Chronic wounds—such as diabetic foot ulcers, venous leg ulcers, pressure injuries, and non-healing surgical wounds—are a significant health concern for many Australians. These wounds not only impact quality of life but also carry a high risk of infection, which can lead to serious complications, hospitalisation, or even amputation.

For carers, patients, and home health aides, understanding how to prevent infections in chronic wounds is essential for promoting healing and safeguarding overall wellbeing.

This article provides a comprehensive, evidence-based guide to best practices in home wound care, drawing on the latest Australian standards and global research.

Throughout, you’ll find practical tips and links to trusted resources, including advanced wound dressing options.

Why Are Chronic Wounds Prone to Infection?

Chronic wounds are defined as wounds that fail to progress through the normal stages of healing in a timely manner, often remaining open for weeks or months.

Unlike acute wounds, which typically heal within a predictable timeframe, chronic wounds stall in the inflammatory phase, creating an environment where bacteria can thrive. Several factors contribute to the high risk of infection in chronic wounds:

• Compromised Skin Barrier: The skin is our first line of defence against germs. When it’s broken for an extended period, bacteria from the environment, skin, or wound exudate can enter and multiply.
• Reduced Blood Flow: Many chronic wounds occur in areas with poor circulation (e.g., legs, feet), limiting the delivery of immune cells and nutrients needed for healing and infection control.
• Underlying Health Conditions: Conditions such as diabetes, vascular disease, and immune suppression impair the body’s ability to fight infection and repair tissue.
• Moisture and Exudate: Chronic wounds often produce excess fluid (exudate), which can macerate surrounding skin and provide a breeding ground for bacteria.
• Biofilm Formation: Bacteria in chronic wounds can form biofilms—a protective layer that makes them harder to eradicate and more resistant to antibiotics.

Key Takeaway: Chronic wounds are especially vulnerable to infection due to prolonged skin breakdown, impaired immunity, and environmental exposure. Preventing infection requires a proactive, holistic approach to wound care at home.

Australian Guidelines and Standards for Wound Prevention and Management

Australia has robust, evidence-based standards for wound prevention and management, developed by Wounds Australia and endorsed by national health authorities. The Australian Standards for Wound Prevention and Management (Fourth Edition, 2023) set out clear expectations for all carers, health professionals, and home health aides:

• Equitable Care: Every Australian with a wound should receive the same high standard of care, regardless of location or who is providing care.
• Evidence-Based Practice: Wound care should be guided by the latest research, clinical judgement, and the individual’s needs and preferences.
• Collaborative Approach: Optimal outcomes are achieved when individuals, families, carers, and health professionals work together.
• Comprehensive Assessment: Regular assessment of the wound, the person’s health, and their environment is essential for early detection of infection and effective management.
• Infection Prevention: Preventing and managing wound-related infection is a core standard, with protocols for hygiene, wound cleaning, dressing selection, and escalation to medical care when needed.

These standards are designed for use by everyone involved in wound care—from registered nurses and GPs to family carers and support workers. They provide a foundation for safe, high-quality home wound care and are freely available online for reference.

Hygiene and Handwashing: The Cornerstone of Infection Prevention

Hand hygiene is the single most important step in preventing wound infections at home. Germs from hands are a common cause of wound contamination, especially during dressing changes or wound cleaning.

Best Practices for Carers and Patients

• Wash hands thoroughly with soap and water for at least 20 seconds before and after touching the wound, changing dressings, or handling wound care supplies.
• Use alcohol-based hand sanitiser (60–95% alcohol) if soap and water are not available, but always use soap and water if hands are visibly dirty or after contact with bodily fluids.
• Wear disposable gloves when cleaning wounds or changing dressings, especially if there is a risk of contact with blood or exudate. Remove gloves carefully and wash hands again afterwards.
• Keep fingernails short and clean to reduce the risk of harbouring bacteria.
• Educate family members and visitors about the importance of hand hygiene around wounds.

