Picture by James Heilman, MD - Own work, CC BY-SA 3.0
Wound inflammation and Infection
Having worked in urgent and emergency medicine I know there is a lot of confusion over inflammation and infection. As many patients presents within 24 hours of receiving a wound believing it is infected.
When a wound happens, a healing process starts the first stage of this in inflammation, in the inflammatory stage blood clots and the area around the wound may swell and become surrounded by a red border, as long as that red border remains around the edge of the wound this can usually be attributed to inflammation rather than infection.
If the red border starts spreading away from the wound in an irregular pattern, which usually starts around 24-48 hours after the initial wound then this is an indication of infection which is treated with an oral antibiotic such as flucloxacillin or Doxycycline which is covered on and obtainable after our expedition medic course for remote foreign travel.
A future point of confusion is when people see fluid leaking from the wound some may automatically think this is pus and therefore a sign of infection, however this is often exudate which is a by-product of wound healing. Exudate being a thin clear liquid whereas pus is a foul thicker liquid.
A final sign to look out for is ascending lymphangitis this is a red line moving towards your groin or armpit, this more often occurs on the limbs as illustrated by the picture above but can also appear on the torso.
This is a potential life-threatening medial emergency, although they can sometime be treated with oral medication, they often need regular intravenous antibiotics. This condition is also known as blood poisoning although this is inaccurate as the red line, tracing the path of the lymphatic system not the veins. However, if it gets to the glands in the armpit and groin it can enter the blood stream from here and cause a whole body (systemic) infection with fever, potentially leading to sepsis and death.
If the wound passes through the inflammatory stage it will enter the stage of proliferation where new tissue growth occurs, then to the maturation stage where the tissue is remodelled and should return t its former state. If the wound it particularly wide and / or not teat or closed correctly then a scar may remain following healing.
The author is a Registered Nurse who served with the RAMC, a Paramedic and Clinical Tutor with additional qualifications in Trauma and Remote Medicine. He has had a long term interest in remote medicine and is the Medical Advisor for several groups and runs courses in Outdoor First Aid, Expedition, Remote and Survival Medicine.