Kingsley Andrew
Infection Control and Tissue Viability, Northern Devon Healthcare Trust, UK.
Ostomy Wound Manage. 2003 Jul;49(7A Suppl):1-7.
Four basic conditions exist in open wounds resulting from the level of bioburden present (bacterial contamination--normal but short-lived state, colonization--normal state, critical colonization--abnormal state, and infection--abnormal state). The two abnormal states have the potential to disrupt the orderly healing sequence, which results in the development of a chronic wound. In addition, the impact of the wound s anatomical position, duration, shape, or presentation; the patient s level of health and control of underlying pathologies; the presence of infection-potentiating factors such as foreign bodies, hematoma, and necrotic tissue; the sources and frequency of exogenous contamination; the considered virulence of the individual micro-flora species; and the potential synergism between different species all require consideration. This article discusses the states of bioburden and other aspects of microbiology relating to wound infection and their application to clinical practice.
开放性伤口因生物负荷水平（细菌污染——正常但短暂状态、定植——正常状态、临界定植——异常状态、感染——异常状态）而存在四种基本情况。两种异常状态有可能扰乱有序的愈合过程，从而导致慢性伤口的形成。此外，伤口的解剖位置、持续时间、形状或外观的影响；患者的健康水平以及对基础疾病的控制情况；感染增强因素如异物、血肿和坏死组织的存在；外源性污染的来源和频率；所考虑的个体微生物种类的毒力；以及不同种类之间潜在的协同作用等都需要加以考虑。本文讨论了生物负荷状态以及与伤口感染相关的微生物学其他方面内容及其在临床实践中的应用。
