Bacteria live virtually everywhere, including on your skin. A skin break due to a cut, scrape, burn or surgical incision gives bacteria an opportunity to potentially invade and cause a wound infection. The bacteria multiply and damage the involved tissue, interfering with wound healing and potentially spreading. Treatments vary depending on the site and severity of a wound infection 46.
Antiseptics are chemicals applied to the skin that kill bacteria or inhibit their growth. These effects can help clear up a localized wound infection by reducing the number of bacteria in an open wound such that your immune system cells can eradicate those that remain.
Different antiseptics exert various effects on a broad spectrum of bacterial species. Because they are used topically, they only act locally and do not pose a risk for the systemic side effects that can occur with oral antibiotics, such as digestive system upset or a reduction in healthful gut bacteria.
Antiseptics come in different forms, including solutions, gels, creams, sprays, and infused bandages. Active ingredients in various antiseptic products used to treat localized wound infections include:
- Antiseptics are chemicals applied to the skin that kill bacteria or inhibit their growth.
- Because they are used topically, they only act locally and do not pose a risk for the systemic side effects that can occur with oral antibiotics, such as digestive system upset or a reduction in healthful gut bacteria.
Antibiotics for a Puncture Wound
Prescription oral, intravenous or injected antibiotics are typically reserved for moderate to severe wound infections, as noted in 2014 guidelines issued by the Infectious Diseases Society of America 2. These medicines, however, are not recommended for mild wound infections.
The antibiotic prescribed depends on the type(s) of bacteria responsible and the severity of the infection. Common antibiotics prescribed for infected wounds include:
- Cefazolin (Ancef)
- Cephalexin (Keflex)
- Clindamycin (Cleocin)
- Trimethoprim/sulfamethoxazole (Bactrim, Septra, TMP/SMX)
- Doxycycline (Doryx, Monodox, Vibramycin)
Topical antibiotics — like bacitracin/neomycin/polymyxin B (Neosporin), bacitracin/polymyxin B (Polysporin) or mupirocin (Bactroban) — typically play a limited role in the treatment of wound infections largely because of the risk of promoting antibiotic-resistant bacteria.
- Prescription oral, intravenous or injected antibiotics are typically reserved for moderate to severe wound infections, as noted in 2014 guidelines.
Drainage and Debridement
Moderate to severe wound infections often require drainage and/or debridement— the medical term for cleaning debris and dead tissue from a wound.
Drainage is particularly important for abscesses (walled-off pockets of infection) and infected surgical incisions. This allows the bacteria and pus an escape route, giving your immune system cells a leg up to overcome the infection.
Debridement is an essential aspect of treatment for deep burns and wound infections that have spread to the soft tissues beneath the skin. The latter infections are rare but very serious and include gas gangrene and so-called flesh-eating infections (known medically as necrotizing faciitis).
- Moderate to severe wound infections often require drainage and/or debridement— the medical term for cleaning debris and dead tissue from a wound.
When to See a Doctor
How to Heal Broken Skin Fast
See a doctor right away if you suffer a bite (animal or human), a deep puncture injury, or a another skin wound contaminated with dirt or other debris that you cannot remove easily with soap and water. Also seek medical care without delay if you develop any warning signs or symptoms that might indicate a wound infection, including:
- Spreading redness or red streaks radiating from a wound
- Swelling, especially if increasing in extent
- Warm or hot skin around a wound
- Pus drainage
- Foul odor emanating from the wound
- Severe or increasing pain
- Increasing wound size
- Delayed healing
- Fever and/or chills
Early treatment is particularly important if you have a condition that increases your risk for a serious wound infection, such as diabetes, poor circulation, or a weakened immune system due to disease or medications you take.
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- World Wide Wounds: Recognition and Management of Wound Infections
- Clinical Infectious Diseases: Practice Guidelines for the Diagnosis and Management of Skin and Soft Tissue Infections: 2014 Update by the Infectious Diseases Society of America
- World Wide Wounds: A Review of the Evidence for the Use of Topical Antimicrobial Agents in Wound Care
- New Zealand Doctor, Pharmacy Today: Wound Infection Prevention and Treatment
- International Wound Infection Institute: Wound Infection in Clinical Practice
- Advances in Wound Care: The Role of Topical Antiseptic Agents Within Antimicrobial Stewardship Strategies for Prevention and Treatment of Surgical Site and Chronic Open Wound Infection
- Prescriber: Topical Antibacterial and Antiviral Agents: Prescribing and Resistance
- 3M Wound Resource Center. http://solutions.3m.co.uk/wps/portal/3M/en_GB/skin-care/wound-resource-centre/
- Mccaughan D, Sheard L, Cullum N, Dumville J, Chetter I. Patients' perceptions and experiences of living with a surgical wound healing by secondary intention: A qualitative study. Int J Nurs Stud. 2018;77:29-38. doi:10.1016/j.ijnurstu.2017.09.015
- Krafts KP. Tissue repair: The hidden drama. Organogenesis. 2010;6(4):225-33. doi:10.4161/org.6.4.12555
- Chetter IC, Oswald AV, Fletcher M, Dumville JC, Cullum NA. A survey of patients with surgical wounds healing by secondary intention; an assessment of prevalence, aetiology, duration and management. J Tissue Viability. 2017;26(2):103-107. doi:10.1016/j.jtv.2016.12.004
- Singh PK, Saxena N, Poddar D, et al. Comparative Study Of Wound Healing In Primary Versus Delayed Primary Closure In Contaminated Abdominal Surgery. Hellenic J Surg. 2016;88:314–320. doi:10.1007/s13126-016-0340-8
- Surgical Patient Education Program: Prepare for the Best Recovery. American College of Surgeons. 2018.
- Rushbrook JL, White G, Kidger L, Marsh P, Taggart TF. The antibacterial effect of 2-octyl cyanoacrylate (Dermabond®) skin adhesive. J Infect Prev. 2014;15(6):236-239. doi:10.1177/1757177414551562
- Lazar HL, Mccann J, Fitzgerald CA, Cabral HJ. Adhesive strips versus subcuticular suture for mediansternotomy wound closure. J Card Surg. 2011;26(4):344-7. doi:10.1111/j.1540-8191.2011.01257.x
- 3M Wound Resource Center.
Dr. Tina M. St. John owns and operates a health communications and consulting firm. She is also an accomplished medical writer and editor, and was formerly a senior medical officer with the U.S. Centers for Disease Control and Prevention. St. John holds an M.D. from Emory University School of Medicine.