Boils, furuncles and impetigo

Boils (furuncles) are localised, subcutaneous pyogenic infections, most frequently by Staphylococcus aureus, originating deep in a hair follicle.

Impetigo is a contagious superficial pyoderma, caused by Staphylococcus aureus and/or group A streptococci, that begins with a superficial flaccid vesicle that ruptures and forms a thick yellowish crust.



References:

• Stedman's Electronic Medical Dictionary, v5.0
• Image from http://www.clinical-virology.org/gallery/images/non_viral/impetigo-1.jpg
  

Wound swabs

Contamination = the presence of organisms in a wound that are not multiplying.

Colonisation = the presence of organisms in a wound that are multiplying but causing negligible host reaction. Colonisation can have a detrimental effect on wound healing, but as the ‘classic’ signs of infection do not accompany it, is often not identified.

Infection = the presence of organisms in a wound that are multiplying and causing a host reaction.

Signs of infection

• delayed healing
• purulent discharge from the wound
• Green, yellow or brown wound exudate or increased amount of wound exudate
• Offensive odour
• Inflammation and erythema of the wound and surrounding tissue – may include cellulitis
• Hypergranulation tissue
• Systemic signs: fever, malaise/lethargy
• Increased or unusual pain (Note: persons with diabetes may not experience this)
• Confusion
• Elevated BSL in diabetics
• Leucocytosis
  

Indications for Wound Swabbing

• An obvious wound exists and the surface can be sampled
• Clinical signs of infection
• Viable tissue exists - not slough or necrotic tissue (although these need to be removed via debridement)
  

References:

• Templeton S., Royal District Nursing Service of SA, http://www.rdns.org.au/research_unit/Newsletters/11_Wound_Sep02.pdf