When should topical antimicrobials be used in wound care?

Topical antimicrobials are indicated primarily when there is a suspicion of infection or when there is a presence of bioburden in the wound. This approach is important for managing wounds that may be at risk for infection or that already exhibit signs of infection. By applying topical antimicrobials in these situations, healthcare providers can help to reduce microbial load, prevent infection from progressing, and promote a more favorable healing environment.

Using topical antimicrobials during all stages of healing is not necessary and may expose wounds to unnecessary products and potential irritation. The application of these agents should be more targeted and prudent, focusing on instances where there is a clear clinical need. Employing them only when systemic antibiotics have failed might delay necessary treatment during the early stages of infection, and waiting until after a wound has fully closed can be counterproductive, as infection control plays a critical role in achieving closure in the first place. Thus, the best practice is to consider their use at the moment infection is suspected or when there is a need to manage bioburden effectively.