The Canadian government has recently approved funding for a large study of nitric oxide gas to see if the results can be duplicated in other nonhealing wounds.
How to Identify Wound Types
Contamination
▸ Example: Fall from a bike, abraded skin.
▸ Bacteria: “Just passing through.”
▸ Signs and symptoms: None.
▸ Healing: Not compromised.
▸ Testing: None necessary.
▸ Treatment: Cleansing with normal saline.
Simple Colonization
▸ Example: Wound of a few days' duration.
▸ Bacteria: Living in the wound, but planktonic and disorganized.
▸ Signs and symptoms: None of note.
▸ Healing: Not compromised.
▸ Testing: None required.
▸ Treatment: Cleansing with normal saline.
Complicated Colonization (Biofilm)
▸ Example: Chronic wound.
▸ Bacteria: Significant in numbers and virulence. Well organized, often as a “biofilm.”
▸ Signs and symptoms: New onset of wound pain and wound-bed deterioration (granulation tissue loss, friability of granulation tissue).
▸ Healing: Compromised.
▸ Testing: None required.
▸ Treatment: Aggressive debridement, possibly with adjunctive antimicrobial measures (such as manuka honey or starch iodine).
Clinical Infection (Rare)
▸ Example: Markedly worsening chronic wound.
▸ Bacteria: Very significant in numbers and virulence.
▸ Signs and symptoms: Significant in numbers and virulence. Well organized, often as “biofilm.” There is evidence of a host inflammatory response (cellulitis) and possible systemic toxicity (fever and malaise).
▸ Healing: Compromised.
▸ Testing: Wound biopsy of base preferable to culture.
▸ Treatment: Systemic antibiotics.
Source: Dr. Kunimoto