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Soft tissue infections
1Department of Surgery, McGill University, Royal Victoria Hospital, Montreal, Quebec, Canada.
World Journal of Surgery
|February 6, 1998
Summary
This review classifies soft tissue infections, emphasizing prompt recognition and treatment of life-threatening diffuse necrotizing infections. Effective management involves aggressive debridement and tailored antibiotic therapy for diverse soft tissue infections.
Area of Science:
- Infectious Diseases
- Dermatology
- Surgical Infections
Background:
- Soft tissue infections present diverse clinical manifestations and nomenclature challenges.
- Accurate classification is crucial for timely management, especially for life-threatening diffuse necrotizing infections.
Purpose of the Study:
- To classify soft tissue infections based on localization and necrosis.
- To outline management strategies for different types of soft tissue infections.
- To highlight key diagnostic markers and treatment approaches for diffuse necrotizing infections.
Main Methods:
- Classification of soft tissue infections by localization and presence of tissue necrosis.
- Review of management strategies for focal nonnecrotizing, diffuse nonnecrotizing (cellulitis), focal necrotizing, and diffuse necrotizing infections.
- Identification of key clinical markers for diffuse necrotizing infections.
Main Results:
- Focal nonnecrotizing infections are typically skin-related and managed with local measures.
- Cellulitis, a common diffuse nonnecrotizing infection, requires stratification and antibiotic treatment.
- Focal necrotizing infections are diagnosed visually and treated with debridement and antibiotics.
- Diffuse necrotizing infections may present insidiously, with key markers including disproportionate edema, subcutaneous gas, and skin vesicles.
Conclusions:
- Prompt identification and treatment of diffuse necrotizing infections are critical.
- Aggressive surgical debridement and broad-spectrum intravenous antibiotics, reassessed within 48 hours, are the optimal strategy for diffuse necrotizing infections.