The pH of wounds during healing and infection: A descriptive literature review

Introduction: Infection is difficult to detect and diagnose in chronic wounds. Misdiagnosis of wound infection risks inappropriate antibiotic prescribing, antibiotic resistance and unnecessary treatment side effects. Alternatively, waiting for the results of microbiological investigations can delay treatment risking spreading or/and systemic infection. There is a need for simple and objective measures of wound infection that provide real-time indication of infection that is accessible to the majority of clinical settings. Methods: A literature review was conducted that explored existing evidence regarding the association between the pH of a wound and wound healing and infection to determine whether a wound pH scale could be used as a marker of infection. Results: The literature review found evidence to suggest that wound pH, and specifically an 'Alkaline pH', is conducive to bacterial bio-burden and reflective of the specific physiological processes of the healing cascade. Conclusions: As such, while pH is not sufficiently understood to be translated into current practice as a metric for infection, the pH scale does have potential as a diagnostic and management indicator and merits exploration.