How to Identify and Treat an Infected Wound

Wound infections can slow healing, cause discomfort, and lead to complications.⁷ Knowing how to prevent infections, recognize early signs, and provide proper treatment is essential for recovery. This article explains how infections occur, how to care for wounds effectively, and ways to support your body’s healing process through nutrition and lifestyle choices.

How do wound become infected?

^{When microorganisms such as bacteria, viruses, or fungi enter a wound and multiply beyond the body’s ability to control them, an infection develops. While our skin normally has bacteria (called natural flora), some harmful bacteria can invade wounds and cause problems.4}

Risk factors

If the body has a reduced capacity to heal, wounds are more likely to become infected. Advanced age, diseases and lifestyle factors have a significant impact on one’s healing capacity.² Some wounds are more likely to become infected than others. Cuts or scrapes caused by dirty objects (such as gardening tools or rough surfaces) carry a higher risk.² Infection can also happen due to poor wound care, such as failing to wash hands before touching a wound, using unclean equipment, or treating a wound in an unsanitary environment.⁸

Health history

Individuals may have health conditions that weaken their body’s ability to fight off infection. These conditions include:

• Diabetes – High blood sugar levels slow healing and make wounds more prone to infection.¹
• Poor circulation – Reduced blood flow limits oxygen and nutrients needed for recovery.¹
• Low immunity – Medical conditions or treatments (such as chemotherapy or steroids) may weaken the immune system.¹
• Lung conditions – Diseases that make breathing difficult reduce the amount of oxygen in the blood and healing is slower.¹

Lifestyle factors

• Smoking and vaping – These reduce oxygen supply to tissues, making wounds heal more slowly.⁶
• Obesity – Excess body weight increases the risk of infection and slows healing.⁶
• Malnutrition – Poor diet prevents the body from getting the nutrients needed for tissue repair.⁶
• Alcohol and illicit drug use – These damage the tissues and systems involved in healing.⁴

The impact of smoking on wound healing

Smoking and vaping significantly slow wound healing by reducing oxygen supply to tissues. Nicotine causes blood vessels to narrow, meaning less oxygen and nutrients reach the wound, making recovery slower and increasing infection risk. If quitting smoking is difficult, reducing nicotine intake while a wound is healing can improve recovery outcomes.⁶

Effects of medications

Get prompt, professional advice if:

• There is more warmth, redness, or pain around the burn³

• It has not healed in two weeks³
• You feel feverish or unwell³
• The burn has pus or a bad smell³
• You have diabetes, low immunity or circulation issues³

Although necessary, some prescription medications can adversely affect wound healing. Awareness of this can help you understand why a wound is healing slowly.

• Non-steroidal anti-inflammatory drugs (NSAIDS) – reduce the ability of white cells to remove debris and microorganisms from the wound.¹
• Blood thinners – impair clot formation and may cause excessive bleeding.¹
• Cancer treatments – damage healthy cells as well as cancer cells.²
• Steroids – lower the immune system function and reduce production of collagen.²
• Treatments for auto-immune disorders – suppress the immune system.²

Location of wound

Some parts of the body are more likely to develop infections due to excess moisture, amount of hair, or closeness to bacteria:

• Perianal area – The skin around the anus is home to many bacteria, especially if hygiene is poor.²
• Hairy areas – Regions with thick hair (such as the scalp, armpits, and groin) can trap moisture, encouraging bacterial growth.²
• Feet and toes – These areas are often enclosed in shoes, creating a warm, damp environment where bacteria thrive. Feet and toes are also more likely to have poor blood flow.²

Tips to prevent wound infection

Good wound care is essential to prevent infection and speed up healing. Key points to remember:

• Dirty wounds and burns have a high risk of infection – use antiseptic cleansers and antimicrobial dressings.⁴
• Clean your hands before and after wound care to prevent bacteria from spreading.⁸
• Use sterile equipment or disinfect tools before and after use. Avoid touching wounds with unclean objects.⁸
• Keep wounds covered with a proper dressing to shield them from bacteria.²
• Change dressings only when necessary, such as if they become wet, dirty, or loose.⁸
• Change dressings in a clean environment – turn off or redirect the air flow of fans and air conditioning, remove pets from the area.

