Skip to main content
SpringerLink
Log in

Soft Tissue Infections

  • Chapter
  • First Online:
Principles of Adult Surgical Critical Care

  • 2239 Accesses

Abstract

Skin and soft tissue infections are a common cause of hospitalization, disability, and antibiotic therapy. Infections commonly managed by surgeons and intensivists include complicated cellulitis and abscesses, severe necrotizing soft tissue infections, and surgical site infections. This chapter will describe the epidemiology, pathogenesis, and therapeutic approach to each. Particular attention is given to necrotizing soft tissue infections and the differentiation of necrotizing infections from non-necrotizing infections, as this is a critical requirement for optimal outcome.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Institutional subscriptions

References

  1. Guidance for Industry: Uncomplicated and complicated skin and skin structure infections- developing antimicrobial drugs treatment. US Dept of Health and Human Services, Food and Drug Administration, Center for Drug Evaluation and Research; 1998.

    Google Scholar 

  2. Jones ME, Karlowsky JA, Draghi DC, et al. Epidemiology and antibiotic susceptibility of bacteria causing skin and soft tissue infections in the USA and Europe: a guide to appropriate antimicrobial therapy. Int J Antimicrob Agents. 2003;22(4):406–19.

    CAS  PubMed  Google Scholar 

  3. Stevens DL, Bisno AL, Chambers HF, et al. Practice guidelines for the diagnosis and management of skin and soft-tissue infections. Clin Infect Dis. 2005;41(10):1373–406.

    PubMed  Google Scholar 

  4. Stevens DL, Bisno AL, Chambers HF, et al. Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the Infectious Diseases Society of America. Clin Infect Dis. 2014;59(2):e10–52.

    PubMed  Google Scholar 

  5. May AK, Stafford RE, Bulger EM, et al. Treatment of complicated skin and soft tissue infections. Surg Infect (Larchmt). 2009;10(5):467–99.

    PubMed  Google Scholar 

  6. May AK. Skin and soft tissue infections. Surg Clin North Am. 2009;89(2):403–20, viii.

    PubMed  Google Scholar 

  7. May AK. Skin and soft tissue infections: the new surgical infection society guidelines. Surg Infect (Larchmt). 2011;12(3):179–84.

    PubMed  Google Scholar 

  8. Sartelli M, Malangoni MA, May AK, et al. World Society of Emergency Surgery (WSES) guidelines for management of skin and soft tissue infections. World J Emerg Surg. 2014;9(1):57.

    PubMed  PubMed Central  Google Scholar 

  9. Phan HH, Cocanour CS. Necrotizing soft tissue infections in the intensive care unit. Crit Care Med. 2010;38(9 Suppl):S460–8.

    PubMed  Google Scholar 

  10. Mangram AJ, Horan TC, Pearson ML, et al. Guideline for prevention of surgical site infection, 1999. Hospital Infection Control Practices Advisory Committee [see comments]. Infect Control Hosp Epidemiol. 1999;20(4):250–78.

    CAS  PubMed  Google Scholar 

  11. May AK, Daniels TL, Obremskey WT, et al. Steroids in the treatment of group a streptococcal necrotizing soft tissue infection. Surg Infect (Larchmt). 2011;12(1):77–81.

    PubMed  Google Scholar 

  12. Stevens DL. Streptococcal toxic-shock syndrome: spectrum of disease, pathogenesis, and new concepts in treatment. Emerg Infect Dis. 1995;1(3):69–78.

    CAS  PubMed  PubMed Central  Google Scholar 

  13. Moet GJ, Jones RN, Biedenbach DJ, et al. Contemporary causes of skin and soft tissue infections in North America, Latin America, and Europe: report from the SENTRY Antimicrobial Surveillance Program (1998-2004). Diagn Microbiol Infect Dis. 2007;57(1):7–13.

    PubMed  Google Scholar 

  14. Awad SS, Elhabash SI, Lee L, et al. Increasing incidence of methicillin-resistant Staphylococcus aureus skin and soft-tissue infections: reconsideration of empiric antimicrobial therapy. Am J Surg. 2007;194(5):606–10.

    CAS  PubMed  Google Scholar 

  15. Moran GJ, Abrahamian FM, Lovecchio F, et al. Acute bacterial skin infections: developments since the 2005 Infectious Diseases Society of America (IDSA) guidelines. J Emerg Med. 2013;44(6):e397–412.

