Overview
Why the Pattern Matters
An open wound may contain microorganisms without being infected.
An open wound may contain microorganisms without being infected. The bedside question is whether microorganisms are now invading tissue and causing damage, and whether the process is still local or is spreading beyond the wound. The most useful clue is the wound's trajectory. Redness and warmth can occur during normal early inflammation, but increasing pain, enlarging dimensions, spreading erythema, new induration, or a change in exudate indicates that the wound is moving away from expected healing. At least two characteristic local signs support a diagnosis of wound infection. Expanding erythema, cellulitis, crepitus, or fever changes the priority from routine wound management to urgent medical assessment.