Soft tissue infections

World J Surg. 1998 Feb;22(2):146-51. doi: 10.1007/s002689900362.


Soft tissue infections vary widely in their nature and severity, and their nomenclature is confusing. A clear approach to management must allow rapid identification and treatment of the diffuse necrotizing infections because they are life-threatening. This review classifies soft tissue infections by their degree of localization and the presence of tissue necrosis. Most focal nonnecrotizing infections start in the skin or adnexae and are easily recognized and readily treated by local measures. Patients with cellulitis, the commonest diffuse nonnecrotizing infection, should be stratified from mild to severe and complicated and then treated with oral or systemic antibiotics. Focal necrotizing infections are relatively uncommon, but they are readily diagnosed on sight and effectively managed by local debridement and systemic antibiotics. In contrast, diffuse necrotizing infections may masquerade in many forms, delaying diagnosis and treatment. Edema out of proportion to erythema, subcutaneous gas, and skin vesicles are important markers. Aggressive sequential debridement and broad-spectrum intravenous antibiotics revised after 48 hours provide the best strategy for management.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Cellulitis / drug therapy
  • Cellulitis / microbiology
  • Cellulitis / pathology
  • Gangrene / microbiology
  • Humans
  • Necrosis
  • Prognosis
  • Severity of Illness Index
  • Soft Tissue Infections / classification*
  • Soft Tissue Infections / drug therapy
  • Soft Tissue Infections / microbiology


  • Anti-Bacterial Agents