    PubMed  Google Scholar 

  16. Deresinski S. Methicillin-resistant Staphylococcus aureus: an evolutionary, epidemiologic, and therapeutic odyssey. Clin Infect Dis. 2005;40(4):562–73.

    CAS  PubMed  Google Scholar 

  17. Miller LG, Perdreau-Remington F, Bayer AS, et al. Clinical and epidemiologic characteristics cannot distinguish community-associated methicillin-resistant Staphylococcus aureus infection from methicillin-susceptible S. aureus infection: a prospective investigation. Clin Infect Dis. 2007;44(4):471–82.

    CAS  PubMed  Google Scholar 

  18. Naimi TS, LeDell KH, Como-Sabetti K, et al. Comparison of community- and health care-associated methicillin-resistant Staphylococcus aureus infection. JAMA. 2003;290(22):2976–84.

    CAS  PubMed  Google Scholar 

  19. Elliott DC, Kufera JA, Myers RA. Necrotizing soft tissue infections. Risk factors for mortality and strategies for management. Ann Surg. 1996;224(5):672–83.

    CAS  PubMed  PubMed Central  Google Scholar 

  20. Pallin DJ, Egan DJ, Pelletier AJ, et al. Increased US emergency department visits for skin and soft tissue infections, and changes in antibiotic choices, during the emergence of community-associated methicillin-resistant Staphylococcus aureus. Ann Emerg Med. 2008;51(3):291–8.

    PubMed  Google Scholar 

  21. Fridkin SK, Hageman JC, Morrison M, et al. Methicillin-resistant Staphylococcus aureus disease in three communities. N Engl J Med. 2005;352(14):1436–44.

    CAS  PubMed  Google Scholar 

  22. King MD, Humphrey BJ, Wang YF, et al. Emergence of community-acquired methicillin-resistant Staphylococcus aureus USA 300 clone as the predominant cause of skin and soft-tissue infections. Ann Intern Med. 2006;144(5):309–17.

    PubMed  Google Scholar 

  23. Moran GJ, Amii RN, Abrahamian FM, et al. Methicillin-resistant Staphylococcus aureus in community-acquired skin infections. Emerg Infect Dis. 2005;11(6):928–30.

    PubMed  PubMed Central  Google Scholar 

  24. Bisno AL, Stevens DL. Streptococcal infections of skin and soft tissues. N Engl J Med. 1996;334(4):240–5.

    CAS  PubMed  Google Scholar 

  25. Swartz MN. Clinical practice. Cellulitis. N Engl J Med. 2004;350(9):904–12.

    CAS  PubMed  Google Scholar 

  26. Chartier C, Grosshans E. Erysipelas. Int J Dermatol. 1990;29(7):459–67.

    CAS  PubMed  Google Scholar 

  27. Chartier C, Grosshans E. Erysipelas: an update. Int J Dermatol. 1996;35(11):779–81.

    CAS  PubMed  Google Scholar 

  28. Defining the group A streptococcal toxic shock syndrome. Rationale and consensus definition. The Working Group on Severe Streptococcal Infections. JAMA. 1993;269(3):390–1.

    Google Scholar 

  29. Eriksson BK, Andersson J, Holm SE, et al. Epidemiological and clinical aspects of invasive group A streptococcal infections and the streptococcal toxic shock syndrome. Clin Infect Dis. 1998;27(6):1428–36.

    CAS  PubMed  Google Scholar 

  30. Kiska DL, Thiede B, Caracciolo J, et al. Invasive group A streptococcal infections in North Carolina: epidemiology, clinical features, and genetic and serotype analysis of causative organisms. J Infect Dis. 1997;176(4):992–1000.

    CAS  PubMed  Google Scholar 

  31. Baddour LM, Bisno AL. Recurrent cellulitis after saphenous venectomy for coronary bypass surgery. Ann Intern Med. 1982;97(4):493–6.

    CAS  PubMed  Google Scholar 

  32. Bouma J, Dankert J. Recurrent acute leg cellulitis in patients after radical vulvectomy. Gynecol Oncol. 1988;29(1):50–7.

    CAS  PubMed  Google Scholar 

  33. Dan M, Heller K, Shapira I, et al. Incidence of erysipelas following venectomy for coronary artery bypass surgery. Infection. 1987;15(2):107–8.

    CAS  PubMed  Google Scholar 

  34. Dupuy A, Benchikhi H, Roujeau JC, et al. Risk factors for erysipelas of the leg (cellulitis): case-control study. BMJ. 1999;318(7198):1591–4.

