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Wound Infection In Clinical Practice: Principles of best practice

David Keast, Donna Angel, Dot Weir, Emily Haesler, Karen Ousey, Keryln Carville, Nicola Waters, Patricia Idensohn, Terry Swanson, Thomas Bjarnsholt
2 March 2022

Wound infection continues to be challenging for people with a wound, their families and health professionals. Wound infection can lead to protracted wound healing, multiple health service visits and increased hospital admission duration. This comes at significant economic cost and negatively impacts quality of life outcomes for the person with a wound and their family. Accurate and timely identification of the signs and symptoms of wound infection are critical to achieving effective management of wound infection. 

This edition of Wound Infection in Clinical Practice, authored by the International Wound Infection Institute (IWII) Committee, is an update from our previous consensus document published in 2016. Advances in research and clinical practice relating to the wound environment, risk factors for infection, biofilm, antimicrobial resistance, and new technologies for identification and management of wound infection have been incorporated into this update. Our intention is to provide practical information based on the latest understanding of the science and clinical applications regarding wound infection. 

We have expanded some chapters and added new chapters, discussed some recent controversies in the field, and provided new definitions relating to the topic that arose from a recent consensus process conducted by the IWII. In updating the document, rigorous methodology was implemented, including a systematic literature review, a Delphi process (to refine definitions), critical appraisal of the evidence on clinical efficacy of topical antimicrobials, and peer review from global key interdisciplinary opinion leaders. 

Integral to this document is an updated version of the IWII Wound Infection Continuum (IWII-WIC) for use by health professionals in their clinical practice and by educators and researchers. To facilitate its use, the IWII-WIC is presented as a removable poster. Other versions of the IWII-WIC are available from the IWII website, including simplified versions for patient and/or student teaching.

The IWII is a volunteer organisation that has been promoting prevention, identification and management of wound infection since 2006. The IWII provides this consensus document free to download via Wounds International (, and from, and the document is available in multiple languages. The IWII also provides additional information and resources to support the implementation of practice guidance outlined in this document, including Made Easy and Top Ten Tips resources focused on aspects of wound infection prevention and management. These text, graphic and multimedia resources will be updated regularly as a part of the IWII implementation plan for this 2022 edition of Wound Infection in Clinical Practice. Membership and access to the IWII is free.

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