Analysis of Wound Infection: A Case Study on Physiological Basis

This case study analyzes a 21-year-old patient, Mary, admitted with an infected laceration on her left foot. It examines the physiological basis of the wound, including signs of infection like redness, warmth, and purulent discharge. The study delves into endogenous and exogenous sources of contamination, detailing the modes of transmission. Furthermore, it provides a rationale for the choice of antibiotics, including ceftriaxone, cephalexin, and dicloxacillin, and discusses potential adverse reactions to dicloxacillin. The case study concludes by outlining the process of wound healing, from rapid haemostasis and inflammation to proliferation, angiogenesis, reepitheliazation, and synthesis. This case study provides insights into the diagnosis, treatment, and healing processes associated with wound infections.

This template must be used to answer the case study.
1 Physiological basis of the wound observations (Total: 10 marks)
The physiological basis represents a broad examination of administration of service users suffering
from functional immobilisation because of injury, disorder or trauma. In accordance with case study,
it is determined that Mary, a 21-year-old lady was admitted to hospital in the emergency department
with an infected laceration on her left foot. It was analysed that the service user has sustained a deep
2 cm long jagged laceration over the lateral aspect of her left foot. The lacerations are basically
caused by sharp objects. A deep cut may be caused because of underlying tissues like fattening of
muscle or bone (Bullock & Manias, (2017). The wound was found to be extremely swollen and also
had a purulent discharge. On inspection, the patients wound was found to be red and warm when
being touched. All these are the major signs and symptoms of wound infection.
Purulent discharge is a liquid which sludge from a wound. This fluid is often green, yellow
or white in colour. It is the outcome of dilating blood vessels which is often seen at the initial level
of healing. A wound swab of Mary was also taken for culture and sensitivity. Wound culture is
basically a sample of liquid which is been taken from the wound and given in lab in order to know
about the bacteria which is the reason behind infection. Redness and warmness in wound shows that
her left foot is severely infected which is extremely painful.
If the wound in patient continues to be red than it is a major symptom for lymphangitis, in
which service user is at risk of developing wound infection. The patient is more likely to suffer from
infection if the cut is large and deep. Moreover, it is risky if caused by a jagged or harmful objects
such as mirror, broken glass, etc. The breakdown of skin because of wound infection also weakens
the body's immune system and raises other problems like inflammation and damage to tissue within
the skin (Craft & Gordon (2015). This can also slowdown the healing of wound and make a human
body more prone to infection. Mary can suffer from infected wound because of bacterial
colonisation arising from viruses which lies inside the body parts or in environment.
1.1 Name one endogenous source of contamination and discuss the mode of transmission
from the source to the new host. (5 marks)

Endogenous infection is a disease which occur in case where microbes of normal bacteria flora paves
a way in sterile part of body that is muscle or brain. It may be seen in Mary because of broken tissue
and can make patients’ immune system weak. The one endogenous source of contamination is when
the patient’s own immune system is being compromised during surgery or impairment in blood. It
happens when a dormant pathogen reacts in service users body and infect the host. In order to cure
these antibacterial can be given to patient which can help them in fighting against the viruses. This
infection is caused because of contamination of surgical wards that directly links various virus to
human body and make them infected (Craft & Gordon, (2015).
The mode of transmission from the infected source to the new host can be through human
reservoirs. The process takes place when bacteria leave via a portal of exist and enter through an
appropriate portal of entry. It occurs when the bacteria leave its reservoirs through portal of
exist and enters into patient’s body and weakens their immune system. It can also enter service
users body by portal of entry in order to infect a hypersensitive host. Name one exogenous
source of contamination and discuss the mode of transmission from the source to the new host.
1.1 Name one exogenous source of contamination and discuss the mode of transmission from the
source to the new host. (5 marks)
An exogenous source is that type of infection which develops infectious bacteria from outside
environment into the human body. It has been noted that the most of the time the infection is been
transmitted through three ways that is person to person, through outside environment or from animal
to human. Like for example the exogenous source of contamination in Mary is outside environment,
as she has suffered injury because of getting hurt from sharp edge of a glass bottle.
These sources hamper the health and well-being of patient and also, slow-down the healing
process of wounds. These infections act as a challenge for health-care professionals and nurses.
The mode of transmission from the source to new host can be either through inanimate
objects like handkerchief which has been used by Mary for bandaging (Lee & Bishop (2016). It is
possible that the handkerchief of patient carries pathogens of bacteria that directly attacks the
susceptible host. A patient suffering from exogenous infections are treated by providing them
antibacterial. This may help them in healing the wounds and enhance their well-being.
1 Rationale for choices of antibiotics (Total 10 Marks)

