scholarly journals WSES/GAIS/WSIS/SIS-E/AAST global clinical pathways for patients with skin and soft tissue infections

2022 ◽  
Vol 17 (1) ◽  
Author(s):  
Massimo Sartelli ◽  
Federico Coccolini ◽  
Yoram Kluger ◽  
Ervis Agastra ◽  
Fikri M. Abu-Zidan ◽  
...  
Keyword(s):  
Soft Tissue ◽  
English Language ◽  
Task Force ◽  
Clinical Pathways ◽  
Subcutaneous Tissue ◽  
Standards Of Care ◽  
Soft Tissue Infections ◽  
Global Alliance ◽  
Surgical Infection ◽  
The World

AbstractSkin and soft-tissue infections (SSTIs) encompass a variety of pathological conditions that involve the skin and underlying subcutaneous tissue, fascia, or muscle, ranging from simple superficial infections to severe necrotizing infections.Together, the World Society of Emergency Surgery, the Global Alliance for Infections in Surgery, the Surgical Infection Society-Europe, The World Surgical Infection Society, and the American Association for the Surgery of Trauma have jointly completed an international multi-society document to promote global standards of care in SSTIs guiding clinicians by describing reasonable approaches to the management of SSTIs.An extensive non-systematic review was conducted using the PubMed and MEDLINE databases, limited to the English language. The resulting evidence was shared by an international task force with different clinical backgrounds.

scholarly journals WSES/GAIS/SIS-E/WSIS/AAST global clinical pathways for patients with intra-abdominal infections

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Massimo Sartelli ◽  
Federico Coccolini ◽  
Yoram Kluger ◽  
Ervis Agastra ◽  
Fikri M. Abu-Zidan ◽  
...  
Keyword(s):  
English Language ◽  
Task Force ◽  
Early Recognition ◽  
Clinical Pathways ◽  
Standards Of Care ◽  
Source Control ◽  
Global Alliance ◽  
Surgical Infection ◽  
The World ◽  
Abdominal Infections

AbstractIntra-abdominal infections (IAIs) are common surgical emergencies and have been reported as major contributors to non-trauma deaths in hospitals worldwide. The cornerstones of effective treatment of IAIs include early recognition, adequate source control, appropriate antimicrobial therapy, and prompt physiologic stabilization using a critical care environment, combined with an optimal surgical approach. Together, the World Society of Emergency Surgery (WSES), the Global Alliance for Infections in Surgery (GAIS), the Surgical Infection Society-Europe (SIS-E), the World Surgical Infection Society (WSIS), and the American Association for the Surgery of Trauma (AAST) have jointly completed an international multi-society document in order to facilitate clinical management of patients with IAIs worldwide building evidence-based clinical pathways for the most common IAIs. An extensive non-systematic review was conducted using the PubMed and MEDLINE databases, limited to the English language. The resulting information was shared by an international task force from 46 countries with different clinical backgrounds. The aim of the document is to promote global standards of care in IAIs providing guidance to clinicians by describing reasonable approaches to the management of IAIs.

scholarly journals A Structured Approach to Skin and Soft Tissue Infections (SSTIs) in an Ambulatory Setting

2021 ◽  
Vol 11 (1) ◽  
pp. 65-74
Author(s):  
Benjamin Silverberg
Keyword(s):  
Soft Tissue ◽  
Consensus Statement ◽  
Urgent Care ◽  
Ambulatory Setting ◽  
Soft Tissue Infections ◽  
Surgical Infection ◽  
Care Facilities ◽  
The World ◽  
Systemic Symptoms ◽  
Structured Approach

The skin is the largest, and arguably, the most vulnerable organ in the human body. Scratches and scrapes, bites and puncture wounds, impetigo and erysipelas—all these disruptions can lead to pain, swelling, and/or systemic symptoms. In this article, which is based on the Infectious Diseases Society of America’s 2014 guidelines and the World Society of Emergency Surgery and Surgical Infection Society of Europe’s 2018 consensus statement, a structured approach to skin and soft tissue infections (SSTIs) is reviewed, comparing treatment for suppurative and non-suppurative infections, and then discussing specific conditions commonly seen in Primary Care and Urgent Care facilities.

scholarly journals 451. High Rates of Hospitalization due to Skin and Soft-Tissue Infections in a Southwest American Indian Population

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S221-S222
Author(s):  
Anne M Davidson ◽  
Terry Burgess ◽  
Agafe Saguros ◽  
Chu Jian Ma ◽  
James McAuley ◽  
...  
Keyword(s):  
Risk Factors ◽  
Soft Tissue ◽  
American Indians ◽  
Subcutaneous Tissue ◽  
American Southwest ◽  
Soft Tissue Infections ◽  
Pathogenic Organism ◽  
Critical Access Hospital ◽  
Potential Risk Factors ◽  
Significant Health

