5 Infection Prevention

Why infection prevention matters

Burns disrupt the skin’s protective barrier, making careful wound assessment and infection-control practices essential. Follow the patient’s burn-care plan and promptly report concerning changes to the clinical team.

Prepare and change dressings safely

Perform Hand hygiene before patient contact and before an aseptic task, such as a dressing change. Use personal protective equipment (PPE) appropriate to the anticipated exposure, and follow the prescribed wound-care technique with appropriate clean or sterile supplies.

If gloves touch a soiled dressing and the next task involves clean supplies, remove the gloves, perform hand hygiene, and put on clean gloves. Do not continue with gloves that may be contaminated, even if they look clean.

Prevent cross-contamination

Keep clean supplies separate from contaminated items. Do not place used dressings on a clean work surface, and do not wear the same gloves while moving between patients. These practices help prevent cross-contamination.

Clean and disinfect reusable equipment between patients according to facility procedures. Standard Precautions include hand hygiene, appropriate PPE, and proper reprocessing of reusable equipment.

Assess for concerning wound changes

A positive wound culture or drainage alone does not prove infection. Interpret these findings alongside changes in the wound and the patient’s overall condition.

Concerning local changes include redness spreading beyond the wound, increasing warmth, swelling, pain, and purulent drainage. A new foul odor, increased drainage, or an unexpected change in wound appearance also warrants assessment. A wound that looks unchanged and is healing as expected, mild itching as it heals, or a culture detecting bacteria without other concerning changes does not by itself establish infection.

Respond to possible infection

Document new odor or increased drainage and promptly notify the clinical team for assessment. Report worsening wound appearance and systemic changes without delay, including fever, confusion, or an overall decline.

Do not independently diagnose infection from a culture result or start leftover antibiotics. Follow the burn-care team’s plan and report concerning changes promptly.

Use antibiotics only as directed

Routine systemic antibiotic prophylaxis is not recommended for burn patients. The treating team determines whether infection is present and whether cultures or antimicrobial treatment are appropriate. Antibiotics may be selected when clinically indicated; they are not automatically required for every burn patient, nor are they categorically inappropriate for burn wound infection.