    CAS  PubMed  PubMed Central  Google Scholar 

  35. Simon MS, Cody RL. Cellulitis after axillary lymph node dissection for carcinoma of the breast. Am J Med. 1992;93(5):543–8.

    CAS  PubMed  Google Scholar 

  36. Hook III EW, Hooton TM, Horton CA, et al. Microbiologic evaluation of cutaneous cellulitis in adults. Arch Intern Med. 1986;146(2):295–7.

    PubMed  Google Scholar 

  37. Kielhofner MA, Brown B, Dall L. Influence of underlying disease process on the utility of cellulitis needle aspirates. Arch Intern Med. 1988;148(11):2451–2.

    CAS  PubMed  Google Scholar 

  38. Lebre C, Girard-Pipau F, Roujeau JC, et al. Value of fine-needle aspiration in infectious cellulitis. Arch Dermatol. 1996;132(7):842–3.

    CAS  PubMed  Google Scholar 

  39. Perl B, Gottehrer NP, Raveh D, et al. Cost-effectiveness of blood cultures for adult patients with cellulitis. Clin Infect Dis. 1999;29(6):1483–8.

    CAS  PubMed  Google Scholar 

  40. Sachs MK. The optimum use of needle aspiration in the bacteriologic diagnosis of cellulitis in adults. Arch Intern Med. 1990;150(9):1907–12.

    CAS  PubMed  Google Scholar 

  41. Bradsher Jr RW, Snow RM. Ceftriaxone treatment of skin and soft tissue infections in a once daily regimen. Am J Med. 1984;77(4C):63–7.

    PubMed  Google Scholar 

  42. Grayson ML, McDonald M, Gibson K, et al. Once-daily intravenous cefazolin plus oral probenecid is equivalent to once-daily intravenous ceftriaxone plus oral placebo for the treatment of moderate-to-severe cellulitis in adults. Clin Infect Dis. 2002;34(11):1440–8.

    CAS  PubMed  Google Scholar 

  43. Brogan TV, Nizet V, Waldhausen JH, et al. Group A streptococcal necrotizing fasciitis complicating primary varicella: a series of fourteen patients. Pediatr Infect Dis J. 1995;14(7):588–94.

    CAS  PubMed  Google Scholar 

  44. Burech DL, Koranyi KI, Haynes RE. Serious group A streptococcal diseases in children. J Pediatr. 1976;88(6):972–4.

    CAS  PubMed  Google Scholar 

  45. Mascini EM, Jansze M, Schouls LM, et al. Penicillin and clindamycin differentially inhibit the production of pyrogenic exotoxins A and B by group A streptococci. Int J Antimicrob Agents. 2001;18(4):395–8.

    CAS  PubMed  Google Scholar 

  46. Zimbelman J, Palmer A, Todd J. Improved outcome of clindamycin compared with beta-lactam antibiotic treatment for invasive Streptococcus pyogenes infection. Pediatr Infect Dis J. 1999;18(12):1096–100.

    CAS  PubMed  Google Scholar 

  47. Eagle H. Experimental approach to the problem of treatment failure with penicillin. I. Group A streptococcal infection in mice. Am J Med. 1952;13(4):389–99.

    CAS  PubMed  Google Scholar 

  48. Stevens DL, Gibbons AE, Bergstrom R, et al. The Eagle effect revisited: efficacy of clindamycin, erythromycin, and penicillin in the treatment of streptococcal myositis. J Infect Dis. 1988;158(1):23–8.

    CAS  PubMed  Google Scholar 

  49. Mulla ZD, Leaverton PE, Wiersma ST. Invasive group A streptococcal infections in Florida. South Med J. 2003;96(10):968–73.

    PubMed  Google Scholar 

  50. Bernard P, Plantin P, Roger H, et al. Roxithromycin versus penicillin in the treatment of erysipelas in adults: a comparative study. Br J Dermatol. 1992;127(2):155–9.

    CAS  PubMed  Google Scholar 

  51. Martin JM, Green M, Barbadora KA, et al. Erythromycin-resistant group A streptococci in schoolchildren in Pittsburgh. N Engl J Med. 2002;346(16):1200–6.

    PubMed  Google Scholar 

  52. York MK, Gibbs L, Perdreau-Remington F, et al. Characterization of antimicrobial resistance in Streptococcus pyogenes isolates from the San Francisco Bay area of northern California. J Clin Microbiol. 1999;37(6):1727–31.