Environmental Hygiene: Clean and disinfect surfaces where wound care is performed. Use a wipeable surface or cover fabric surfaces with a clean cloth. Keep pets away from the wound care area and store wound care products in a clean, sealed container.

Key Takeaway: Consistent, thorough hand hygiene by everyone involved in wound care is the most effective way to prevent infection at home.

Clean vs Sterile Technique in Home Wound Care

A common question is whether wound care at home should be performed using a sterile or clean technique. Current evidence and Australian guidelines support the use of a clean technique for most chronic wound care at home.

What’s the Difference?

• Sterile Technique: All equipment, dressings, and gloves are sterile. Used in operating theatres and for invasive procedures.
• Clean Technique: Focuses on reducing the number of microorganisms. Uses clean (not necessarily sterile) gloves, dressings, and equipment. Hands are washed, and a clean field is prepared.

Research shows no significant difference in infection rates between clean and sterile techniques for chronic wound care, provided proper hand hygiene and clean supplies are used. Sterile technique may be required for surgical wounds in the first 24–48 hours or for wounds entering sterile body cavities, but for most home care situations, clean technique is safe and effective.

Practical Tips:

• Use clean, single-use or well-washed reusable equipment.
• Prepare a clean workspace and avoid touching the wound or dressing with bare hands.
• Follow manufacturer instructions for wound care dressings and supplies.

Key Takeaway: For most chronic wounds managed at home, a clean technique—combined with strict hand hygiene—is sufficient to prevent infection.

Wound Cleaning Solutions and Methods

Proper wound cleaning is essential for removing bacteria, debris, and dead tissue, creating an environment that supports healing and reduces infection risk.

What Should You Use to Clean a Wound?

• Normal Saline (0.9% sodium chloride): The gold standard for wound irrigation. It’s gentle, non-toxic, and effective at flushing away contaminants.
• Potable Tap Water: For minor wounds, clean running tap water is an acceptable alternative if saline is not available.
• Mild Soap: Can be used to clean the skin around the wound, but avoid getting soap directly into the wound bed.
• Avoid Harsh Antiseptics: Hydrogen peroxide, iodine, and alcohol can damage healthy tissue and delay healing. Use only if specifically recommended by a healthcare professional.

How to Clean a Wound at Home

• Wash your hands and put on clean gloves.
• Gently rinse the wound with saline or clean water, using a syringe or squeeze bottle to provide gentle pressure.
• Remove visible debris with sterile tweezers if necessary.
• Pat the wound dry with a clean, sterile cloth or gauze—never rub.
• Apply an appropriate wound care dressing as directed.

Frequency: Clean the wound at each dressing change, or as advised by your healthcare provider.

Key Takeaway: Use saline or clean water for wound cleaning, avoid harsh chemicals, and be gentle to protect new tissue.

Dressing Selection and Principles

Choosing the right wound care dressing is crucial for protecting the wound, managing moisture, and supporting healing. The ideal dressing keeps the wound moist (but not wet), absorbs excess exudate, protects against bacteria, and is comfortable for the patient.

Types of Wound Dressings

Explore wound care dressings, wound dressing, and wound dressings for a wide range of options suitable for different wound types and stages.

Principles of Dressing Selection

• Match the dressing to the wound’s needs: Consider exudate level, depth, infection risk, and patient comfort.
• Moisture Balance: Keep the wound moist but not soggy. Too much moisture can cause maceration; too little can slow healing.
• Atraumatic Removal: Choose dressings that minimise pain and trauma when changed, especially for fragile or sensitive skin.
• Change Frequency: Follow manufacturer and healthcare provider recommendations. Change dressings when they become wet, soiled, or lose adhesion.

Key Takeaway: The right dressing supports healing, protects the wound, and makes care easier for both patients and carers.