Supporting healing with lifestyle choices

Your body’s ability to heal can be helped or hindered by lifestyle factors. Here’s how to give wounds the best chance at recovery:

Healthy nutrition for for wound healing

A balanced diet and adequate hydration improve the body’s ability to heal and fight off infection. Try to avoid or limit “junk” food that is usually high in sugar and unhealthy fats. Some nutritional supplements are designed to boost wound healing, but check with your health care professional before using them.² Some important nutrients are:

• Protein – Supports tissue repair and immune function. Found in meat, fish, eggs, nuts, and dairy.²
• Vitamin C – Helps collagen formation and boosts immunity. Found in citrus fruits, berries, and leafy greens.²
• Zinc – Speeds healing and reduces inflammation. Found in seafood, mushrooms, organ meats, and seeds.²
• Iron – Promotes oxygen delivery to tissues. Found in red meat, spinach, oysters and whole milk.²
• For people with diabetes, keeping blood glucose levels stable is essential. High sugar levels interfere with immune function and increase infection risk.
• Eating high fibre foods (such as whole grains and vegetables) and avoiding excess sugar can help manage blood sugar levels.³

Signs of wound infection

Inflammation is a normal part of healing, but can be mistaken for infection. When a wound is new, the body responds by sending blood to the area, which can cause redness, warmth, and mild swelling. This is the body’s way of repairing damage and preventing harmful microbes from spreading.² 

However, if these symptoms continue for more than four days, or are accompanied by pus, worsening pain, or a foul smell, infection is more likely the cause.⁴

Watch for…

If you experience two or more of the following signs, your wound may be infected:

• Increasing redness, swelling, or warmth around the wound.⁴
• Excess fluid or pus leaking from the wound.⁴
• Worsening pain that does not improve.⁴
• Bad smell coming from the wound.⁴
• Unusual wound tissue, changing from pink or red to brown, white, or black.⁴

But remember…

These signs may not be obvious in people with low immunity or poor blood flow.⁴ If these people feel unwell it is wise to see a doctor.

What should you do if the wound is infected?

Seek medical attention promptly – A doctor or wound care nurse may test the wound to identify bacteria causing the infection.⁴

• Use an antiseptic wound cleansing solution.⁷ – Avoid using vinegar, hydrogen peroxide, bleach, alcohol, or household disinfectants – even when diluted, they will do more harm than good.²
• Apply antimicrobial dressings – These will fight infection and keep the right moisture balance. Check the ingredients for things you might be allergic to and follow the manufacturer’s instructions.² 

Antibiotics: Are they necessary?

Antibiotics are frequently misused in relation to wounds. If there are no signs of infection, antibiotics are unnecessary. Even when tests confirm a bacterial infection, antibiotics only kill specific bacteria, and wounds often contain multiple species. Other microbes like viruses and fungi can be present too, and antibiotics do not work on these. Misuse and overprescribing of antibiotics has led to increasing antimicrobial resistance globally, making infections harder to treat.⁷ Proper wound care, combined with antiseptic wound cleansers and antimicrobial dressings is more effective. This approach also reduces the need for antibiotics.⁷

Reducing wound pain

Wound related pain is a complex issue, requiring personalised assessment and management. There are, however, some helpful tips that apply to everyone:

• The cleansing solution should be at body temperature to minimise pain and promote healing.⁵
• Use dressings that maintain a moist wound environment and avoid any products that stick to the skin – secure dressings with a bandage and tape instead.⁵
• Use pain relief according to your doctor’s instructions. Take it 30 minutes before dressing changes if the procedure increases pain.⁵

The last word

Wound care is a highly specialised field requiring a thorough understanding of wound characteristics, healing processes, and dressing properties. Choosing the right dressing requires consideration of moisture balance, infection risk, and personal needs. The vast array of advanced dressings available can make selection confusing. Furthermore, wounds change over time, so their management must change too. To ensure you get the most appropriate treatment, it is best to seek regular advice from a wound care professional. Using evidence-based guidelines, they will provide you with an individualised care plan to suit your changing needs.