ABSTRACT
INTRODUCTION Carrel alluded to the concept of bioburden in 1921 (1), when he noted, “an abscess far removed from the site of healing can cause a delay in the healing process.” Wounds are rarely a purely locoregional phenomenon; a dynamic balance exists between the patients’ medical status and their ability to heal. Prompt and directed attention toward optimizing metabolic support, control of hyperglycemia, antimicrobial therapy, and tissue support are critical aspects in the successful care of patients and their wounds. The importance of optimizing nutrition, vascular status, hemodynamics, moisture control, pressure relief, immunologic status, and the control of edema cannot be overstated in the quest for improved and successful wound healing. It is well established that wound healing is impaired with infection, and this is one area that the clinician can directly intervene, treat, improve, and potentially prevent quite readily.
