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3.7.7 - Severe Soft Tissue Disorders

from Section 3.7 - Infection and Immunity

Published online by Cambridge University Press:  27 July 2023

By
Elizabeth Potter ,
Gabor Dudas  and
Alexander Fletcher
Edited by
Ned Gilbert-Kawai ,
Debashish Dutta  and
Carl Waldmann
Ned Gilbert-Kawai
Affiliation:
The Royal Liverpool Hospital
Debashish Dutta
Affiliation:
Princess Alexandra Hospital NHS Trust, Harlow
Carl Waldmann
Affiliation:
Royal Berkshire Hospital, Reading
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Summary

Key Learning Points

  1. 1. Many soft tissue disorders carry high morbidity and mortality.

  2. 2. Early diagnosis and rapid definitive management are crucial for a successful outcome.

  3. 3. Multidisciplinary working is essential.

  4. 4. Consider using isolation rooms to prevent infection if there is significant loss of the skin barrier.

  5. 5. In severe cases, admission to the intensive care unit can be beneficial.

Keywords

soft tissue disorderspressure ulcerstoxic shock syndromecellulitisnecrotising fasciitistoxic epidermal necrolysiscompartment syndrome
Type
Chapter
Information
Intensive Care Medicine
The Essential Guide
 , pp. 262 - 266
Publisher: Cambridge University Press
Print publication year: 2021

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References

References and Further Reading

Bechar, J, Sepehripour, S, Hardwicke, J, Filobbos, G. Laboratory risk indicator for necrotising fasciitis (LRINEC) score for the assessment of early necrotising fasciitis: a systematic review of the literature. Ann R Coll Surg Engl 2017;99:341–6.CrossRefGoogle ScholarPubMed
Burnham, JP, Kirby, JP, Kollef, MH. Diagnosis and management of skin and soft tissue infections in the intensive care unit: a review. Intensive Care Med 2016;42:1899–911.CrossRefGoogle ScholarPubMed
Burnham, JP, Kollef, MH. Understanding toxic shock syndrome. Intensive Care Med 2015;41:1707–10.CrossRefGoogle ScholarPubMed
Cranendonk, DR, van Vught, LA, Wiewel, MA, et al. Clinical characteristics and outcomes of patients with cellulitis requiring intensive care. JAMA Dermatol 2017;153:578–82.CrossRefGoogle ScholarPubMed
Creamer, D, Walsh, SA, Dziewulski, P, et al. UK guidelines for the management of Stevens–Johnson syndrome/toxic epidermal necrolysis in adults 2016. Br J Dermatol 2016;174:1194–227.CrossRefGoogle ScholarPubMed
Medical Advisory Secretariat. Pressure ulcer prevention: an evidence-based analysis. Ont Health Technol Assess Ser 2009;9:1–104.Google Scholar
National Pressure Ulcer Advisory Panel, European Pressure Ulcer Advisory Panel, Pan Pacific Pressure Injury Alliance. 2014. Prevention and treatment of pressure ulcers: quick reference guide. www.epuap.org/wp-content/uploads/2016/10/quick-reference-guide-digital-npuap-epuap-pppia-jan2016.pdfGoogle Scholar
Wong, CH, Khin, LW, Heng, KS, Tan, KC, Low, CO. The LRINEC (Laboratory Risk Indicator for Necrotizing Fasciitis) score: a tool for distinguishing necrotizing fasciitis from other soft tissue infections. Crit Care Med 2004;32:1535–41.CrossRefGoogle Scholar

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