References

Wound infection in clinical practice, 3rd edn. : Wounds International; 2022

Sen CK. Human wounds and its vurden: an updated compendium of estimates. Adv Wound Care. 2019; 8:(2)39-48 https://doi.org/10.1089/wound.2019.0946

Lo ZJ, Lim X, Eng D Clinical and economic burden of wound care in the tropics: a 5-year institutional population health review. Int Wound J. 2020; 17:(3)790-803 https://doi.org/10.1111/iwj.13333

Guest JF, Fuller GW, Vowden P. Diabetic foot ulcer management in clinical practice in the UK: costs and outcomes. Int Wound J. 2018; 15:(1)43-52 https://doi.org/10.1111/iwj.12816

Guest JF, Fuller GW, Vowden P. Venous leg ulcer management in clinical practice in the UK: costs and outcomes. Int Wound J. 2018; 15:(1)29-37 https://doi.org/10.1111/iwj.12814

Dowsett C, Bellingeri A, Carville K A route to more effective infection management: The Infection Management Pathway. Wounds Int. 2020; 11:(3)50-57

Wound infection in clinical practice: principles of best practice, 1st edn. : MEP Ltd; 2008

Wound infection in clinical practice, 2nd edn. : Wounds International; 2016

Haesler E, Ousey K. Evolution of the wound infection continuum. Wounds International. 2018; 9:(4)6-10

Smith V, Devane D, Begley CM, Clarke M. Methodology in conducting a systematic review of systematic reviews of healthcare interventions. BMC Med Res Methodol. 2011; 11:(1) https://doi.org/10.1186/1471-2288-11-15

Shea BJ, Reeves BC, Wells G AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. BMJ. 2017; 358 https://doi.org/10.1136/bmj.j4008

Chapter V: Overviews of reviews. 2021. https://tinyurl.com/4hthwxpc (accessed 13 November 2022)

Sterne JA, Savović J, Page MJ RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ. 2019; 366 https://doi.org/10.1136/bmj.l4898

Sterne JA, Hernán MA, Reeves BC ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions. BMJ. 2016; 355 https://doi.org/10.1136/bmj.i4919

Haesler E, Swanson T, Ousey K Establishing a consensus on wound infection definitions. J Wound Care. 2022; 31:S48-S59 https://doi.org/10.12968/jowc.2022.31.Sup12.S48

Fitch K, Bernstein SJ, Aguilar MD The RAND/UCLA appropriateness method user's manual.: RAND; 2001

Haesler E, Swanson T, Ousey K, Carville K. Clinical indicators of wound infection and biofilm: reaching international consensus. J Wound Care. 2019; 28:s4-s12 https://doi.org/10.12968/jowc.2019.28.Sup3b.S4

Ata A, Lee J, Bestle SL Postoperative hyperglycemia and surgical site infection in general surgery patients. Arch Surg. 2010; 145:(9)858-864 https://doi.org/10.1001/archsurg.2010.179

Lecube A, Pachón G, Petriz J Phagocytic activity is impaired in type 2 diabetes mellitus and increases after metabolic improvement. PLoS One. 2011; 6:(8) https://doi.org/10.1371/journal.pone.0023366

Schultz GS, Sibbald RG, Falanga V Wound bed preparation: a systematic approach to wound management. Wound Repair Regen. 2003; 11:S1-S28 https://doi.org/10.1046/j.1524-475X.11.s2.1.x

Sørensen LT. Wound healing and infection in surgery: the pathophysiological impact of smoking, smoking cessation, and nicotine replacement therapy: a systematic review. Ann Surg. 2012; 255:(6)1069-1079 https://doi.org/10.1097/SLA.0b013e31824f632d

Stechmiller JK. Understanding the role of nutrition and wound healing. Nutr Clin Pract. 2010; 25:(1)61-68 https://doi.org/10.1177/0884533609358997

Torpy JM, Burke A, Glass RM. Wound Infections. JAMA. 2005; 294:(16) https://doi.org/10.1001/jama.294.16.2122

An overview of surgical site infections: aetiology, incidence and risk factors. 2005. https://tinyurl.com/2p8pefey (accessed 9 November 2022)

Gouin JP, Kiecolt-Glaser JK. The impact of psychological stress on wound healing: methods and mechanisms. Immunol Allergy Clin North Am. 2011; 31:(1)81-93 https://doi.org/10.1016/j.iac.2010.09.010

