Infectious Wounds

Probiotics Compete With Pathogens by Competitive Exclusion

Non-Infectious Wounds

Probiotics Help For Healing Non-Infectious Wounds

Pressure Sores

Probiotics Help to Heal Bedsores In Very Short Period

Diabetic Ulcers

Probiotics Heal Diabetic Ulcers Painless with no Infection Formation

Surgery Wounds

Probiotics Be Effective of Surgery Wounds

Burn Wounds

Probiotics Heal Burn Wounds Swiftly Without Any Infection

Venous Ulcers

Probiotic Cream Compete With Venous Wounds

Intertrigo (Nappy Rash)

Probiotics May Be Used for Intertrigo (Nappy Rash) Care


A Guide to Looking After Wound

Wound Free Worry Free

This information has been created to help keep yourself healthy and independent by following these four simple steps below.

  1. Keep it Clean
  • Warmed tap water is effective in cleansing wounds
  • You may be asked to shower your wound
  • Avoid getting soap on the wound and rinse it well by flushing running water on it
  • Antiseptics are not recommended
  1. Keep It Covered
  • A closed wound (eg following a surgical procedure) heals best if it is kept clean and dry
  • An open wound heals best if it is cleaned well and kept moistly
  • Dressings help new tissue and skin growth and protect the wound from further damage and infection
  1. Keep It Moist
  • Open wounds are less painful and heal faster if they are kept moist
  • Some new dressings can be left on the wound for up to 7 days
  • Don't be alarmed if your wound is not dressed daily
  1. Keep a Lookout

You can help by telling a health professional eg doctor or nurse if the following happens: increased pain, swelling, redness around the wound.

Helping It Heal...What You Can Do

  • Follow good personal hygiene habits
  • Choose healthy foods such as dairy products, cereals, fruit and vegetables, poultry and lean meats
  • Stop smoking
  • Get plenty of rest
  • Report any redness, swelling, tenderness or pain around the wound to a health professional e.g. doctor or nurse
  • Follow advice from a health professional eg doctor or nurse

What The Dressing Will Do

  • Some of the new dressings used today look like rubber or plastic. They may even be waterproof
  • Their aim is to work with your body to heal the wound, faster with less pain, by keeping it moist and warm


New technology enables the dressings to remain on the wound for several days. A slight smell is normal and expected when the dressing is changed.



Wound Healing

The scientific evidence is now conclusive that the best way to heal a wound is not to allow it to dry and create

a crust. The human body is composed of many cells and a lot of water. Cells manage to perform their functions in a more constructive manner within a fluid environment. The consequence of this knowledge is the production of dressings and devices to aid the body in healing a wound within a balanced moist environment. The health clinician caring for your wound will assess relevant aspects and plan the appropriate care.

An understanding of the wounds needs is obtained through a thorough assessment of the wounded patient. Assessment requires the clinician to ask many questions pertaining to past medical and surgical history together with current medication history. This information is then added to the assessment of the wound tissue and surrounding skin in order to establish the correct diagnosis and reveal all factors that may inhibit or delay healing.

When the clinician is satisfied that a thorough history has been obtained a treatment regime is planned. Planning involves setting both short and long-term goals. The longer term is complete healing but in the short term, goals may include the removal of any dead tissue or promoting the healthy new growth of tissue.

Products have been developed to achieve these goals and your wound clinician will advise you of the dressings needed to heal the wound.

Dressings are generally classified according to their function so you may require dressings to:

  • Absorb the ooze coming from the wound
  • Protect the new tissue growing in the wound
  • Help to remove the dead/dirty tissue in the wound
  • Encourage new skin to grow over the healthy red tissue
  • Help to reduce bacteria/bugs in the wound
  • Protect the skin around the wound

Some dressings come in forms that adhere to the skin in order to be waterproof and some are not waterproof. Your health clinician will inform you about what you need to do to keep your dressings in good order and dry if necessary. If no adhesive/waterproof dressing is used then you will require some form of tape or bandage to hold the dressing in the correct place and prevent slippage and ensure that it stays dry during shower or other daily activities.

There are many forms of bandages available. Some bandages are used to hold the dressings in place and some are used to assist in reducing swelling of the tissue surrounding the wound. It is important that when a health professional applies a dressing or a bandage to your wound they explain the purpose of these so that you are completely informed and have an understanding of the short term treatment aims.


