Increased bacterial burden and infection: NERDS and STONES

The purpose of this article is to provide practitioners with an overview of wound infection/ inflammation and bacterial balance and to offer a guide to the assessment and treatment of chronic wounds. Assessing the wound for clinical signs and symptoms of inflammation and infection is an important part of preparing the wound bed for healing. This article presents easy-to-use clinical criteria for diagnosing superficial bacterial burden and deep tissue infection (NERDS and STONES) as well as an organised approach to the selection of appropriate topical and systemic treatments.