Korol E, Johnston K, Waser N al. A systematic review of risk factors associated with surgical site infections among surgical patients. PLoS One. 2013; 8:(12) https://doi.org/10.1371/journal.pone.0083743

Haubner F, Ohmann E, Pohl F Wound healing after radiation therapy: review of the literature. Radiat Oncol. 2012; 7:(1) https://doi.org/10.1186/1748-717X-7-162

Cheadle WG. Risk factors for surgical site infection. Surg Infect (Larchmt). 2006; 7:s7-s11 https://doi.org/10.1089/sur.2006.7.s1-7

Curtis BJ, Hlavin S, Brubaker AL Episodic binge ethanol exposure impairs murine macrophage infiltration and delays wound closure by promoting defects in early innate immune responses. Alcohol Clin Exp Res. 2014; 38:(5)1347-1355 https://doi.org/10.1111/acer.12369

Reichman DE, Greenberg JA. Reducing surgical site infections: a review. Rev Obstet Gynecol. 2009; 2:(4)212-221

Consensus document. Surgical wound dehisence improving prevention and outcomes.: Wounds International; 2018

Sen CK. Wound healing essentials: Let there be oxygen. Wound Repair Regen. 2009; 17:(1)1-18 https://doi.org/10.1111/j.1524-475X.2008.00436.x

Sibbald RG, Orsted H, Schultz GS Preparing the wound bed 2003: focus on infection and inflammation. Ostomy Wound Manage. 2003; 49:(11)24-51

Swanson T, Keast DH, Cooper R Ten top tips: identification of wound infection in a chronic wound. Wounds Middle East. 2015; 2:(1)20-25

Kalan LR, Brennan MB. The role of the microbiome in nonhealing diabetic wounds. Ann N Y Acad Sci. 2019; 1435:(1)79-92 https://doi.org/10.1111/nyas.13926

Stryja J, Sandy-Hodgetts K, Collier M Surgical site infection: Preventing and managing surgical site infection across health care sectors. J Wound Care. 2020; 29:S1-S72 https://doi.org/10.12968/jowc.2020.29.sup2b.s1

Lipsky BA, Senneville É, Abbas ZG Guidelines on the diagnosis and treatment of foot infection in persons with diabetes (IWGDF 2019 update). Diabetes Metab Res Rev. 2020; 36 https://doi.org/10.1002/dmrr.3280

Ward D, Holloway S. Validity and reliability of semi-quantitative wound swabs. Br J Community Nurs. 2019; 24:S6-S11 https://doi.org/10.12968/bjcn.2019.24.sup12.s6

Wilson AP, Sturridge MF, Treasure T, Grüneberg RN. A scoring method (ASEPSIS) for postoperative wound infections for use in clinical trials of antibiotic prophylaxis. Lancet. 1986; 327:(8476)311-312 https://doi.org/10.1016/S0140-6736(86)90838-X

Wilson AP, Weavill C, Burridge J, Kelsey MC. The use of the wound scoring method ‘ASEPSIS’ in postoperative wound surveillance. J Hosp Infect. 1990; 16:(4)297-309 https://doi.org/10.1016/0195-6701(90)90002-6

Wilson AP, Webster A, Gruneberg RN Repeatability of asepsis wound scoring method. Lancet. 1986; 327:(8491)1208-1209 https://doi.org/10.1016/S0140-6736(86)91185-2

Gardner SE, Frantz RA, Doebbeling BN. The validity of the clinical signs and symptoms used to identify localized chronic wound infection. Wound Repair Regen. 2001; 9:(3)178-186 https://doi.org/10.1046/j.1524-475x.2001.00178.x

Fierheller M, Sibbald RG. A clinical investigation into the relationship between increased periwound skin temperature and local wound infection in patients with chronic leg ulcers. Adv Skin Wound Care. 2010; 23:(8)369-379 https://doi.org/10.1097/01.ASW.0000383197.28192.98

Monteiro-Soares M, Russell D, Boyko EJ Guidelines on the classification of diabetic foot ulcers (IWGDF 2019). Diabetes Metab Res Rev. 2020; 36 https://doi.org/10.1002/dmrr.3273

Bravo-Molina A, Linares-Palomino JP, Vera-Arroyo B Inter-observer agreement of the Wagner, University of Texas and PEDIS classification systems for the diabetic foot syndrome. Foot Ankle Surg. 2018; 24:(1)60-64 https://doi.org/10.1016/j.fas.2016.10.009

