RISK FACTORS

• Older age
  
• Diabetes
  
• Immune system disorders, cancer, human immunodeficiency virus infection, and malnutrition
  
• Paralysis or other limited mobility (wheelchairs, confined to bed)
  
• Hospitalization, which increases risk for infection by organisms that are resistant to antibiotics
  

COMPLICATIONS OF WOUND INFECTIONS

• Death of surrounding tissue, including muscle, connective tissue, or bones, which may require surgical debridement (removal of dead tissue)
  
• Spread of the infection to the bloodstream, involving other organs
  
• Septic shock, a critical illness involving the whole body, which may require intensive care and life support and lead to multiple organ failure or death
  

SURGICAL WOUND INFECTIONS
The incision (cut) in the skin performed for an operation can become infected. Surgical wound infections can range from redness surrounding a small portion of the incision to deeper infections involving underlying muscles or to a severe infection spread through the bloodstream. Doctors take precautions to prevent surgical wound infections, including use of sterile (free from germs) procedures and instruments and appropriate use of antibiotics. Risk factors for surgical wound infections include diabetes, emergency procedures, smoking, severe obesity, altered immune function, malnutrition, low body temperature, and long operation times.

TREATMENT
Treating wound infections depends on the nature of the wound, degree of infection, and the bacteria responsible for the infection. All wounds should be cleaned, any foreign materials (such as dirt or splinters) removed, and any pus drained. Prescription antibiotics may be necessary to treat the infection and prevent its spread. A tetanus vaccine booster shot may be indicated to prevent the occurrence of tetanus (lockjaw), a serious illness that includes severe muscle spasms. Severe infections or infections that occur in persons with medical problems may require hospitalization and intravenous (through a vein directly into the bloodstream) antibiotics. In the case of sepsis or septic shock, intensive care and life support may be needed.

FOR MORE INFORMATION

• Centers for Disease Control and Prevention
  800/311-3435
  http://www.cdc.gov
  
• American College of Surgeons
  800/621-4111
  http://www.facs.org
  

INFORM YOURSELF
To find this and previous JAMA Patient Pages, go to the Patient Page link on JAMA's Web site at http://www.jama.com. Many are available in English and Spanish.

Sources: American College of Surgeons, National Institute of Allergy and Infectious Diseases, Centers for Disease Control and Prevention

The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call 718/946-7424.

TOPIC: INFECTIONS