Prevention of infection is much preferred to having to treat an established wound infection.

Suggested/ indicators of infection include:

• Redness beyond the margins of the wound.
• Systemic symptoms including fever.

Meticulous hand hygiene is imperative during the dressing procedure – pay attention to the principles of infection control, frequent handwashing/ use of alcohol hand sanitizers, avoid double dipping into ointments eg use plastic spoons or wooden spatulas instead.

• Oral antibiotics should be used sparingly, and only for proven infections. EB is a lifelong disease, and with time resistance can be a major problem with indiscriminate use of antibiotics. The use of topical treatment eg muciprocin and bacitracin should also be judicious; routine use should be avoided. Although these products should be applied three times a day for the best effect, but most will only use it once a day at dressing changes.
• Silver products are another option for moderately infected wounds but are expensive. There are many different products to choose from, and whilst resistance isn’t a common occurrence, there are still some concerns over long term use. Their use should probably be restricted to one week at a time.
• Honey is popular is some regions. Medihoney is one commercial medical product. Do not use over the counter store honey, some may have spores of clostridium botulinum.
• SSD, a traditional burn ointment is convenient to use but has been shown to be possibly pro-inflammatory ie slows healing, increases scarring. It is used less often in burns for this reason.