Abstract Background Skin and soft-tissue infections (SSTIs) involve the skin, subcutaneous tissue, fascia, or muscle. Hospitalizations due to SSTIs represent a significant health disparity for American Indians (AI), but specific literature is limited. We characterized SSTI hospitalizations at our critical access hospital that exclusively serves an AI population in the American Southwest. Methods We identified patients hospitalized (admitted or transferred) with an SSTI from June 2017 to May 2018. Relevant cases underwent chart extraction for demographics, SSTI characteristics, laboratory and microbiologic data, relevant history and co-morbidities. All variables were summarized using descriptive statistics. Odds ratios and P-values with two-tailed tests were used to identify risk factors for multiple SSTI episodes. Results During the study period, 289 unique individuals comprised 343 SSTI hospitalizations / episodes (18% of the 1,883 total hospitalizations). The unadjusted annual rate of SSTI hospitalization was 2,018 per 100,000. There were 13 cases of necrotizing fasciitis (NF) with an unadjusted rate of 76 per 100,000 per year. Only 183 episodes (53%) had a wound culture performed, with 84% positive for a pathogenic organism, compared with 287 episodes (84%) with a blood culture performed, of which only 7% were positive for a pathogen. Methicillin-resistant Staphylococcus aureus (MRSA), methicillin-sensitive SA (MSSA)and/or Streptococcus pyogenes accounted for 74.9% (n = 125) and co-infection with these three organisms accounted for 22.2% (n = 37) of positive wound cultures (n = 167). An SSTI in the last year (49%), diabetes (41.9%), alcohol abuse (40%) and hypertension (39%) were common among all 289 individuals. Diabetes (OR 3.3, P < 0.01), hypertension (OR 2.8, P < 0.01), renal disease (OR 2.7, P < 0.05), previous SSTI (OR 3.0, P < 0.01) were associated with a higher risk of multiple SSTI hospitalizations. Conclusion The incidence rate of SSTI hospitalization in this Southwest AI population was 9-times greater than the general US population and 4-times greater than prior reports in Southwest AI. The NF rate was >10-times the general US population rate. We describe common co-morbidities among these SSTI episodes and potential risk factors for repeat hospitalization. Disclosures All authors: No reported disclosures.

Noma and Necrotizing Fasciitis of the Face and Neck

2021 ◽  
Author(s):  
Lauren E. Miller ◽  
David A. Shaye
Keyword(s):  
Soft Tissue ◽  
Necrotizing Fasciitis ◽  
Head And Neck ◽  
Subcutaneous Tissue ◽  
Neck Region ◽  
Superficial Fascia ◽  
Soft Tissue Infections ◽  
Head And Neck Region ◽  
Necrotizing Soft Tissue Infections ◽  
The Face

AbstractNecrotizing fasciitis (NF) is part of the class of necrotizing soft tissue infections characterized by rapid fascial spread and necrosis of the skin, subcutaneous tissue, and superficial fascia. If left untreated, NF can rapidly deteriorate into multiorgan shock and systemic failure. NF most commonly infects the trunk and lower extremities, although it can sometimes present in the head and neck region. This review provides an overview of NF as it relates specifically to the head and neck region, including its associated clinical features and options for treatment. Noma, a related but relatively unknown disease, is then described along with its relationship with severe poverty.

Soft Tissue Infection

2019 ◽  
Author(s):  
Mark A. Malangoni ◽  
Christopher R McHenry
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Infection ◽  
Toxic Shock Syndrome ◽  
Bacterial Infections ◽  
Subcutaneous Tissue ◽  
Tissue Infection ◽  
Soft Tissue Infections ◽  
Toxic Shock ◽  
Necrotizing Soft Tissue Infection ◽  
Human Bites