Advanced and Specialised Dressings

Negative Pressure Wound Therapy and PICO Dressing Wound

Negative Pressure Wound Therapy (NPWT) uses a gentle vacuum to remove excess fluid, reduce swelling, and promote blood flow to the wound bed. It’s especially useful for hard-to-heal wounds, surgical wounds, and wounds with high exudate.

The pico dressing wound is a single-use, portable NPWT system designed for home use. It consists of a small pump connected to an absorbent dressing, which is applied over the wound and sealed with adhesive strips. The pump gently draws out fluid and helps protect the wound from bacteria.

Benefits of PICO Dressing Wound:

• Can remain in place for up to 7 days, reducing dressing change frequency.
• Helps maintain a moist, protected environment.
• May improve healing rates and reduce infection risk in complex wounds.
• Portable and easy to use at home with proper instruction.

Important: Always follow your nurse or doctor’s instructions for using NPWT and monitor for signs of infection or device malfunction.

Mepitel Wound Care and Contact Layers

Mepitel wound care is a gentle, two-sided wound contact layer with Safetac® technology. It’s designed to minimise pain and trauma during dressing changes by not sticking to the moist wound bed, while allowing exudate to pass through to a secondary absorbent dressing.

Key Features:

• Suitable for a wide range of wounds, including skin tears, burns, ulcers, and surgical wounds.
• Can remain in place for up to 7–14 days, with only the secondary dressing changed as needed.
• Reduces the need for frequent primary dressing changes, supporting undisturbed healing.

Contact layers like Mepitel are especially helpful for fragile skin, painful wounds, or wounds at risk of sticking to dressings.

Key Takeaway: Advanced dressings such as PICO and Mepitel offer effective, patient-friendly options for managing complex wounds at home.

Dressing Change Frequency and Technique at Home

How often should you change a wound dressing? The answer depends on the wound type, dressing material, exudate level, and stage of healing.

General Guidelines

• Acute wounds: Change every 1–3 days, or as needed based on exudate.
• Chronic wounds: May require daily changes, especially if exudate is heavy or infection is present.
• Advanced dressings (hydrocolloid, foam, NPWT, Mepitel): Can often remain in place for 3–7 days, or as directed by your healthcare provider.
• Always change the dressing immediately if it becomes wet, soiled, loose, or if there are signs of infection.

Dressing Change Technique

• Prepare a clean workspace and gather all supplies.
• Wash your hands and put on clean gloves.
• Carefully remove the old dressing, noting any changes in the wound (colour, odour, exudate).
• Clean the wound as described above.
• Dry the surrounding skin and apply barrier cream if needed.
• Apply the new dressing according to instructions.
• Dispose of used dressings and gloves in a sealed bag.
• Wash your hands again.

Tip: Document each dressing change, noting the wound’s appearance, any concerns, and the date/time.

Key Takeaway: Consistent, careful dressing changes are vital for infection prevention and wound healing.

Recognising Signs of Wound Infection and Sepsis

Early detection of infection is critical for preventing complications. Carers and patients should monitor wounds daily for changes.

Signs of Local Wound Infection

• Increased redness, swelling, or warmth around the wound
• Worsening pain or tenderness
• Pus or yellow/green discharge
• Foul odour from the wound
• Delayed healing or wound breakdown
• The wound looks more red than usual or has a foul smell

Signs of Spreading or Systemic Infection (Sepsis)

• Fever or chills
• Red streaks spreading from the wound
• Rapidly increasing swelling or pain
• Feeling generally unwell, confused, or weak
• Fast heart rate or breathing
• Nausea or vomiting

Sepsis is a medical emergency. If you notice these symptoms, seek urgent medical help.

Key Takeaway: Know the warning signs of infection and act quickly—early intervention saves lives.

When to Seek Medical Help and Escalation Pathways

While many wounds can be managed at home, some situations require prompt medical attention.

