From the Guidelines
If you have a sutured wound that is infected, the most important step is to seek medical attention promptly to have the sutures removed and the wound drained, as this is the primary treatment for surgical site infections, as recommended by the Infectious Diseases Society of America 1. The signs of infection include increasing redness, warmth, swelling, pus, increasing pain, or red streaks extending from the wound. A healthcare provider will likely clean the wound, possibly remove some or all sutures to allow drainage.
- The use of antibiotics may be necessary in some cases, such as when there is a significant systemic response, including erythema and induration extending >5 cm from the wound edge, temperature >38.5°C, heart rate >110 beats/minute, or white blood cell (WBC) count >12 000/µL, as stated in the guidelines 1.
- Common oral antibiotics for skin infections include cephalexin, clindamycin, or trimethoprim-sulfamethoxazole, but the choice of antibiotic should be guided by the suspected or confirmed causative organisms and local resistance patterns, as recommended by the Infectious Diseases Society of America 1.
- It is essential to keep the wound clean by gently washing with mild soap and water, apply antibiotic ointment as directed, and cover with a clean bandage.
- The dressing should be changed daily or when soiled, and the affected area should be elevated when possible to reduce swelling.
- Completing the full course of antibiotics, even if symptoms improve, is crucial to ensure that the infection is fully cleared, as stated in the guidelines 1.
- Wound infections can worsen quickly and spread to surrounding tissues or bloodstream if not properly treated, which is why professional medical evaluation is essential rather than attempting to treat it yourself.
From the Research
Wound Infection with Sutures
- A wound with sutures that becomes infected can be caused by various bacteria, including Staphylococcus aureus and Streptococcus pyogenes 2, 3.
- The infection can be polymicrobial, making treatment more challenging 3, 4.
- The use of topical antibiotics can be effective in treating secondary bacterial skin infections, including those with sutures, as it provides a high antibiotic concentration at the site of infection and avoids the risk of systemic allergic reactions or generalized side effects 3.
Treatment Options
- Amoxicillin-clavulanic acid has been shown to be effective in eliminating Streptococcus pyogenes from a mixed infection with Staphylococcus aureus, even in the presence of a beta-lactamase-producing strain of S. aureus 2.
- Cephalexin is another effective antibiotic for the treatment of streptococcal and staphylococcal skin infections, including those with sutures, with cure rates of 90% or higher 5.
- Other treatment options include penicillinase-resistant semi-synthetic penicillins, first-generation cephalosporins, macrolides, and combination antibacterials such as amoxicillin/clavulanate potassium and trimethoprim/sulfamethoxazole 3, 4.