Oyibo SO, Jude EB, Tarawneh I A comparison of two diabetic foot ulcer classification systems: the Wagner and the University of Texas wound classification systems. Diabetes Care. 2001; 24:(1)84-88 https://doi.org/10.2337/diacare.24.1.84

Lindsay S, Oates A, Bourdillon K. The detrimental impact of extracellular bacterial proteases on wound healing. Int Wound J. 2017; 14:(6)1237-1247 https://doi.org/10.1111/iwj.12790

Sibbald RG, Woo K, Ayello EA. Increased bacterial burden and infection: the story of NERDS and STONES. Adv Skin Wound Care. 2006; 19:(8)447-461 https://doi.org/10.1097/00129334-200610000-00012

Woo KY, Sibbald RG. A cross-sectional validation study of using NERDS and STONEES to assess bacterial burden. Ostomy Wound Manage. 2009; 55:(8)40-48

Dissemond J, Gerber V, Lobmann R Therapeutic index for local infections score (TILI): a new diagnostic tool. J Wound Care. 2020; 29:(12)720-726 https://doi.org/10.12968/jowc.2020.29.12.720

Siaw-Sakyi V. Early wound infection identification using the WIRE tool in community health care settings: An audit report. Br J Community Nurs. 2017; 22:S20-S27 https://doi.org/10.12968/bjcn.2017.22.Sup12.S20

Picarillo AP. Introduction to quality improvement tools for the clinician. J Perinatol. 2018; 38:(7)929-935 https://doi.org/10.1038/s41372-018-0100-4

Clinical Excellence Commission. Quality improvement tools. 2022. https://tinyurl.com/2p8hdkt2 (accessed 10 November 2022)

Korzendorfer H, Hettrick H. Biophysical technologies for management of wound bioburden. Adv Wound Care. 2014; 3:(12)733-741 https://doi.org/10.1089/wound.2013.0432

Biofilms
Wound dressings
Wound hygiene

IWII Wound Infection in Clinical Practice consensus document: 2022 update

01 December 2022
Education

Abstract

Wound infection is a major challenge for clinicians globally, with accurate and timely identification of wound infection being critical to achieving clinical and cost-effective management, and promotion of healing. This paper presents an overview of the development of the International Wound Infection Institute (IWII)'s 2022 Wound Infection in Clinical Practice consensus document. The updated document summarises current evidence and provides multidisciplinary healthcare providers with effective guidance and support on terminology, paradigms related to biofilm, identification of wound infection, wound cleansing, debridement and antimicrobial stewardship. Integral to the update is revision of wound infection management strategies which are incorporated within the IWII's Wound Infection Continuum (IWII–WIC) and management plan. The aim of the 2022 IWII consensus document update was to provide an accessible and useful clinical resource in at least six languages, incorporating the latest evidence and current best practice for wound infection and prevention. Dissemination techniques for the consensus are discussed and highlighted.

The International Wound Infection Institute (IWII) is a volunteer organisation that aims to promote prevention, identification and management of wound infection through publications, research, awareness campaigns and educational opportunities. The IWII produces a regularly updated consensus document that summarises the best clinical practice. The aim is to assist practitioners in updating their understanding and skills regarding prevention, identification and management of wound infection. The most recent edition of this consensus document was published in 2022.1 The updated 2022 document summarises current evidence, providing multidisciplinary healthcare practitioners with guidance on terminology, paradigms related to biofilm, identification of wound infection, wound cleansing, debridement and antimicrobial stewardship. Integral to the update is revision of wound infection management strategies which are incorporated within the IWII's Wound Infection Continuum (IWII–WIC) and management plan, including efficacy of cleansing solutions, aseptic technique and antimicrobial stewardship. This project did not require ethical approval.

Wound infection is a major global challenge and presents healthcare systems with considerable economic burdens, as well as directly impacting on patients' quality of life.2,3 Accurate and timely identification of a wound infection using clinical signs and symptoms, and other diagnostic modalities, is critical to achieving optimal and cost-effective management as well as promoting wound healing.4,5,6

Register now to continue reading

Thank you for visiting Journal of Wound Care's World Union of Wound Healing Supplement and reading some of our peer-reviewed resources for healthcare professionals. To read more, please register today.

Register
Or continue by

Signing in with your registered email address

antimicrobial
antimicrobial stewardship
biofilm
clinical guidance
debridement
infection
wound
wound care
wound cleansing
wound continuum
wound dressing
wound healing
wound infection