Various classification systems for necrotizing skin and soft tissue infections help in the study of the disease, doesn’t necessarily help in the care of the patient.
Dish water exudates and grey necrotic tissue are macroscopic findings of necrotizing soft tissue infection.
Along with early debridement, very broad spectrum IV antibiotics is the mainstay of necrotizing soft tissue infection.
Hyperbaric oxygen is not a proven therapy of necrotizing soft tissue infection.
Switching from castille soap to a once daily 2% chlorhexidine body wash reduces MRSA colonization rates of Surgical ICU patients.
MRSA (Methicillin Resistant Staphylococcus Aureus) is currently the leading pathogen of surgical site infection
Chloraprep (contains alcohol) use must be selective – beware of starting a fire on the surgical site.
After fasciotomies, negative wound therapy could be helpful for getting rid of edema and keeping wound clean and dry.
Negative pressure wound systems have been associated with complications of death and injuries.
Measuring compartment pressures, position of the head and trunk relative to the extremities is important when zeroing the transducer
When performing a Fasciiotomy – one approach anterolateral incision and then posteromedial incision
Calciphylaxis is associated with high calcium phosphorus product (Ca x P).
Infected Calciphylaxis lesions must be completely excised which is associated with a high mortality rate.
Pressure sores is a “never” event.
Smoking cessation is a mainstay of managing hidradenitis supperativa
Carbon dioxide laser excision is now being tried to treat moderate infections of hidradenitis supperativa (not severe enough for hospitalization).
Biopsy of complex skin lesions is important for diagnosis
Pyoderma Gangrenosum – 50-70% will have systemic disease (like inflammatory bowel disease (UC / Crohn’s Disease).