Goal: If a wound develops signs of infection (e.g., increasing pain, erythema, purulent drainage) or the patient becomes systemically ill (e.g., fever, tachycardia, hypotension, lethargy, decreased mental status), wound infection must be identified and treated. Treat infected wounds with a combination of local wound care and systemic antibiotics.
Daily sugar or honey dressings for infected wounds may successfully treat infection in very austere settings.12 This involves irrigating the wound with saline or the cleanest water available and then filling it with sugar or honey, which is left in place under a dry dressing, repeating every 24 hours.
Severe wound infection is life threatening and may require aggressive debridement, up to and including amputation. Evacuate patient. If evacuation is not possible, obtain telemedicine consultation and initiate infection treatments above.