Stotts listed several risk factors associated with infection of a chronic wound. The author is from the University of California San Francisco.
Risk factors for infection in a chronic wound:
(1) malnutrition or nutritional deficiency (vitamins, minerals)
(2) comorbid conditions (diabetes mellitus, congestive heart failure, liver disease, renal failure, hypoxic lung disease, morbid obesity)
(3) medications (corticosteroids, chemotherapeutic agents, immunosuppressives)
(4) sutures or foreign debris
(5) immunodeficiency
(6) hypoperfusion with ischemia of region
(7) hypothermia
(8) necrotic material
(9) remote infection
(10) colonization with Staphylococcus aureus
(11) smoking and/or tobacco use
(12) blood transfusion
where:
• NSAIDs were listed as a drug class associated with infection. I cannot think of how these would predispose to infection. They would be an indicator of comorbid disease.
• Hypoxia was listed as a cause, but this would seem to reflect comorbid lung disease.
Additional ones I would add:
(1) substandard nursing and wound care
(2) repetitive trauma, especially with decreased pain sensation (seen in Buruli ulcers)