Soft tissue infections are a diverse group of diseases that involve the skin and underlying subcutaneous tissue, fascia, or muscle. The authors review the diagnosis and management of the main soft tissue infections seen by surgeons, including both superficial infections and necrotizing infections. When the characteristic clinical features of necrotizing soft tissue infection are absent, diagnosis may be difficult. In this setting, laboratory and imaging studies become important. Studies emphasizes that computed tomography should continue to be used judiciously as an adjunct to clinical judgment. The delay between hospital admission and initial débridement is the most critical factor influencing morbidity and mortality. Once the diagnosis of necrotizing soft tissue infection is established, patient survival and soft tissue preservation are best achieved by means of prompt operation. Bacterial infections of the dermis and epidermis are covered in depth, along with animal and human bites. Methicillin-resistant Staphylococcus aureus (MRSA) accounts for up to 70% of all S. aureus infections acquired in the community and is the most common organism identified in patients presenting to the emergency department with a skin or soft tissue infection. The more classic findings associated with deep necrotizing infections—skin discoloration, the formation of bullae, and intense erythema—occur much later in the process. It is important to understand this point so that an early diagnosis can be made and appropriate treatment promptly instituted. The review’s discussion covers in depth the etiology and classification of soft tissue infection, pathogenesis of soft tissue infections, toxic shock syndrome, and reports on mortality from necrotizing soft tissue infection. This review 8 figures, 22 tables, and 58 references. Keywords: Erysipelas, cellulitis, soft tissue infection, necrotizing fasciitis, myonecrosis, toxic shock syndrome

scholarly journals A Case of Necrotizing Soft-tissue Infections Accompanied with Broad Necrosis of Buccal Skin and Subcutaneous Tissue

2012 ◽  
Vol 32 (3) ◽  
pp. 199-204 ◽  
Author(s):  
Seiji KONDO ◽  
Katsuaki KAMATANI ◽  
Tomohiko KUTSUNA ◽  
Yasuto YOSHIHAMA ◽  
Tatsuo SHIROTA ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Subcutaneous Tissue ◽  
Soft Tissue Infections ◽  
Necrotizing Soft Tissue Infections

Surgical Infection Society 2020 Updated Guidelines on the Management of Complicated Skin and Soft Tissue Infections

2021 ◽  
Author(s):  
Therese M. Duane ◽  
Jared M. Huston ◽  
Morgan Collom ◽  
Adam Beyer ◽  
Sara Parli ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Infections ◽  
Surgical Infection ◽  
Complicated Skin

Skin and Soft Tissue Infections

2012 ◽  
pp. 341-350
Author(s):  
Imad M Tleyjeh ◽  
Larry M Baddour
Keyword(s):  
Soft Tissue ◽  
Necrotizing Fasciitis ◽  
Skin Infection ◽  
Subcutaneous Tissue ◽  
Clinical Manifestations ◽  
Hair Follicles ◽  
Soft Tissue Infections ◽  
Exposed Skin ◽  
Common Skin ◽  
The Face

Common skin and soft tissue infections covered in this chapter include impetigo, folliculitis, furuncles, carbuncles, cellulitis, and necrotizing fasciitis. Impetigo is a superficial pustular skin infection. Multiple lesions occur on exposed skin of the face and extremities. Staphylococcus aureus causes most cases. Folliculitis is a superficial skin infection of hair follicles. A furuncle is a purulent, painful nodular skin infection involving the hair follicle that is usually a complication of folliculitis. A carbuncle is a cluster of abscesses in subcutaneous tissue that drain through hair follicles. The prevailing pathogen for both furuncles and carbuncles is S aureus. Skin abscesses involve the dermis and deeper skin tissues. Often a pustule is present on the skin. For most cases the pathogen is S aureus. Cellulitis involves skin and subcutaneous tissues. Clinical manifestations of cellulitis include swelling, erythema, tenderness, and warmth. Necrotizing forms of cellulitis are necrotizing fasciitis types I and II. Clinical features include fulminant destruction of tissue and systemic toxicity.

Necrotizing Soft Tissue Infections

2016 ◽  
Author(s):  
Michael Ehmann
Keyword(s):  
Soft Tissue ◽  
Key Management ◽  
Subcutaneous Tissue ◽  
Decubitus Ulcer ◽  
Arterial Disease ◽  
Soft Tissue Infections ◽  
Necrotizing Soft Tissue Infections ◽  
Progressive Necrosis ◽  
Traumatic Wound ◽  
Peripheral Arterial

Necrotizing soft tissue infections (NSTI) are characterized by extensive and rapidly progressive necrosis that may involve the skin, subcutaneous tissue, fascia, or muscle and are associated with a high degree of morbidity and mortality. Preceding trauma, foreign body penetration, wound contamination, and surgical intervention are all risk factors for NSTI. Clinical examination often reveals extensive tissue involvement with pain but commonly without signs of cellulitis. Crepitant cellulitis occurs most commonly in patients with preexisting lower extremity peripheral arterial disease, decubitus ulcer, or a traumatic wound. Synergistic necrotizing cellulitis (ie, non-clostridial gangrene), in contrast, does involve deeper tissues. Early stabilization, including antibiotics and supportive measures, should be considered; consultation with a surgeon is key. Management must include aggressive resuscitative measures and hemodynamic support.

Sign in / Sign up

Export Citation Format

Share Document