How To Prevent An infection

The more you know about what is happening, the better prepared you'll be to take care of yourself.

Any wound from amputation or other surgery is at risk of becoming infected because the skin opening can allow germs or dirt to enter the bloodstream. Infections can cause tenderness or pain, fever, redness, swelling and/or discharge. These infections can lead to further complications or surgery or even death if not treated properly.

If you suspect you are getting an infection, do something. Act quickly, before a small irritation becomes a serious problem.

The best way to handle an infection is to prevent it:

  1. Wash your residual limb with mild soap and water, then rinse and pat dry. Do this at least once a day, or more if you sweat a lot or are treating a rash or infection. Ask your pharmacist to recommend a nonperfumed, pH-balanced lotion.
  2. Wash anything that comes into contact with your skin (liners, socks, inner socket, etc.) with mild soap and water, then rinse and dry (check manufacturer's instructions).
  3. Do not use alcohol-based lotions on your skin, as it dries it out and can cause cracks, which can lead to infections.
  4. Use only enough softening lotion to avoid flaking, peeling dry skin. Ask your pharmacist to recommend a non-perfumed moisturizing lotion. Do not apply moisturizing lotion to the amputated limb immediately before applying prosthesis. The best time to apply lotion is at night before going to bed. It is important to prevent either excessive dryness or excessive humidity of the skin.
  5. Maintain a good prosthetic fit; learn how to adjust your sock ply, if applicable, or go for a prosthetic adjustment if you start to get redness over a pressure area. This will prevent the pressure area from becoming a pressure sore.
  6. Maintain correct alignment of your prosthesis by wearing the correct heel height that your prosthesis was aligned with and by maintaining a good socket fit.
  7. Eat a balanced diet and drink plenty of water (unless you have liquid intake restrictions) to maintain supple, healthy skin.
  8. If you have diabetes, monitor and maintain your glucose levels.
  9. If you have decreased sensation in your limb, remove your prosthesis several times per day to check for pressure areas.

You may have a wound that you are very capable of managing yourself. Sometimes, however, a wound needs professional management from a doctor or nurse. These wounds can include leg ulcers, lacerations and skin tears or wounds that have not healed properly after an operation.


Foot Wounds

One pair must last a lifetime - take good care of them and they will look after you

With the rising incidence of diabetes, it is essential that everyone has a greater understanding of what constitutes good foot care. People suffering from diabetes have greater risks of sustaining injuries to their feet and these wounds may take much longer than normal to heal and be associated with more complications.

Suggestions for good foot care include:

  • Smoking impairs arterial circulation
  • Inspect feet daily-using a mirror for difficult-to-see areas. If there are problems with eyesight or access, then a relative may be able to assist
  • Palpate the feet looking for any rough 'thick' skin as this is indicative of the excessive pressure
  • Feel for temperature changes or areas of tenderness and this could indicate a reduced circulation
  • Wash feet daily and dry thoroughly. Do not soak feet or use strong astringents
  • If the skin is dry moisturizer can be applied but not between the toes to prevent infections
  • If possible when older, have a trained podiatrist cut toenails and care for any rough areas of skin
  • Preferably do not walk about without some form of footwear to protect your feet from damage
  • Do not place very hot objects e.g. hot water bottle, over feet or sit too near hot or very cold objects as burns may result from the reduction in sensation experienced by some patients
  • Do not self-treat corns as more damage may result
  • Ensure the shoes accommodate the feet without causing any reddened areas, ideally, the shoes for elderly will have extra depth and extra width, and lace-up – so that if swelling occurs the laces can be opened up and the foot comfortably placed in the shoe rather than being squeezed in

If a wound on the foot fails to improve within one week it is suggested that further advice is sought from a health specialist or podiatrist. Often the non-healing wound may be the first sign that diabetes is present.

Wounds on feet require 'off-loading' or protection against further pressure, management of the ooze so that the skin does not become soft and soggy and reduction of bacterial counts via antimicrobial dressing.

Antiseptics may be used to assist in cleaning the skin of foot wounds and then antimicrobial dressings such as iodine, silver, tea tree oil, enzymes or honey dressings may assist in managing any bacteria contained within the wound.

