice. International Wound Journal, 16(3), 601-620. https://doi.org/10.1111/iwj.13069
    1. Cooper, R., & Kirketerp-Møller, K. (2018). Non-antibiotic antimicrobial interventions and antimicrobial stewardship in wound care. Journal of Wound Care, 27(6), 355-377. https://doi.org/10.12968/jowc.2018.27.6.355
    1. Dowsett, C., Bellingeri, A., Carville, K., Garten, A., & Woo, K. (2020). A route to more effective infection management: The infection management pathway. Wounds International, 11(3), 50-57.
    1. Drew, P., Posnett, J., Rusling, L., & Wound Care Audit Team. (2007). The cost of wound care for a local population in England. International Wound Journal, 4(2), 149-155. https://doi.org/10.1111/j.1742-481X.2007.00337.x

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