Acute and chronic wound infections: microbiological, immunological, clinical and therapeutic distinctions

J Wound Care. 2022 May 2;31(5):436-445. doi: 10.12968/jowc.2022.31.5.436.

Abstract

Wound infection is a complex pathology that may manifest either as a rapid onset acute condition, or as a prolonged chronic condition. Although systemic antibiotic therapy is often appropriate and necessary for acute wound infections, it is often used inappropriately, excessively and unsuccessfully in chronic wound infections. Overuse of antibiotics in chronic (hard-to-heal) wound management contributes to antibiotic resistance. This literature review confirms that acute and chronic wound infections are significantly differentiated by their cause (microbial phenotype), the subsequent host immune response and by the resulting clinical manifestations. Consequently, recognition of the type of wound infection followed by appropriate and timely therapy is required to improve wound healing outcomes while encouraging more judicious and responsible use of antibiotics.

Keywords: acute; antibiotics; antimicrobial stewardship; biofilm; chronic; hard-to-heal; infection; wound; wound care; wound healing; wound hygiene; wound infection; wounds.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use
  • Chronic Disease
  • Drug Resistance, Microbial
  • Humans
  • Persistent Infection
  • Wound Healing
  • Wound Infection* / drug therapy
  • Wound Infection* / microbiology

Substances

  • Anti-Bacterial Agents