Regular dressings and trying not to put any increased pressure on the wound are necessary to successfully heal the wound in a reasonable time frame.


Moist Wound Healing

What is moist wound healing?
Active dressings, what are they and why do we use them?

ALGINATES ANTIMICROBIALS FILMS FOAMS HYDROCOLLOIDS HYDROGELS are the names of dressing products that can be described as "active" dressings because they interact with the wound bed in providing a "moist" environment, conducive to optimum healing. This article will provide a brief overview of these active dressings and why moist wound healing has become a preferred approach when managing most chronic wounds rather than encouraging the wound to dry out and form a scab.

* Moist wound healing is not recommended when there is dry dead tissue with insufficient blood flow to the affected body part to support inflammation and wound healing; and in palliative care where healing is not a realistic goal and necrotic tissue provides protection of deeper vascular structures.

The principles of moist wound healing came about from research conducted in the' 40s where it was found that wounds actually closed faster by covering the wound and keeping the area moist. The moist environment stimulated activity in the wound bed allowing cells to repair the injured tissue and remove wound debris.

The growth of new skin was found to be faster and more efficient in a moist environment when compared to leaving a scab to dry out. It is more difficult and a slower process for cells to repair skin under a dry hard scab. This is only until the outer skin layers eventually shed.

The scab itself can become a problem if left open. It can be knocked, traumatized and at times serve as a focus for bacteria (bacteria may have been multiplying under the scab and the inflammatory process can start over). Dressings can be used to prevent dehydration of the wound surface and gently absorb fluid or offer protection for fragile new skin until it regains strength.

Dressings are selected on the basis of their action to match the goal of care. These dressings have been described as "intelligent" implying that little thought is needed when applying it to a wound. This assumption could not be further from the truth. Wound healing is a complex process and the wound is only the end result or a symptom of deeper problems that have caused the development of a wound in the first instance.

ALGINATES are highly absorbing biodegradable fibrous material derived from brown seaweed that interacts with wound surface to produce a gel-like substance to aid gentle removal when saturated. Alginates have been used in the food industry for many years and are available in flat sheets to lie over the wound bed or in a "rope" to pack into a wound cavity. Alginates have been added to other types of dressings like gels and hydrocolloids to aid extra absorbency within the dressings. The main function of the alginate is to absorb exudates, gently fill a cavity while healing and can stop bleeding once applied.

Some of the names of alginates are kaltostat, sorbsan, algoderm, algisite m, tegaderm alginate, sorbalgon, melgisorb, curasorb, seasorb, calcicare.

Active dressings promote moist wound healing. There are several groups of active dressings that provide a moist environment for the wound. They are: hydrocolloids, hydrogels, films, foams and antimicrobials.

Managing Wound Odours

Coping with wound odour can be extremely challenging and have a profound negative effect on the patient, and their family at a time when more support is needed. Wound odour can diminish appetite and activity and when masked with sprays or fragrances can set up an ongoing reminder of the negative wound experience.

Wound odours need to be clearly evaluated as either those coming directly from the wound or the odour of the wound fluid mixed with dressing material which may disappear after the dressing change.

If the odour is present after wound cleaning then it is most likely an infection or dead tissue. Some specific bacteria have characteristic odours such as sweet or ammonia-like, other bacteria can create foul odours due to tissue breakdown.

In identifying the cause of the malodour three main areas can be examined:

  1. Infection: Determine the type of infection by discussing with your GP who may recommend a swab or biopsy to decide if you need antibiotics or if the wound would benefit from an antimicrobial dressing.
  2. Necrotic tissue: The action of some dressings can reduce the amount of necrotic tissue in a wound. Offensive smelling tissue can be removed by the nurse or doctor depending on the location, extent and cause. These and other options will need to be discussed with your GP or specialist. If there is no further treatment recommended dressings can be selected to contain discharge and absorb the odour.
  3. Fistula: An opening or tracking passage deep into the tissue beyond the wound. Fluid can accumulate inside a fistula that may not be noticed on the outside, but a foul odour could be the only indication. Further surgical opinion is needed if this is suspected so it is important to share your concerns with your GP.