    CAS  PubMed  PubMed Central  Google Scholar 

  53. Sriskandan S, McKee A, Hall L, et al. Comparative effects of clindamycin and ampicillin on superantigenic activity of Streptococcus pyogenes. J Antimicrob Chemother. 1997;40(2):275–7.

    CAS  PubMed  Google Scholar 

  54. Miller LG, Perdreau-Remington F, Rieg G, et al. Necrotizing fasciitis caused by community-associated methicillin-resistant Staphylococcus aureus in Los Angeles. N Engl J Med. 2005;352(14):1445–53.

    CAS  PubMed  Google Scholar 

  55. Broder J, Jerrard D, Olshaker J, et al. Low risk of infection in selected human bites treated without antibiotics. Am J Emerg Med. 2004;22(1):10–3.

    PubMed  Google Scholar 

  56. Medeiros I, Saconato H. Antibiotic prophylaxis for mammalian bites. Cochrane Database Syst Rev. 2001;(2):CD001738.

    Google Scholar 

  57. Zubowicz VN, Gravier M. Management of early human bites of the hand: a prospective randomized study. Plast Reconstr Surg. 1991;88(1):111–4.

    CAS  PubMed  Google Scholar 

  58. Brook I, Frazier EH. Aerobic and anaerobic bacteriology of wounds and cutaneous abscesses. Arch Surg. 1990;125(11):1445–51.

    CAS  PubMed  Google Scholar 

  59. Bosshardt TL, Henderson VJ, Organ Jr CH. Necrotizing soft-tissue infections. Arch Surg. 1996;131(8):846–52.

    CAS  PubMed  Google Scholar 

  60. Grayson ML. Diabetic foot infections. Antimicrobial therapy. Infect Dis Clin North Am. 1995;9(1):143–61.

    CAS  PubMed  Google Scholar 

  61. Itani KM, Dryden MS, Bhattacharyya H, et al. Efficacy and safety of linezolid versus vancomycin for the treatment of complicated skin and soft-tissue infections proven to be caused by methicillin-resistant Staphylococcus aureus. Am J Surg. 2010;199(6):804–16.

    CAS  PubMed  Google Scholar 

  62. Lipsky BA, Itani K, Norden C. Treating foot infections in diabetic patients: a randomized, multicenter, open-label trial of linezolid versus ampicillin-sulbactam/amoxicillin-clavulanate. Clin Infect Dis. 2004;38(1):17–24.

    CAS  PubMed  Google Scholar 

  63. Stevens DL, Smith LG, Bruss JB, et al. Randomized comparison of linezolid (PNU-100766) versus oxacillin-dicloxacillin for treatment of complicated skin and soft tissue infections. Antimicrob Agents Chemother. 2000;44(12):3408–13.

    CAS  PubMed  PubMed Central  Google Scholar 

  64. Stevens DL, Herr D, Lampiris H, et al. Linezolid versus vancomycin for the treatment of methicillin-resistant Staphylococcus aureus infections. Clin Infect Dis. 2002;34(11):1481–90.

    CAS  PubMed  Google Scholar 

  65. Weigelt J, Kaafarani HM, Itani KM, et al. Linezolid eradicates MRSA better than vancomycin from surgical-site infections. Am J Surg. 2004;188(6):760–6.

    CAS  PubMed  Google Scholar 

  66. Weigelt J, Itani K, Stevens D, et al. Linezolid versus vancomycin in treatment of complicated skin and soft tissue infections. Antimicrob Agents Chemother. 2005;49(6):2260–6.

    CAS  PubMed  PubMed Central  Google Scholar 

  67. Stevens DL, Wallace RJ, Hamilton SM, et al. Successful treatment of staphylococcal toxic shock syndrome with linezolid: a case report and in vitro evaluation of the production of toxic shock syndrome toxin type 1 in the presence of antibiotics. Clin Infect Dis. 2006;42(5):729–30.

    PubMed  Google Scholar 

  68. Ellis-Grosse EJ, Babinchak T, Dartois N, et al. The efficacy and safety of tigecycline in the treatment of skin and skin-structure infections: results of 2 double-blind phase 3 comparison studies with vancomycin-aztreonam. Clin Infect Dis. 2005;41 Suppl 5:S341–53.

    CAS  PubMed  Google Scholar 

  69. Psoinos CM, Flahive JM, Shaw JJ, et al. Contemporary trends in necrotizing soft-tissue infections in the United States. Surgery. 2013;153(6):819–27.