1.1 Rationale for the stat dose of ceftriaxone administered IVI immediately. (3 marks)
It is analysed that Mary covered the wound with handkerchief which worsen the situation of
wound. However, next morning after observing all the signs and symptoms of wounds, ceftriaxone 1
gram was given and administered IVI. The rationale for imparting this medication is in order to cure
wound infection (Lee & Bishop (2016). The therapeutic indications state that this medicine is given
to patients who are suffering from soft tissues infections. Mary has been provided with this medicine
because she was suffering from chronic wound infection which increased risk of damaging tissues
around wound. This medicine is given in form of drug injection, and it should be administered by
nurses over 5 minutes.
Rationale for the oral cephalexin. (2 marks)
It has been observed that nurses recommended Mary to take oral cephalexin 500mg in every six
hours before being sent to home. Rationale for using this medicine is that, it is given to treat
bacteria which raised because of endogenous or exogenous sources (Marieb & Hoehn (2016). If,
Mary skips this medicine then, it increases risk to develop further infection which will be
resistant to antibiotics. Rationale for the change to oral dicloxacillin. (4 marks)
Dicloxacillin sodium oral capsule 500mg is used to cure variety of bacterial infection. The motive
behind changing medication was to reduce the growth of bacteria. The drug helps in healing the
wound which is caused by infection.
1.1 State two adverse reactions to dicloxacillin. (1 mark)
Oral dicloxacillin has various side effects that can lay negative impact on patient’s body. They are:
 No or little urination
 Service user may face problem like severe pain in stomach.

1 Process by which Mary’s wound will heal (Total: 5 marks)
The process by which Mary's wound can be healed are:
Rapid haemostasis- It can be termed as a mechanism which can help in preventing bleeding. It can
be achieved by undergoing a process known as vasoconstriction where the vessels of blood are
tightly closed. This will help in preventing loss of blood and purulent discharge from infected
laceration.
Inflammation- It is one of the method undertaken by human body itself that prepares body to
overcome injury. The process will support in detecting that the cells which are injured and
replace them with the new one. (Marieb & Hoehn, (2016). This process is too long but it can
reduce the chances of regeneration in case of Mary as her wound is badly infected.
Proliferation- After occurring of inflammation, the body spreads various types of healthy cells are
involved which are accountable for proliferation. This a process which includes transfer of healthy
cells in a human body. This method is similar to haemostasis, where cells work together in order to
compress blood vessel which will be effective for treating and healing wound. It help in controlling
and preventing bleeding
Angiogenesis- After proliferation when Mary's bleeding is being controlled, her body will start re-
generating tissues. It will form new blood vessels. This process is known as angiogenesis. It is
shown when the body's cells start replacing the injured veins and arteries with the new one (Craft &
Gordon (2015).
Reepitheliazation- After angiogenesis, when patients body starts regrowing veins, then after this
the cells start working on the damaged skin. The injured skin cells are being removed by them and
replace it with new skin. This procedure includes developing of layers in skin to protect wound
which will be effective for healing the wound
Synthesis: This is the last step in which body develops some amount of protein in form of blood clot
that will prevent bleeding and will help in forming new layer of skin.

REFERENCES
Bullock, S., & Manias, E. (2017). Fundamentals of pharmacology (8th ed.). Frenchs Forest,
Australia: Pearson Australia.
Craft, J., & Gordon, C. (Eds.). (2015). Understanding pathophysiology (2nd Australian and New
Zealand ed.). Chatswood, Australia: Elsevier.
Lee, G., & Bishop, P. (Eds.). (2016). Microbiology and infection control for health professionals
(6th ed.). Melbourne, Victoria: Pearson Australia.
Marieb, E.N., & Hoehn, K. (2016). Human anatomy & physiology (10th global ed.). Harlow,
United Kingdom: Pearson Education.
Online
Endogenous vs. Exogenous Infections. (2015). [ONLINE] Available through:
<http://blog.eoscu.com/blog/endogenous-vs.-exogenous-infections-its-all-about-crowd-
control>