Case Study on Wound Infection

This case study discusses the symptoms, causes, and treatment options for wound infection. It explains the stages of wound healing and the medications used to treat the infection. The study also highlights the importance of identifying the type of infection and the sources of contamination. The content is relevant to nursing professionals and students studying healthcare courses.

Running head: CASE STUDY ON WOUND INFECTION
CASE STUDY ON WOUND INFECTION
Name of the student:
Name of the university:
Author note:

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CASE STUDY ON WOUND INFECTION
Question 1:
Mary was seen to develop a laceration wound after cutting her left feet with a broken
piece of glass on the sand. This type of wound that is mainly produced by the tearing of the soft
tissue and is usually irregular and jagged. Researchers are of the opinion that laceration is
contaminated with the bacteria as well as the debris from the various objects that cause the cut.
Mary was seen to have purulent discharge from the wound.
Studies suggest that purulent discharge that comes out from the wound can help the
nursing professionals to identify the condition of the wound and understand what kind of
intervention should be applied. Purulent discharge mainly occurs when the blood vessels try to
dilate during the early stages of the healing. Bacteria remain present at this time (Holmes et al.,
2015). The body is seen to create a moist environment around the wound during this time with an
attempt for healing itself. Researchers are of the opinion that when drainage becomes purulent,
there is high chance that the wound has become infected. It becomes easier for the germs to get
inside the skin when such condition develops. The germs are seen to spread under these affected
tissues and can cause the infection (Zhan et al., 2015). This stage makes the tissues swollen and
painful. Studies also suggest that such discharge implies that the wound will not heal quickly as
germs have increased chances in getting in the wounds because of its surface area. Therefore,
there is high chance that the wound developed by Mary is infected with germs.
Another important physiological symptom that can also help the nursing professionals to
identify the condition of the wound is the red and warm condition of the wound when touched.
Studies have shown that when wounds become infected, they become painful with redness
occurring around the edges of the skin and this red area feels warm or hot. When infections are

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CASE STUDY ON WOUND INFECTION
seen to spread further, the redness is seen to keep spreading to more of the areas of the skin and
this situation results in increase of temperature along with fevers and aches (Drisfke et al., 2015).
The wound of the patient named Mary is seen to develop such redness around the wound and the
wound is warm when touched. Therefore, the wound can be stated to be infected and requires
immediate nursing intervention.
Question 2:
Endogenous infection can be defined as the infectious agent that remains present in the
body but in the dormant or the in-apparent stage. Often self-contamination of the wound might
be the one of the reason by which the condition of the wound had worsened in the patient named
Mary. Many of the researchers are of the opinion that physical migration of the endogenous flora
of the patient, which are present on the skin, mucous membranes as well as gastrointestinal tract,
can result in worsening of the infections (Zhou et al., 2018). In this case, study, it might have
happened that the microns present on the skin of the patient near her wound might have entered
into it making the situation worse. Studies have suggested when wounds occur on the skin
surfaces, the normal flora of bacteria that might comprise of Staphylococcus species and many
others can enter the wound. They might take one of the endogenous source and pathway to travel
to the wounds causing infection.
Exogenous source of infection mainly includes those microorganisms that are introduced
to the close biological system from the external world and are mainly seen to exist in the aquatic
and terrestrial environments and even in the atmosphere. Two important suspected sources can
be considered here which might have helped the microorganisms to enter into the wounds of the
patient. Mary has been in a beach resort and therefore bacterial present in the soil or the sand

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CASE STUDY ON WOUND INFECTION
may have affected the wound causing severe infection. Researchers are of the opinion that about
60000 microorganisms resides in the wounds out of which many are pathogenic (Portou et al.,
2015). Therefore, this can be one of the sources of infection. Another source of infection is the
handkerchief that she had used to wrap the wound. The handkerchief might have been
contaminated with different exogenic and pathogenic bacteria that could have contributed to the
contamination of the wound.
Question 3:
The initial dose of Ceftriaxone was given to Mary intravenously. This is the medication,
which was used by the nursing professionals for treatment of the wound initially in the patient.
Researchers are of the opinion that this medication is given for treatment of the various types of
conditions like that of the urinary tract infections, infection in the years as well as lungs and
meningitis that are caused by the bacteria. It is helpful in treating bacterial meningitis, bacterial
septicemia, gonococcal infection, urinary tract infection, pneumonia, and bone and joint
infections (Bullock and Manis et al., 2017). Apart from the various types of infection in which
this medication issued, it is also skin and structure infection. Studies show that this medication
can be helpful in treating cellulites, wound infection as well as cutaneous abscesses that are
caused by Streptococcus pyogenes as well as Staphylococcus aureus. The patient in the case
study is also seen to have developed severe wound infection and therefore the nurses are seen to
have injected this infection. The effect of this medication stays for 24 hours and is seen to work
rapidly after intravenous or intramuscular routes of administration are provided ad kill broad
ranges of bacteria. Therefore, the professionals initially give this medication.

