Skin integrity, antimicrobial stewardship and infection control: a critical review of current best practice

Abstract

Skin integrity' refers to intact, unbroken, and healthy skin. Disruption of skin integrity can be caused by intrinsic and extrinsic factors including altered nutritional status, vascular disease, diabetes, and tissue injury, and this is often associated with development of localised clinical infection. Skin health and hygiene is important for preventing wounds and development of localised clinical infection or sepsis. Clinical wound infection is an increasing problem in healthcare, with the potential for increasing the burden of antimicrobial resistance (AMR), if antimicrobials are overused to treat wound infection.In this review we discuss skin integrity and wound infection prevention and outline the guiding principles of antimicrobial resistance and antimicrobial stewardship for infection control. Additionally, we provide a critical review of current best practice, highlighting the pathway to guide management of patients at risk of infection development, and discuss the latest research progress on antimicrobial resistance and skin integrity.