Seek Medical Help If:

• The wound is deep, large, or bleeding heavily and won’t stop after 10 minutes of pressure.
• There are signs of infection (see above).
• The wound is not healing or is getting worse after a few days.
• You have a fever, feel unwell, or notice red streaks from the wound.
• There is a foreign object stuck in the wound.
• The wound was caused by an animal or human bite, or a dirty/rusty object.
• You have not had a tetanus shot in the last five years.

Escalation Pathways:

• Contact your GP or wound care nurse for advice.
• Attend an urgent care centre or emergency department for severe symptoms.
• For chronic, non-healing wounds, ask for referral to a specialist wound clinic.

Key Takeaway: Don’t delay seeking help if you’re concerned—timely medical care can prevent serious complications.

Managing Comorbidities That Affect Wound Healing

Chronic conditions such as diabetes, vascular disease, malnutrition, and immune suppression significantly impact wound healing and infection risk.

Diabetes

• High blood sugar impairs immune function and blood flow, increasing infection risk.
• Diabetic neuropathy can reduce sensation, making it harder to notice injuries.
• Strict blood sugar control, daily foot checks, and prompt treatment of any wounds are essential.

Vascular Disease

• Poor circulation limits oxygen and nutrient delivery to the wound.
• Compression therapy, exercise, and vascular assessment may be needed.

Nutrition

• Protein, vitamin C, zinc, and adequate hydration are vital for tissue repair.
• Malnutrition delays healing and increases infection risk.

Key Takeaway: Managing underlying health conditions is as important as wound care itself for preventing infection and promoting healing.

Pain Management and Analgesia During Dressing Changes

Pain is a common and often under-recognised issue in chronic wound care. Uncontrolled pain can delay healing, reduce quality of life, and make dressing changes distressing.

Strategies for Minimising Pain

• Use atraumatic dressings (e.g., silicone-based, non-adherent contact layers like Mepitel) to reduce pain during removal.
• Pre-medicate with oral pain relief (paracetamol or prescribed analgesics) before dressing changes if needed.
• Topical analgesics (e.g., lidocaine gel) may be used for localised pain, as advised by your healthcare provider.
• Gentle technique: Be slow and careful when removing dressings and cleaning wounds.
• Non-pharmacological methods: Distraction, music, relaxation, and breathing techniques can help manage pain.

Key Takeaway: Address pain proactively—comfortable wound care supports healing and patient wellbeing.

Infection Prevention in the Home Environment and Cleaning Surfaces

The home environment can harbour bacteria that increase infection risk.

Best Practices

• Clean and disinfect wound care surfaces before and after each dressing change.
• Use single-use disposable items where possible.
• Clean reusable equipment (scissors, tweezers) with disinfectant between uses.
• Dispose of used dressings and gloves in sealed bags.
• Keep pets away from the wound care area.
• Store wound care supplies in a clean, dry, sealed container.

Key Takeaway: A clean environment is as important as clean hands in preventing wound infections at home.

Education and Training Resources for Carers and Home Health Aides

Education empowers carers and patients to provide safe, effective wound care.

Where to Find Reliable Information

• Wounds Australia: Factsheets, guidelines, and consumer resources.
• Wound care certification courses: For home health nurses and carers, such as those offered by Vohra Wound Physicians.
• GPs, nurses, and pharmacists: Can provide hands-on training and answer questions.
• Written materials: Reinforce verbal education and support ongoing learning.

Key Takeaway: Ongoing education and support are vital for carers and home health aides managing chronic wounds.

Telehealth and Remote Monitoring for Chronic Wounds

Telehealth has become an increasingly valuable tool for wound care, especially for people in rural or remote areas, or during times when in-person visits are difficult.

Benefits of Telehealth

• Enables remote wound assessment and monitoring via photos or video calls.
• Provides access to specialist advice without travel.
• Studies show telehealth is as effective as in-person care for many wound types.
• Increases patient and carer confidence and engagement.

Tips for Using Telehealth:

• Take clear, well-lit photos of the wound for remote assessment.
• Keep a record of wound progress and any concerns to discuss during telehealth appointments.
• Follow up promptly if advised to seek in-person care.

