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Clinical Microbiology Reviews, April 2001, p. 244-269, Vol. 14, No. 2
0893-8512/01/$04.00+0   DOI: 10.1128/CMR.14.2.244-269.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.

Wound Microbiology and Associated Approaches to Wound Management

P. G. Bowler,1,* B. I. Duerden,2,3 and D. G. Armstrong4,5

ConvaTec Global Development Center, Deeside, Flintshire,1 Department of Medical Microbiology, University of Wales College of Medicine, Cardiff,2 Public Health Laboratory Service, London,3 and Department of Medicine, Manchester Royal Infirmary, Manchester,4 United Kingdom, and Department of Surgery, Southern Arizona Veterans Affairs Medical Center, Tucson, Arizona5

The majority of dermal wounds are colonized with aerobic and anaerobic microorganisms that originate predominantly from mucosal surfaces such as those of the oral cavity and gut. The role and significance of microorganisms in wound healing has been debated for many years. While some experts consider the microbial density to be critical in predicting wound healing and infection, others consider the types of microorganisms to be of greater importance. However, these and other factors such as microbial synergy, the host immune response, and the quality of tissue must be considered collectively in assessing the probability of infection. Debate also exists regarding the value of wound sampling, the types of wounds that should be sampled, and the sampling technique required to generate the most meaningful data. In the laboratory, consideration must be given to the relevance of culturing polymicrobial specimens, the value in identifying one or more microorganisms, and the microorganisms that should be assayed for antibiotic susceptibility. Although appropriate systemic antibiotics are essential for the treatment of deteriorating, clinically infected wounds, debate exists regarding the relevance and use of antibiotics (systemic or topical) and antiseptics (topical) in the treatment of nonhealing wounds that have no clinical signs of infection. In providing a detailed analysis of wound microbiology, together with current opinion and controversies regarding wound assessment and treatment, this review has attempted to capture and address microbiological aspects that are critical to the successful management of microorganisms in wounds.

* Corresponding author. Mailing address: ConvaTec GDC, First Avenue, Deeside Industrial Park, Deeside, Flintshire CH5 2NU, United Kingdom. Phone: 44 (0) 1244 584300. Fax: 44 (0) 1244 584311. E-mail: phil.bowler{at}bms.com.

Clinical Microbiology Reviews, April 2001, p. 244-269, Vol. 14, No. 2
0893-8512/01/$04.00+0   DOI: 10.1128/CMR.14.2.244-269.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.


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