From the Guidelines
Wound erythema should be managed by assessing the severity of the infection and the presence of systemic symptoms, with antibiotics recommended only for more extensive infections or those with systemic inflammatory response criteria, as stated in the 2018 WSES/SIS-E consensus conference recommendations 1.
Key Considerations
- Normal erythema appears as mild redness immediately surrounding the wound, typically lasting 2-3 days after injury as part of the inflammatory phase of healing.
- If the redness spreads beyond the immediate wound area, feels warm to touch, or is accompanied by increasing pain, swelling, pus, or fever, it likely indicates infection requiring treatment.
- The 2018 WSES/SIS-E consensus conference recommendations suggest that incisional SSIs should always be drained, irrigated, and if needed, opened and debrided, with empiric broad-spectrum antibiotic treatment initiated in patients with systemic inflammatory response criteria or signs of organ failure 1.
Management of Wound Erythema
- For mild infected wounds, topical antibiotics like mupirocin (Bactroban) applied three times daily for 7-10 days may be sufficient.
- More extensive infections require oral antibiotics such as cephalexin 500mg four times daily or clindamycin 300mg four times daily for 7-10 days, as recommended by the 2018 WSES/SIS-E consensus conference 1.
- While monitoring the wound, keep it clean by gently washing with mild soap and water, apply a thin layer of petroleum jelly to maintain moisture, and cover with a sterile bandage changed daily.
Importance of Early Detection and Treatment
- Erythema occurs because blood vessels dilate during inflammation, bringing immune cells to fight potential pathogens and deliver nutrients for tissue repair.
- If erythema worsens despite treatment or is accompanied by red streaking, significant swelling, or systemic symptoms, seek immediate medical attention as this may indicate a spreading infection requiring more aggressive intervention, as highlighted in the practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the Infectious Diseases Society of America 1.
From the Research
Wound Erythema
- Wound erythema is not directly addressed in the provided studies, however, wound care and cleansing are discussed in detail.
- The studies focus on the importance of proper wound cleansing and the potential negative effects of unnecessary or improper cleansing techniques 2, 3, 4.
- Key components of wound care include debridement, irrigation, and wound cleaning, which can help remove necrotic tissue and reduce wound bioburden to enhance wound healing 4.
- The use of topical antiseptics and cleansers is also discussed, with concerns raised about their potential negative impact on wound healing mechanisms 3.
- Some studies suggest that certain cleansers, such as polyhexanide/betaine, may be non-toxic and effective in enhancing wound healing, but further research is needed 4.