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CASE STUDY ON WOUND INFECTION
Cephalexin can be described as the cephalosporin antibiotic that mainly helps in fighting
with bacteria and are helpful in the treatment of infections. They are helpful in treating bacteria
caused by the upper respiratory infection, ear infections as well as skin infections and urinary
tract infections. Initially, before the identification of the particular type of bacteria that had
infected the wound, the professionals gave it to the patient. Researchers are of the opinion that
this medication helps in treatment of skin structure infections which are mainly caused by the
different types of susceptible isolates of the following gram positive bacteria like that of
Staphylococcus aureus and Streptococcus pyogene (Craft et al., 2015). Since, Mary had
developed wound in her feet that showed signs of bacterial infection, therefore nurses have given
this medication until the man microbe for infection is not identified.
The pathologist ultimately identified that the microorganism that contributed to the
disorder was Staphylococcus aureus. The medication named cephalexin that was provided
initially was a broad-spectrum disorder that helped in fighting bacteria of various types and was
not specific to one microbe (Han & Ceilley, 2017). However, dicloxacillin is a narrow spectrum
betalactam antibiotic that belongs to the penicillin class. It has proved to be extremely helpful for
treatment infections that are caused by non-resistant and susceptible gram-positive bacteria. It is
extremely powerful in acting against microbes that produces beta lactamase that are otherwise
resistant to the other penicillin (Lee & Bishop, 2012). Since this medication is a narrow spectrum
medication which have proved to be extremely helpful in the treatment of mild-to-moderate
staphylococcal infections, therefore the medication was exchanged from a broad spectrum drug
to that of the narrow spectrum drug because of its increased success in treatment of the beta-
lactamase producing enzymes. It is the penicillinase-resistant working penicillin and as

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CASE STUDY ON WOUND INFECTION
Staphylococcus aureus is penicilinase-resistant because of the role of beta lactamase, this
medication is considered the gold standards for the treatment.
The adverse effects of the medication of dicloxacillin are stomach illness causing nausea,
digestive problems and vomiting. It also results in bleeding as well as blood clotting disorder and
even liver and kidney disorders.
Question 4:
The first stage of wound healing is the homeostasis phase when the blood starts clotting
at the wounded site. In this step, blood vessels constrict for restricting the flow of the blood. In
Mary, this stage has passed and the infection had disrupted the next phase which is called the
inflammatory phase. This stage occurs when blood vessels leak transudate causing localized
swelling. During this stage, the damaged cells as well as the pathogens and bacteria will be
removed from the wound area and the medication will help in killing the bacteria as well. The
white blood cells, growth factors as well as nutrients and enzymes may create swelling and is
commonly seen during this stage (Marieb et al., 2016). Then her wound will enter in the
proliferative stage where would be rebuilt with new tissues made up of the collagen and
extracellular matrix. Then she will enter into the remodeling stage of wound healing when
collagen would be remodeled into type1 from type 3 and the wound will fully close.

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CASE STUDY ON WOUND INFECTION
References:
Bullock, S & Manias, E. (2017). Fundamentals of Pharmacology (8th edition) French forest ,
Austrlai: Pearson Australia
Craft, J., Gordon, C., Huether, S. E., McCance, K. L., & Brashers, V. L. (2015). Understanding
pathophysiology-ANZ adaptation. Elsevier Health Sciences.
Dreifke, M. B., Jayasuriya, A. A., & Jayasuriya, A. C. (2015). Current wound healing procedures
and potential care. Materials Science and Engineering: C, 48, 651-662.
https://doi.org/10.1016/j.msec.2014.12.068
Han, G., & Ceilley, R. (2017). Chronic wound healing: a review of current management and
treatments. Advances in therapy, 34(3), 599-610. https://doi.org/10.1007/s12325-017-
0478-y
Holmes, C. J., Plichta, J. K., Gamelli, R. L., & Radek, K. A. (2015). Dynamic role of host stress
responses in modulating the cutaneous microbiome: implications for wound healing and
infection. Advances in wound care, 4(1), 24-37.
https://www.liebertpub.com/doi/abs/10.1089/wound.2014.0546
Lee, G., & Bishop, P. (2012). Microbiology and infection control for health professionals.
Pearson Higher Education AU. Retrieved from: https://books.google.co.in/books?
hl=en&lr=&id=qhTiBAAAQBAJ&oi=fnd&pg=PP1&dq=microbiology+and+infection+c
ontrol+for+health+professionals+Lee&ots=hxQ7f6LZ-
a&sig=RawVyNsKPSO_Q5MGLvvqtHYtSvc#v=onepage&q=microbiology%20and
%20infection%20control%20for%20health%20professionals%20Lee&f=false

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CASE STUDY ON WOUND INFECTION
Marieb, E. N., & Hoehn, K. (2016). Human anatomy & physiology: Harlow: Pearson Education
Limited, 2016.
Portou, M. J., Baker, D., Abraham, D., & Tsui, J. (2015). The innate immune system, toll-like
receptors and dermal wound healing: a review. Vascular Pharmacology, 71, 31-36.
https://doi.org/10.1016/j.vph.2015.02.007
Zhan, L. X., Branco, B. C., Armstrong, D. G., & Mills Sr, J. L. (2015). The Society for Vascular
Surgery lower extremity threatened limb classification system based on Wound,
Ischemia, and foot Infection (WIfI) correlates with risk of major amputation and time to
wound healing. Journal of vascular surgery, 61(4), 939-944.
https://doi.org/10.1016/j.jvs.2014.11.045
Zhou, J., Yao, D., Qian, Z., Hou, S., Li, L., Jenkins, A. T. A., & Fan, Y. (2018). Bacteria-
responsive intelligent wound dressing: Simultaneous In situ detection and inhibition of
bacterial infection for accelerated wound healing. Biomaterials, 161, 11-23.
https://doi.org/10.1016/j.biomaterials.2018.01.024