Key Takeaway: Telehealth can enhance wound care at home—ask your healthcare provider about remote monitoring options.

Antibiotic Use and Topical Antimicrobials in Chronic Wounds

Antibiotics and topical antimicrobials play a role in managing infected wounds, but should be used judiciously to prevent resistance and side effects.

Key Points

• Topical antimicrobials (e.g., silver, iodine, honey dressings) may be used for localised wound infections, but evidence for their superiority over standard dressings is limited.
• Systemic antibiotics are reserved for wounds with spreading infection or systemic symptoms (fever, sepsis).
• Avoid routine use of antibiotics or antimicrobial dressings for colonised (but not infected) wounds.
• Follow local guidelines and seek medical advice before starting antibiotics.

Key Takeaway: Use antibiotics and antimicrobials only when clinically indicated, and always complete prescribed courses.

Preventing Pressure Injuries and Offloading Techniques

Pressure injuries (bedsores) are a common type of chronic wound, especially in people with limited mobility.

Prevention Strategies

• Regular repositioning: Change position at least every two hours to relieve pressure on vulnerable areas.
• Use pressure-relieving devices: Special mattresses, cushions, and heel protectors can reduce risk.
• Keep skin clean and dry: Manage moisture from incontinence or sweating.
• Optimise nutrition and hydration: Support skin integrity and healing.
• Inspect skin daily: Look for early signs of redness or breakdown.

Offloading: For foot ulcers, use offloading devices (e.g., special boots, casts) to reduce pressure and promote healing.

Key Takeaway: Preventing pressure injuries is a team effort—regular movement, support surfaces, and skin care are essential.

Wound Debridement Options and Home Considerations

Debridement—the removal of dead, damaged, or infected tissue—is often necessary to promote healing and prevent infection in chronic wounds.

Types of Debridement

• Sharp/Surgical: Performed by trained professionals using sterile instruments. Fast and effective for large areas of necrosis.
• Enzymatic: Uses topical agents to break down dead tissue. Suitable for some home care situations.
• Autolytic: Uses moisture-retentive dressings (hydrocolloid, hydrogel) to allow the body’s own enzymes to liquefy dead tissue. Gentle and suitable for many home settings.
• Mechanical: Involves physical removal (e.g., wet-to-dry dressings, irrigation). Can be painful and non-selective.
• Biological: Uses sterile maggots to selectively consume dead tissue (less common in home care).

Home Considerations:

• Autolytic debridement is often preferred at home due to its gentleness and ease of use.
• Sharp debridement should only be performed by trained professionals.
• Monitor for infection: Debridement can increase infection risk if not done properly.

Key Takeaway: Debridement is a critical part of wound care—discuss the best approach with your healthcare provider.

Trust Wound Care Products From a Trusted Healthcare Supplier

Caring for chronic wounds at home can be challenging, but with the right knowledge, tools, and support, infection can be prevented and healing promoted. The keys to success are:

• Meticulous hand hygiene and environmental cleanliness
• Gentle, effective wound cleaning with saline or clean water
• Thoughtful selection and regular changing of wound care dressings
• Early recognition of infection and prompt escalation to medical care
• Management of underlying health conditions and pain
• Ongoing education, support, and use of telehealth where appropriate

By following these best practices and working closely with your healthcare team, you can confidently manage chronic wounds at home and reduce the risk of infection. For more information and to explore a wide range of advanced wound care dressings—including wound care dressings, wound dressing, wound dressings, pico dressing wound, and mepitel wound care—visit trusted Australian medical suppliers and consult your healthcare provider for personalised advice.

Remember: Early intervention, consistent care, and a collaborative approach are your best allies in preventing infection and supporting healing in chronic wounds.

If you have questions or concerns about wound care at home, don’t hesitate to reach out to your GP, wound care nurse, or pharmacist. Your health and safety are always the top priority.