The International Wound Infection Institute—a new global platform for the clinical management of infected wounds

The International Wound Infection Institute (IWII) is an independent international group of clinicians, scientists and other professionals working in wound management, dedicated to furthering the advancement of infection control through best practice, education, training and research. Wound infection is one of the most challenging aspects of wound management today. It is a major contributor to health care costs around the world, and causes significant distress to patients and carers. In the community, poor management of patients because of social and environmental factors is common while hospitals struggle to control dramatic increases in hospital-acquired infections. Injudicious use of antibiotics has led to the emergence of resistant strains, and, with an ageing population of frailer patients who are more susceptible to infection; the problem can only get worse. In an attempt to control rising infection rates, policy makers and health care systems apply well-intentioned targets and goals to health care providers, but rarely give the support and resources necessary to achieve their aims. For example, in the USA, health care systems will soon be unable to claim reimbursement for treating hospital-acquired infections; while in the UK hospitals are penalised if they fail to achieve specified reductions in infection rates. The IWII was set up with the specific aim of providing support to everyone who is involved in this fight against wound infection. In 2006, a meeting was held in Budapest to explore the level of interest and possible future directions for a group dedicated to this purpose. On 2 June 2008, at a meeting in Toronto, the newly formed IWII held its first formal Annual General Meeting, establishing itself as a truly independent body with elected officers and an agreed framework for future activities (Figure 1). The International Wound Infection Institute (IWII) members at its first AGM, Toronto, 2 June 2008. The task that the IWII has set itself is enormous, but the meeting identified and agreed on a number of projects in three priority areas that would be of immediate benefit to its members: There is an urgent need to identify the types of material on wound infection that could be used to educate healthcare professionals from all levels and specialities. The Education sub committee is completing a curriculum outline in nine modules on wound infection, with key slides and related materials (Figure 2). Recent data suggest that 60% of chronic wounds seen at first presentation are colonised with biofilms that impede healing, yet escape detection when current standard laboratory tests are applied. The Research subcommittee will investigate the possibility of providing a new biofilm testing protocol to improve detection and subsequent treatment of wounds colonised with biofilms (Figure 3). A major difficulty in changing attitudes and practices in wound care is the apparent lack of evidence to support certain interventions or practices, and even to support some of the major definitions that are widely used in wound management. The Evidence sub group has just completed a draft evidence review on 89 key papers dealing with wound infection. This is available to all who register on the IWII web site. Dealing with complexity in wound healing. Biofilms — a major component of wound infection?. As the IWII develops, members will be encouraged to propose and initiate projects in these areas. ‘Wound Infection in Clinical Practice’ which was launched at the 2008 meeting of the World Union of Wound Healing Societies is a consensus document that provides ‘broad, clear and safe guidance on the areas of diagnosis and the topical/systemic treatment of bacterial wound infection’. In his foreword, Prof. Keith Harding says that the wide disciplinary and geographical representation of the panel ensures that the principles are both practical and adaptable for use in local settings worldwide. A range of thought-provoking talks have been delivered at the two Annual General Meetings held by the IWII (in Toronto and just recently in Dallas) on topics including: health care–acquired infections, data collection , implementing change in wound management, and areas of cutting-edge research that could have a significant impact on how wounds are diagnosed and managed in the future. To service a global membership, the web site is the communications hub of the Institute (http://www.woundinfection-institute.com). Currently, members can find the latest news about the Institute, and raft of resources such as a list of references on wound infection, collected data on topical antimicrobials, wound infection in clinical practice and National Institute for Clinical Excellence (NICE) guidelines on surgical site infections, as well as the recently completed evidence review and curriculum outlines. Plans for the future include discussion boards to give members a forum for pooling their experience on difficult diagnostic or management problems, a literature archive with commentary and evidence rankings, the IWII educational programme, and expanded news sections to keep members up to date with developments in the area of wound infection. A significant series of presentation sets on wound infection management will be available very shortly. The IWII is open to anyone who has a professional interest in wound infection, including administrative and support staff, industry and patients. One of the factors contributing to the problems of wound infection is the differing levels of understanding, interest and sense of responsibility among the various stakeholders. The Institute is multidisciplinary and welcomes applications from community care and hospitals, surgery and nursing, management and health care commissioners—in short, anyone who is prepared to take an active part in tackling the growing problem of wound infection. Joining is easy, simply visit the web site at http://www.woundinfection-institute.com. The IWII is grateful to Smith & Nephew Wound Management and Photopharmica Ltd for their unrestricted grants and continuing support. The Institute is now actively seeking support from other industry and non industry sponsors, and is truly independent in its aims and activities. The current committee of the IWII is presented in Table 1. Keith Harding (chair of the IWII) & Roland Renyi (IWII secretariat)

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