Study of Subcutaneous Pressure in Lower Limb Cellulitis and its Correlation With Surgical Intervention

Introduction Cellulitis is a prevalent bacterial skin infection, particularly affecting the lower limbs and often necessitating clinical intervention due to its considerable incidence rate. Factors like venous insufficiency, lymphedema, and recurring episodes increase the risk of relapse, complicating treatment strategies. Although antibiotics and limb elevation are standard care, severe cases may require surgical intervention. This study investigates subcutaneous pressure as a potential biomarker to assess the severity of lower limb cellulitis and its association with the need for surgical intervention. Methods This observational study was conducted at Sree Balaji Medical College and Hospital, Chennai, involving 105 patients from January 2023 to January 2024 for a duration of one year. Participants were selected based on specific inclusion and exclusion criteria, focusing on adults with unilateral cellulitis below the knee. Subcutaneous pressure was measured using a Stryker intracompartmental pressure monitor, and limb circumference was measured for both the affected and healthy legs. Statistical analysis was performed using paired t-tests, Mann-Whitney U tests, and Levene's test to assess the differences between treatment groups. Results The study found that participants aged 36-45 years constituted the largest proportion (25, 23.8%), and males represented 57.1% of the sample. The most frequent clinical signs were pain (30, 28.57%) and swelling (25, 23.81%). Common comorbidities included diabetes mellitus (30, 28.6%) and venous insufficiency (25, 23.8%). Significant differences were observed between cellulitic and normal legs regarding circumference (p=0.003) and subcutaneous pressure (p=0.003). Patients who underwent surgical intervention showed a greater reduction in symptoms at discharge (1, 2.44%) compared to those receiving only antibiotics (9, 14.06%). Conclusion Elevated subcutaneous pressure correlates strongly with disease severity and the likelihood of requiring surgical intervention in lower limb cellulitis. Patients undergoing surgery had faster recoveries and fewer residual symptoms at discharge. Measuring subcutaneous pressure can be a useful tool in clinical decision-making, potentially improving outcomes and reducing complications in severe cellulitis cases.