Clinical characteristics of patients with lower limb cellulitis and antibiotic usage in Hospital Kuala Lumpur: a 7‐year retrospective study

Ch’ng, Chin Chwen; Johar, Asmah

doi:10.1111/ijd.12850

Cited by 6 publications

(5 citation statements)

References 20 publications

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“…In a similar study by Eid et al, closure was obtained at an overall average of 4.2 tightening sessions (range 3-7) whereas, Park et al and Cheng et al reported 2-6 sessions for wound approximation. [21][22][23] Marek et al and Chiverton et al suggested obtaining closure in single sitting. 20,24 We achieved wound approximation in 4 tightening sessions which was on par with other studies in literature.…”

Section: Discussionmentioning

confidence: 99%

Comparative study of delayed primary closure by shoelace technique versus conventional secondary suturing method in closure of fasciotomy wounds, done for spreading cellulitis with compartment syndrome

Thrishuli

Kumar

2020

Int Surg J

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Background: Fasciotomy is a standard treatment for acute compartment syndrome. Historically, fasciotomy incisions were usually left open till oedema settles down. In literature, there is a wide range of wound closure techniques published, but none of them is deemed to be the best. In this study, focus is laid on whether delayed primary closure (DPC) by shoelace technique, is as effective as conventional secondary suturing, in closure of fasciotomy wounds, done for spreading cellulitis.Methods: All those patients who met below mentioned inclusion criteria and underwent fasciotomy, were allocated into 2 groups (A and B) where Group A consists of 30 patients undergoing conventional secondary suturing, whereas Group B consists of 30 patients undergoing DPC by shoelace technique for closure of fasciotomy wounds. Parameters such as duration of hospital stay, time taken for complete wound closure, local wound complications, hospital expenses, anaesthesia related complications between the two groups were compared.Results: Patients who underwent DPC for fasciotomy wound closure achieved wound closure ~7 days earlier with 5 days lesser hospital stay than that of those who underwent conventional secondary suturing. Average health care cost of Group B was significantly lower compared to Group A, but there was no statistically significant difference in incidence of wound infections between the two groups.Conclusions: DPC by shoelace technique, takes less time for wound closure and hence the need for nursing care and hospital stay is significantly reduced in comparison to the conventional secondary suturing method.

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Section: Discussionmentioning

confidence: 99%

Comparative study of delayed primary closure by shoelace technique versus conventional secondary suturing method in closure of fasciotomy wounds, done for spreading cellulitis with compartment syndrome

Thrishuli

Kumar

2020

Int Surg J

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“…The study population was similar to that described in literature with a predominance of older people and men. 3,11,12 The clinical presentations were also classical with diabetes mellitus as a major risk factor. 4,[13][14][15][16] Most of the patients received Inj crystalline penicillin and cloxacillin for Streptococci and Staphylococci.…”

Section: Discussionmentioning

confidence: 99%

“…3,11,12 The clinical presentations were also classical with diabetes mellitus as a major risk factor. 4,[13][14][15][16] Most of the patients received Inj crystalline penicillin and cloxacillin for Streptococci and Staphylococci. 13 Subcutaneous pressures were elevated in patients with cellulitis of the leg when compared to the normal leg.…”

Section: Discussionmentioning

confidence: 99%

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Subcutaneous pressure in cellulitis of the leg: can it be a predictor for early surgical intervention?

Nadarajan¹,

Chase²,

Roopavathana³

et al. 2016

Int Surg J

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INTRODUCTIONCellulitis is a spreading bacterial infection of the dermis and subcutaneous tissues. It occurs among both men and women. 1 The incidence of lower limb cellulitis was reported relatively high with 199 cases per 100,000 person-years in a population based study. 2 The most common causative organisms are Streptococcus pyogenes and Staphylococcus aureus. 3 The risk factors are toe web intertrigo, leg ulcers, trauma causing breach in the skin continuity, venous insufficiency, lymphedema, diabetes, obesity and immuno-compromised conditions. The most common risk factors for recurrence are venous insufficiency and lymphedema and previous episode of cellulitis. 4 The most common pathogenesis is the breach in skin integrity especially the toe web space. The Streptococci and Staphylococci produce toxins which cause inflammatory mediator release, resulting in the edema and skin changes.5 If the infection is persisting in the subcutaneous plane, the edema worsens leading to local complications resulting in systemic sepsis and multiple organ dysfunction. The common clinical ABSTRACT Background: Cellulitis, an infection of skin and subcutaneous tissue is usually managed conservatively and surgical intervention is required for local complications. The aim of this study was to correlate the subcutaneous pressure with the need for early surgical intervention in cases of lower limb cellulitis. Methods: We prospectively measured subcutaneous pressures in the normal leg and in the leg with cellulitis. Patients managed with parenteral antibiotics were compared to those managed with parenteral antibiotics and surgical intervention with standard statistical tests. Results: The median subcutaneous pressure was 3 mmHg and 9 mmHg in the normal leg and the other with cellulitis respectively. The mean of difference in subcutaneous pressure in legs with cellulitis compared to normal legs was 5.93 mmHg and 8.29 mmHg in the conservative group and surgical intervention group respectively. The difference in subcutaneous pressure between the normal leg and in the leg with cellulitis was statistically significant (p<0.001). The difference in the average pressure between surgical intervention group and conservative group was 2.36 mmHg and was statistically significant (p<0.05). The optimal threshold (difference in pressure) was identified as >=7 with sensitivity of 85.7% and specificity of 57.1%. Area under the ROC curve (SE) was 0.71 (0.10) with 95% CI (0.51, 0.87). Conclusions:The subcutaneous pressure in leg with cellulitis is a predictor for the need for early surgical intervention. It can be used as an adjunct in management and clinical decision making for cases of cellulitis of lower limbs.

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“…Staphylococcus aureus and Streptococcus pyogenes are the organisms that cause staph infections the most frequently [4] . Venous insufficiency, lymphedema, and a previous episode of cellulitis are the most common risk factors for a return of cellulitis [5] . Infections can emerge everywhere there is a breach in the skin's protective barrier.…”

Section: Introductionmentioning

confidence: 99%

The study of subcutaneous pressure in cellulitis of the leg and its relationship to management

Rao¹,

V²

2019

Int. J. Surg. Sci.

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Background: Investigating how subcutaneous pressure impacts the requirement for amputation in cases of leg cellulitis. Cellulitis is an infection of the skin and the tissues beneath it. Subcutaneous edoema is caused by an inflammatory reaction that causes redness, heat, and discomfort. Methods: This observational study included 25 people who had unilateral cellulitis of the legs. Subcutaneous pressure was measured in both healthy and cellulitic limbs of voluntarily sampled volunteers. The study comprised patients with lower-extremity cellulitis of the knee who sought care at the surge or the

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Clinical characteristics of patients with lower limb cellulitis and antibiotic usage in Hospital Kuala Lumpur: a 7‐year retrospective study

Abstract: Identifying clinical characteristics of those at risk may help to prevent recurrence of cellulitis and long-term complications.

Cited by 6 publications

References 20 publications

Comparative study of delayed primary closure by shoelace technique versus conventional secondary suturing method in closure of fasciotomy wounds, done for spreading cellulitis with compartment syndrome

Comparative study of delayed primary closure by shoelace technique versus conventional secondary suturing method in closure of fasciotomy wounds, done for spreading cellulitis with compartment syndrome

Subcutaneous pressure in cellulitis of the leg: can it be a predictor for early surgical intervention?

The study of subcutaneous pressure in cellulitis of the leg and its relationship to management

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