In order to control the odour there are three main areas to address:

  1. Environmental: Considering products to use inside the room, opening a window to change the air can be effective. Products are available that neutralise odours and kill bacteria chemically. These are available in sprays, gels & drops (deodorisers). Products that absorb the odour (charcoal, kitty litter, sodium bicarbonate) and products that disguise the odour (room fragrances, aerosol scent sprays, essential oils) are also available.
  2. Systemic control: Antibiotic or antifungal medications can be prescribed but careful monitoring is needed to review the effectiveness.
  3. Topical control: Products can be used directly on top or inside the wound to contain, absorb or reduce odours. Activated charcoal, medical honey and Stomal Therapy appliances or bags can be fashioned around the wound to contain the wound and exudate.



"Wound and skin infections mean infected by one or more species of pathogen microorganism"

"To Infect means presence of any microorganisms on a host, stay and reproduce on there"

"In the case of these microorganisms are pathogenic then clinical diseases will occur."

"The main problem is PATHOGENS"


Delayed Healing or Chronic Wounds

When managing wound care in the community there are two types of wounds that can occur, acute wounds that usually heal within 2-4 weeks, or chronic wounds that are delayed in healing and stay around from 6 weeks or so to several years.

There are many factors that may delay wound healing. If the person with the wound does not have effective blood circulation, or if there is a recurrent infection, there could also be an underlying disease that hasn't been detected or controlled well. This will also cause a delay in wound healing.

It is extremely important to speak to a health professional if you have a wound that's not healing within an expected time frame as it could be a result of many different things.

Consider why the healing may be delayed. It is more appropriate to consider the "whole" person rather than just what to put over the "hole".

There has been a revolution in wound management products since the early 90's so you may hear all sorts of solutions and remedies about what is the best thing to cover the wound. The important point is always to find out what caused the wound in the first place and why it may not be following the predicted path to healing.

Once that is sorted out then choosing a dressing that suits the conditions of the wound is the next step. Sometimes the wound conditions can change so the dressing choice needs to change as well. Seek professional help to get on the right track, because it could also be an inappropriate dressing that is causing a delay in healing. The modern dressings are complex and will interact with the wound bed so clear guidance is needed.

There are many things that can cause delayed wound healing. In diabetes, a blood sugar reading over 8mmols/L will affect the healing capacity. If the body is trying to repair tissue then nutrition is very important. Skin hygiene or just keeping the wound clean by changing bandages and dressings when they are wet is necessary to avoid an infection.

If these things are taken care of and the wound is still not healing then it is important to seek professional help to investigate why the healing is delayed.

Protein intake is important because it provides the building blocks for tissue repair. Protein sources can be found in meats, fish, nuts, lentils or in a nutritional supplement. If a wound is not continuing to show signs of healing, and there is weight loss from a hospital stay or trauma, then a nutritional supplement may be needed to help the recovery.

A good multivitamin and at least 1,000 mg a day of Vitamin C may help speed up the healing process. A GP can arrange for a blood test to see if a supplement or extra iron is needed to aid wound repair, or refer a dietician to help with meal plans. Alternatively, making an effort to eat well could have a surprising result.

The wound must be kept clean at all times to control bacteria and promote healing. In acute wounds, inflammation is normal for a few days but if this continues then it can lead to infection. Increasing pain, excess fluid from the wound, redness, swelling, odour from the wound or a temperature are all symptoms of an infection. Seek medical advice as antibiotics may be needed to fight the infection.

Protecting the wound is imperative so securing the dressings is important and ensuring it is the right size for the wound. Keeping the area dry is also worthwhile and keeping the wound bed undisturbed so it has a chance to heal is just as important as changing it often enough. Seek help or make an effort to protect the dressing under the shower. Some dressings are waterproof but it doesn't take much to have the water leak in.

Once the wound has healed then providing protection with a barrier cream or moisturizer is also worthwhile because the area will be fragile and take a while to recover and regain strength again.

The elderly or frail or those without sensation, it may be worthwhile providing a protective sleeve to prevent reoccurring injury.

Wound management is complex particularly if the healing is delayed and the wound has become "chronic". By understanding the nature and cause of the wound and eliminating the things that can be controlled, for example, hygiene, diet, protection then healing can be achieved.

If the wound is not healing then consider what your doctor could do to help investigate or assist with those things that cannot be easily controlled.