CLUBS will be expected to stress education and compliance around skin infections in the coming weeks, after a rise in the number of players missing games due to cuts and lacerations that have become infected this season.
Collingwood announced on Monday that key forward Dan McStay is expected to miss a further month, after a finger injury that required surgery to repair the tendon back in April became infected last week.
McStay's setback was one of a number of infection-related injuries to be sustained this year, with Magpies skipper Darcy Moore nearly missing the side's clash with Greater Western Sydney after a scratch to his elbow became infected back in May.
Melbourne superstar Clayton Oliver was admitted to hospital earlier this month for an infected blister to his foot, West Coast's Liam Duggan also went to hospital for a toe infection, while Fremantle defender Brennan Cox was sidelined after a scab on his knee became infected following a skateboarding accident.
Giants defender Nick Haynes was another unable to progress from the AFL's 12-day concussion protocols last month, after a scab on his back became infected and meant he was unable to take part in a series of important training sessions.
According to renowned sports physician Dr Peter Larkins, the rise in footballers missing games due to infections this season isn't surprising but can be monitored more stringently by players in the future.
"They've always existed in the sporting world," Dr Larkins told AFL.com.au.
"Things like abrasions and lacerations in footy, and in any sport, we see all the time. What people probably appreciate is that the skin is covered in all of these potential infection bugs all the time, they just don't get through a breach like a pimple or a scratch or a laceration.
"For any reason, if you're in a bit slack on the hygiene, the bug getting into your system can create an infection. You talk about sweat and heat and the things that bugs love to live in.
"Sometimes, some players may not be as diligent at taking the advice about hygiene or taking the medication or keeping the dressing on. But it doesn't take much for a bug to get in a cut or a split or a breach in the skin.
"You think of all the boot stud scratches that you see, most players come off and you'll see scratches and abrasions on them. Normally, they don't turn into infections because they keep them clean. But it's a pretty easy step to go to the next level. I think that's probably been the case with most of them, if we look at it."
While club medical staff deal with a host of minor and non-threatening infections throughout the course of a season, there is a belief that more can be done by players to ensure the risk of a more serious injury doesn't grow.
"Personal hygiene and player compliance becomes the biggest thing, because sometimes players don't appreciate the high risk and so they're not compliant with keeping the dressing on or perhaps taking the antibiotics," Dr Larkins said.
"Player education becomes a big thing for the club doctors and health staff, making sure they keep an eye on any scratch or abrasion they get playing this weekend. If it looks a bit red or a bit angry, you've got to point it out to the doctor as soon as it happens. The doctor might say, 'No we'll put you on antibiotics ahead of time'.
"Infections happen all of the time. In the footy world, you're not dealing with as clean an environment, so it's not surprising that these instances come along."
It is, however, important to differentiate between types of infection. For example, an infection from a skin laceration can be vastly different to internal or bone infections. There have also been examples of infections being caused as a result of players receiving an injection to treat a different injury.
"Every time I do an injection, I say to the patient that every injection is a potential infection," Dr Larkins said.
"As a doctor, if we're putting an injection in an ankle or a shoulder today, we're cleaning the skin with alcohol and getting rid of the bugs from the skin because it happens in every circumstance. Even in doctors' offices.
"When you think about clubrooms and changerooms and dirty footy ovals, there are a lot of injections done. The doctors are trying to do it in the most sterile and clean environment they can."
It's led to a host of clubs recently taking a more conservative approach to players returning from injuries where there has been either a skin laceration, or a compound fracture in the area.
"If the circumstances were dirty where it happened, they would certainly be taking a more conservative attitude," Dr Larkins said.
"Any abrasions should be looked at by the doctor. They use Betadine or chlorhexidine, those antiseptics to clean them so the bugs don't get in. It happens all the time. Often, you don't hear about them. There are players running around every weekend who are taking antibiotics for a little superficial scratch that got infected during the week, but the clubs don't make a big deal of it because the player doesn't get that sick as it's not in their bloodstream or they don't end up in hospital.
"It's a common thing that a lot of attention hasn't been drawn to, but I don't think there has been any change as to the reason why it would be happening more."