    PubMed  Google Scholar 

  70. Talan DA, Krishnadasan A, Gorwitz RJ, et al. Comparison of Staphylococcus aureus from skin and soft-tissue infections in US emergency department patients, 2004 and 2008. Clin Infect Dis. 2011;53(2):144–9.

    PubMed  Google Scholar 

  71. Anaya DA, McMahon K, Nathens AB, et al. Predictors of mortality and limb loss in necrotizing soft tissue infections. Arch Surg. 2005;140(2):151–7.

    PubMed  Google Scholar 

  72. Childers BJ, Potyondy LD, Nachreiner R, et al. Necrotizing fasciitis: a fourteen-year retrospective study of 163 consecutive patients. Am Surg. 2002;68(2):109–16.

    PubMed  Google Scholar 

  73. Hsiao CT, Weng HH, Yuan YD, et al. Predictors of mortality in patients with necrotizing fasciitis. Am J Emerg Med. 2008;26(2):170–5.

    PubMed  Google Scholar 

  74. Liu YM, Chi CY, Ho MW, et al. Microbiology and factors affecting mortality in necrotizing fasciitis. J Microbiol Immunol Infect. 2005;38(6):430–5.

    PubMed  Google Scholar 

  75. Wong CH, Chang HC, Pasupathy S, et al. Necrotizing fasciitis: clinical presentation, microbiology, and determinants of mortality. J Bone Joint Surg Am. 2003;85-A(8):1454–60.

    Google Scholar 

  76. Feingold DS, Weinberg AN. Group A streptococcal infections. An old adversary reemerging with new tricks? Arch Dermatol. 1996;132(1):67–70.

    CAS  PubMed  Google Scholar 

  77. Nichols RL, Florman S. Clinical presentations of soft-tissue infections and surgical site infections. Clin Infect Dis. 2001;33 Suppl 2:S84–93.

    PubMed  Google Scholar 

  78. Stevens DL, Tanner MH, Winship J, et al. Severe group A streptococcal infections associated with a toxic shock-like syndrome and scarlet fever toxin A. N Engl J Med. 1989;321(1):1–7.

    CAS  PubMed  Google Scholar 

  79. Stevens DL. Dilemmas in the treatment of invasive Streptococcus pyogenes infections. Clin Infect Dis. 2003;37(3):341–3.

    PubMed  Google Scholar 

  80. Vinh DC, Embil JM. Rapidly progressive soft tissue infections. Lancet Infect Dis. 2005;5(8):501–13.

    PubMed  Google Scholar 

  81. Stevens DL, Bryant AE. Pathogenesis of Clostridium perfringens infection: mechanisms and mediators of shock. Clin Infect Dis. 1997;25 Suppl 2:S160–4.

    PubMed  Google Scholar 

  82. Stevens DL, Tweten RK, Awad MM, et al. Clostridial gas gangrene: evidence that alpha and theta toxins differentially modulate the immune response and induce acute tissue necrosis. J Infect Dis. 1997;176(1):189–95.

    CAS  PubMed  Google Scholar 

  83. Brett MM, Hood J, Brazier JS, et al. Soft tissue infections caused by spore-forming bacteria in injecting drug users in the United Kingdom. Epidemiol Infect. 2005;133(4):575–82.

    CAS  PubMed  PubMed Central  Google Scholar 

  84. Kimura AC, Higa JI, Levin RM, et al. Outbreak of necrotizing fasciitis due to Clostridium sordellii among black-tar heroin users. Clin Infect Dis. 2004;38(9):e87–91.

    PubMed  Google Scholar 

  85. Chew SS, Lubowski DZ. Clostridium septicum and malignancy. ANZ J Surg. 2001;71(11):647–9.

    CAS  PubMed  Google Scholar 

  86. Wong CH, Khin LW, Heng KS, et al. 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(7):1535–41.

    PubMed  Google Scholar 

  87. Bilton BD, Zibari GB, McMillan RW, et al. Aggressive surgical management of necrotizing fasciitis serves to decrease mortality: a retrospective study. Am Surg. 1998;64(5):397–400.

    CAS  PubMed  Google Scholar 

  88. McHenry CR, Piotrowski JJ, Petrinic D, et al. Determinants of mortality for necrotizing soft-tissue infections. Ann Surg. 1995;221(5):558–63.

    CAS  PubMed  PubMed Central  Google Scholar 

  89. Chan T, Yaghoubian A, Rosing D, et al. Low sensitivity of physical examination findings in necrotizing soft tissue infection is improved with laboratory values: a prospective study. Am J Surg. 2008;196(6):926–30.

    PubMed  Google Scholar 

  90. Yaghoubian A, de Virgilio C, Dauphine C, et al. Use of admission serum lactate and sodium levels to predict mortality in necrotizing soft-tissue infections. Arch Surg. 2007;142(9):840–6.

    CAS  PubMed  Google Scholar 

  91. Hsiao CT, Lin LJ, Shiao CJ, et al. Hemorrhagic bullae are not only skin deep. Am J Emerg Med. 2008;26(3):316–9.

    PubMed  Google Scholar 

  92. Anaya DA, Dellinger EP. Necrotizing soft-tissue infection: diagnosis and management. Clin Infect Dis. 2007;44(5):705–10.

    CAS  PubMed  Google Scholar 

  93. Stamenkovic I, Lew PD. Early recognition of potentially fatal necrotizing fasciitis. The use of frozen-section biopsy. N Engl J Med. 1984;310(26):1689–93.

    CAS  PubMed  Google Scholar 

  94. Freischlag JA, Ajalat G, Busuttil RW. Treatment of necrotizing soft tissue infections. The need for a new approach. Am J Surg. 1985;149(6):751–5.

    CAS  PubMed  Google Scholar 

  95. Majeski JA, Alexander JW. Early diagnosis, nutritional support, and immediate extensive debridement improve survival in necrotizing fasciitis. Am J Surg. 1983;145(6):784–7.

    CAS  PubMed  Google Scholar 

  96. Rouse TM, Malangoni MA, Schulte WJ. Necrotizing fasciitis: a preventable disaster. Surgery. 1982;92(4):765–70.

    CAS  PubMed  Google Scholar 

  97. Sudarsky LA, Laschinger JC, Coppa GF, et al. Improved results from a standardized approach in treating patients with necrotizing fasciitis. Ann Surg. 1987;206(5):661–5.

    CAS  PubMed  PubMed Central  Google Scholar 

  98. Wall DB, de Virgilio C, Black S, et al. Objective criteria may assist in distinguishing necrotizing fasciitis from nonnecrotizing soft tissue infection. Am J Surg. 2000;179(1):17–21.

    CAS  PubMed  Google Scholar 

  99. Green RJ, Dafoe DC, Raffin TA. Necrotizing fasciitis. Chest. 1996;110(1):219–29.

    CAS  PubMed  Google Scholar 

  100. Okoye O, Talving P, Lam L, et al. Timing of redebridement after initial source control impacts survival in necrotizing soft tissue infection. Am Surg. 2013;79(10):1081–5.

    PubMed  Google Scholar 

  101. Echols J, Friedman B, Mullins R, et al. Initial experience with a new system for the control and containment of fecal output for the protection of patients in a large burn center. Chest. 2004;126(4 SUPPL):862S.

    Google Scholar 

  102. Eke N. Fournier's gangrene: a review of 1726 cases. Br J Surg. 2000;87(6):718–28.

    CAS  PubMed  Google Scholar 

  103. Cheadle WG. Risk factors for surgical site infection. Surg Infect (Larchmt). 2006;7 Suppl 1:S7–11.

    PubMed  Google Scholar 

  104. Bratzler DW, Dellinger EP, Olsen KM, et al. Clinical practice guidelines for antimicrobial prophylaxis in surgery. Surg Infect (Larchmt). 2013;14(1):73–156.

    PubMed  Google Scholar 

  105. Nelson RL, Glenny AM, Song F. Antimicrobial prophylaxis for colorectal surgery. Cochrane Database Syst Rev. 2009;(1):CD001181.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Trauma and Surgical Critical Care, Department of Surgery, Vanderbilt University Medical Center, Nashville, TN, 37212, USA

    Addison K. May MD

Authors
  1. Addison K. May MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Addison K. May MD .

Editor information

Editors and Affiliations

  1. Trauma, Surgical Critical Care, Emergency Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA

    Niels D. Martin

  2. Trauma, Surgical Critical Care, Emergency Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA

    Lewis J. Kaplan

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

May, A.K. (2016). Soft Tissue Infections. In: Martin, N.D., Kaplan, L.J. (eds) Principles of Adult Surgical Critical Care. Springer, Cham. https://doi.org/10.1007/978-3-319-33341-0_24

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-33341-0_24

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-33339-7

  • Online ISBN: 978-3-319-33341-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation