Surgery pp 237-257 | Cite as

Infections of Skin and Soft Tissue

  • Philip S. Barie
  • Soumitra R. Eachempati


Infections of skin and soft tissue (SSTIs) encompass a diverse set of conditions, but there are commonalities that justify their consideration as a group. Some SSTIs are not dangerous to the patient, whereas others are life threatening and require radical surgical debridement as well as broad-spectrum antibiotic therapy. The U.S. Food and Drug Administration (FDA) classified SSTIs as uncomplicated or complicated infections for the purposes of clinical trial design and enrollment. This framework is also useful for clinical description.1


Surgical Site Infection Antibiotic Prophylaxis Soft Tissue Infection Necrotizing Fasciitis Hidradenitis Suppurativa 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. 1.
    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;41:1373–1406.PubMedCrossRefGoogle Scholar
  2. 2.
    Swartz MN. Cellulitis. N Engl J Med 2004;350:904–912.PubMedCrossRefGoogle Scholar
  3. 3.
    Miller SR, Mondry T, Reed JS, et al. Delayed cellulitis associated with conservative therapy for breast cancer. J Surg Oncol 1998;242–245.Google Scholar
  4. 4.
    Brook I, Frazier EH. Aerobic and anaerobic bacteriology of wounds and cutaneous abscesses. Arch Surg 1990;125:1445–1451.PubMedGoogle Scholar
  5. 5.
    National Nosocomial Infections Surveillance (NNIS) System report, data summary from January 1992 through June 2004, issued October 2004. Am J Infect Control 2004;232:5470–485.Google Scholar
  6. 6.
    Fridkin SK, Hageman JC, Morrison M, et al. Active Bacterial Core Surveillance Program of the Emerging Infections Program Network. Methicillin-resistant Staphylococcus aureus disease in three communities. N Engl J Med 2005;352:1436–1444.PubMedCrossRefGoogle Scholar
  7. 7.
    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;352:1445–1453.PubMedCrossRefGoogle Scholar
  8. 8.
    Frazee BW, Lynn J, Charlebois ED, et al. High prevalence of methicillin-resistant Staphylococcus aureus in emergency department skin and soft tissue infections. Ann Emerg Med 2005;45:311–320.PubMedCrossRefGoogle Scholar
  9. 9.
    Lewis JS 2nd, Jorgensen JH. Inducible clindamycin resistance in staphylococci: should clinicians and microbiologists be concerned? Clin Infect Dis 2005;40:280–285.PubMedCrossRefGoogle Scholar
  10. 10.
    Dupuy A, Benchikhi H, Roujeau JC, et al. Risk factors for erysipelas of the leg (cellulitis): case-control study. BMJ 1999;318:1591–1594.PubMedGoogle Scholar
  11. 11.
    Bisno AL, Stevens DL. Streptococcal infections in skin and soft tissues. N Engl J Med 1996;334:240–245.PubMedCrossRefGoogle Scholar
  12. 12.
    Hirshmann JV. Impetigo: etiology and therapy. Curr Clin Top Infect Dis 2002;22:42–51.Google Scholar
  13. 13.
    Raz R, Miron D, Colodner R, et al. A 1-year trial of nasal mupirocin in the prevention of recurrent staphylococcal nasal colonization and skin infection. Arch Intern Med 1996;156:1109–1112.PubMedCrossRefGoogle Scholar
  14. 14.
    Klempner MS, Styrt B. Prevention of recurrent staphylococcal skin infections with low-dose clindamycin therapy. JAMA 1988;260:2682–2685.PubMedCrossRefGoogle Scholar
  15. 15.
    Attanoos RL, Appleton MA, Douglas-Jones AG. The pathogenesis of hidradenitis suppurativa: a closer look at apocrine and apoeccrine glands. Br J Dermatol 1995;133:254–258.PubMedCrossRefGoogle Scholar
  16. 16.
    Deroo H, Aelbrecht M, t’Kindt J. Hidradenitis suppurativa. Dermatologica 1990;180:193–194.PubMedGoogle Scholar
  17. 17.
    Edlich RF, Silloway KA, Rodeheaver GT. Epidemiology, pathology, and treatment of axillary hidradenitis suppurativa. J Emerg Med 1986;4:369–378.PubMedCrossRefGoogle Scholar
  18. 18.
    Jemec GB, Heidenheim M, Nielsen NH. Hidradenitis suppurativa—characteristics and consequences. Clin Exp Dermatol 1996;21:419–423.PubMedCrossRefGoogle Scholar
  19. 19.
    Stevens DL, Herr D, Lampiris H, Hunt JL, Batts DH, Hafkin B. Linezolid versus vancomycin for the treatment of methicillinresistant Staphylococcus aureus infections. Clin Infect Dis 2002;34:1481–1490.PubMedCrossRefGoogle Scholar
  20. 20.
    Seltzer E, Dorr MB, Goldstein BP, et al., and the Dalbavancin Skin and Soft-Tissue Study Group. Once-weekly dalbavancin versus standard of care antimicrobial regimens for treatment of skin and soft-tissue infections. Clin Infect Dis 2003;37:1298–1303.PubMedCrossRefGoogle Scholar
  21. 21.
    Arbeit RD, Maki D, Tally FP, et al., and the Daptomycin 98-01 and 99-01 Investigators. The safety and efficacy of daptomycin for the treatment of complicated skin and skin-structure infections. Clin Infect Dis 2004;38:1673–1681.PubMedCrossRefGoogle Scholar
  22. 22.
    Wilcox M, Nathwani D, Dryden M. Linezolid compared with teicoplanin for the treatment of suspected or proven gram-positive infections. J Antimicrob Chemother 2004;53:335–344.PubMedCrossRefGoogle Scholar
  23. 23.
    Giordano P, Song J, Pertel P, et al. Sequential intravenous/oral moxifloxacin versus intravenous piperacillin-tazobactam followed by oral amoxicillin-clavulanate for the treatment of complicated skin and skin structure infections. Int J Antimicrob Agents 2005;26:357–365.PubMedCrossRefGoogle Scholar
  24. 24.
    Ellis-Grosse EJ, Babinchak T, Dartois N, et al., for the Tigecy-cline 300 and 305 cSSSI Study Groups. The efficacy and safety of tigecycline in the treatment of skin and skin-structure infection: results of two double-blind phase 3 comparison studies with vancomycin-aztreonam. Clin Infect Dis 2005;41(suppl 5):S341–S353.PubMedCrossRefGoogle Scholar
  25. 25.
    Jauregui LE, Babazadeh S, Seltzer E, et al. Randomized, doubleblind comparison of once-weekly dalbavancin versus twice-daily linezolid therapy for the treatment of complicated skin and skin structure infections. Clin Infect Dis 2005;41:1407–1412.PubMedCrossRefGoogle Scholar
  26. 26.
    Weigelt J, Itani K, Stevens D, et al. Linezolid versus vancomycin in treatment of complicated skin and soft tissue infections. Antimicrob Agents Chemother 2005;49:2260–2266.PubMedCrossRefGoogle Scholar
  27. 27.
    Fabian TC, File TM, Embil JM, et al. Meropenem versus imipenem-cilastatin for the treatment of hospitalized patients with complicated skin and skin structure infections: results of a multicenter, randomized, double-blind comparative study. Surg Infect 2005;6:269–282.CrossRefGoogle Scholar
  28. 28.
    Lipsky BA. Medical treatment of diabetic foot infections. Clin Infect Dis 2004;39(suppl 2):S104–S114.PubMedCrossRefGoogle Scholar
  29. 29.
    Lipsky BA, Berendt AR, Deery HG, et al. Diagnosis and treatment of diabetic foot infections. Clin Infect Dis 2004;39:885–910.PubMedCrossRefGoogle Scholar
  30. 30.
    Reiber GE, Pecoraro RE, Knepsell TD. Risk factors for amputation in patients with diabetes mellitus: a case control study. Ann Intern Med 1992;117:97–105.PubMedGoogle Scholar
  31. 31.
    Wilson RM. Neutrophil function in diabetes. Diabet Med 1986;3:509–512.PubMedGoogle Scholar
  32. 32.
    McMahon MM, Bistrian BR. Host defenses and susceptibility to infection in patients with diabetes mellitus. Infect Dis Clin North Am 1005;9:1–10.Google Scholar
  33. 33.
    Wheat LJ, Allen SD, Henry M, et al. Diabetic foot infections: bacteriologic analysis. Arch Intern Med 1986;146:1935–1940.PubMedCrossRefGoogle Scholar
  34. 34.
    Lipsky BA, Itani K, Norden C, et al., and the Linezolid Diabetic Foot Infections Study Group. Treating foot infections in diabetic patients: a randomized, multicenter, open-label trial of linezolid versus ampicillin-sulbactam/amoxicillin-clavulanate. Clin Infect Dis 2004;38:17–24.PubMedCrossRefGoogle Scholar
  35. 35.
    Gerding DN. Foot infections in diabetic patients: the role of anaerobes. Clin Infect Dis 1995;20(suppl 2):S283–S288.PubMedGoogle Scholar
  36. 36.
    Armstrong DG, Lavery GA, Harkless LB. Validation of a diabetic wound classification system: the contribution of depth, infection, and ischemia to risk of amputation. Diabetes Care 1998;21:855–859.PubMedCrossRefGoogle Scholar
  37. 37.
    Jeffcoate WJ, Lipsky BA. Controversies in diagnosing and managing osteomyelitis of the foot in diabetes. Clin Infect Dis 2004;39(suppl 2):S115–S122.PubMedCrossRefGoogle Scholar
  38. 38.
    Lipsky BA. Osteomyelitis of the foot in diabetic patients. Clin Infect Dis 1997;25:1318–1326.PubMedCrossRefGoogle Scholar
  39. 39.
    Lipsky BA. Evidence-based antibiotic therapy of diabetic foot infections. FEMS Immunol Med Microbiol 1999;26:267–276.PubMedCrossRefGoogle Scholar
  40. 40.
    Raymakers JT, Houben AJ, van de Hayden JJ, et al. The effect of diabetes and severe ischemia in the penetration of ceftazidime into tissues of the limb. Diabetes Med 2001;18:229–234.CrossRefGoogle Scholar
  41. 41.
    Harkless L, Boghossian J, Pollak R, et al. An open-label, randomized study comparing efficacy and safety of intravenous piperacillin/tazobactam and ampicillin/sulbactam for infected diabetic foot ulcers. Surg Infect 2005;6:27–40.CrossRefGoogle Scholar
  42. 42.
    Lipsky BA, Armstrong DG, Citron DM, et al. Ertapenem versus piperacillin/tazobactam for diabetic foot infections (SIDESTEP): prospective, randomised, controlled, double-blinded, multicentre trial. Lancet 2005;366:1695–1703.PubMedCrossRefGoogle Scholar
  43. 43.
    Stone JA, Cianci P. The adjunctive role of hyperbaric oxygen in the treatment of lower extremity wounds in patients with diabetes. Diabetes Spectrum 1997;10:118–123.Google Scholar
  44. 44.
    Wunderlich RP, Peters EJG, Lavery L. Systemic hyperbaric oxygen therapy, lower extremity wound healing, and the diabetic foot. Diabetes Care 2000;23:1551–1555.PubMedCrossRefGoogle Scholar
  45. 45.
    Estes JM, Pomposelli FB Jr. Lower extremity arterial reconstruction in patients with diabetes mellitus. Diabet Med 1996;13:S43–S50.PubMedGoogle Scholar
  46. 46.
    Tannenbaum GA, Pomposelli FB Jr, Marcaccio EJ, et al. Safety of vein bypass grafting to the dorsal pedal artery in diabetic patients with foot infections. J Vasc Surg 1992;15:982–990.PubMedCrossRefGoogle Scholar
  47. 47.
    Horan TC, Gaynes RP, Martone WJ, Jarvis WR, Emori TG. CDC definitions of nosocomial surgical site infections, 1992: a modification of CDC definitions of surgical wound infections. Infect Control Hosp Epidemiol 1992;13:606–608.PubMedCrossRefGoogle Scholar
  48. 48.
    Barie PS. Surgical site infections: epidemiology and prevention. Surg Infect 2002;3(suppl 1):S9–S21.CrossRefGoogle Scholar
  49. 49.
    Fry DE. The economic costs of surgical site infection. Surg Infect 2002;3(suppl 1):S37–S43.CrossRefGoogle Scholar
  50. 50.
    National Nosocomial Infections Surveillance System (NNIS) System Report: data summary from January 1992–June 2001, issued August 2001. Am J Infect Control 2001;29:404–421.CrossRefGoogle Scholar
  51. 51.
    Garibaldi RA, Cushing D, Lerer T. Risk factors for postoperative infection. Am J Med 1991;91(suppl 3B):158S–163S.PubMedCrossRefGoogle Scholar
  52. 52.
    Dellinger EP, Hausmann SM, Bratzler DW, et al. Hospitals collaborate to decrease surgical site infections. Am J Surg 2005;190:9–15.PubMedCrossRefGoogle Scholar
  53. 53.
    Emori TG, Gaynes RP. An overview of nosocomial infections, including the role of the microbiology laboratory. Clin Microbiol Rev 1993;6:428–442.PubMedGoogle Scholar
  54. 54.
    Raymond DP, Pelletier SJ, Crabtree TD, et al. Surgical infection and the ageing population. Am Surg 2001;67:827–832.PubMedGoogle Scholar
  55. 55.
    Latham R, Lancaster AD, Covington JF, et al. The association of diabetes and glucose control with surgical-site infections among cardiothoracic surgery patients. Infect Control Hosp Epidemiol 2001;22:607–612.PubMedCrossRefGoogle Scholar
  56. 56.
    Pomposelli JJ. Baxter JK III, Babineau TJ, et al. Early postoperative glucose control predicts nosocomial infection rate in diabetic patients. JPEN J Parenter Enteral Nutr 1998;22:77–81.PubMedCrossRefGoogle Scholar
  57. 57.
    Delgado-Rodriguez M, Medina-Cuadros M, Martinez-Gallego G, et al. Total cholesterol, HDL cholesterol, and risk of nosocomial infection: a prospective study in surgical patients. Infect Control Hosp Epidemiol 1997;18:9–18.PubMedGoogle Scholar
  58. 58.
    Malone DL, Genuit T, Tracy JK, et al. Surgical site infections: reanalysis of risk factors. J Surg Res 2002;103:89–95.PubMedCrossRefGoogle Scholar
  59. 59.
    Scott JD, Forrest A, Feuerstein S, et al. Factors associated with postoperative infection. Infect Control Hosp Epidemiol 2001;22:347–351.PubMedCrossRefGoogle Scholar
  60. 60.
    Mangram AJ, Horan TC, Pearson ML, et al. Guideline for prevention of surgical site infection, 1999. Hospital Infection Control Practices Advisory Committee. Infect Control Hosp Epidemiol 1999;20:250–278.PubMedCrossRefGoogle Scholar
  61. 61.
    Tepaske R, Velthuis H, Oudemans-van Straatan HM, et al. Effect of preoperative oral immune-enhancing nutritional supplement on patients at high risk of infection after cardiac surgery: a randomized placebo-controlled trial. Lancet 2001;358:696–701.PubMedCrossRefGoogle Scholar
  62. 62.
    Gianotti L, Braga M, Nespoli L, et al. A randomized controlled trial of preoperative oral supplementation with a specialized diet in patients with gastrointestinal cancer. Gastroenterology 2002;122:1763–1770.PubMedCrossRefGoogle Scholar
  63. 63.
    Higgins A, London J, Charland S, et al. Prophylactic antibiotics for elective laparoscopic cholecystectomy: are they necessary? Arch Surg 1999;134:611–613.PubMedCrossRefGoogle Scholar
  64. 64.
    Harling R, Moorjani N, Perry C, MacGowan AP, Thompson MH. A prospective, randomised trial of prophylactic antibiotics versus bag extraction in the prophylaxis of wound infection in laparoscopic cholecystectomy. Ann R Coll Surg Engl 2000;82:408–410.PubMedGoogle Scholar
  65. 65.
    Lewis RT. Oral versus systemic antibiotic prophylaxis in elective colon surgery: a randomized study and meta-analysis send a message from the 1990s. Can J Surg 2002;45:173–180.PubMedGoogle Scholar
  66. 66.
    Song F, Glenny A-M. Antimicrobial prophylaxis in colorectal surgery: a systematic review of randomized controlled trials. Br J Surg 1998;85:1232–1241.PubMedCrossRefGoogle Scholar
  67. 67. Accessed January 2, 2007.Google Scholar
  68. 68.
    Tejirian T, DiFrtonzo LA, Haigh PI. Antibiotic prophylaxis for preventing wound infection after breast surgery: a systematic review and meta-analysis. J Am Coll Surg 2006;203:729–734.PubMedCrossRefGoogle Scholar
  69. 69.
    Cunningham M, Bunn F, Handscomb K. Prophylactic antibiotics to prevent surgical site infection after breast cancer surgery (review). Cochrane Database Syst Rev 2006;2:CD005360.Google Scholar
  70. 70.
    Aufenacker TJ, Koelemay JW, Gouma DJ, Simons MP. Systematic review and meta-analysis if the effectiveness of antibiotic prophylaxis in prevention of wound infection after mesh repair of abdominal wall hernia. Br J Surg 2006;93:5–10.PubMedCrossRefGoogle Scholar
  71. 71.
    Sanchez-Manuel FJ, Seco-Gil JL. Antibiotic prophylaxis for hernia repair. Cochrane Database Syst Rev 2004;4:CD003769.Google Scholar
  72. 72.
    Stewart A, Evers PS, Earnshaw JJ. Prevention of infection in arterial reconstruction. Cochrane Database Syst Rev 2006;3:CD003073.Google Scholar
  73. 73.
    Bratzler DW, Houck PM, and the Surgical Infection Prevention Guideline Writers Workgroup. Antimicrobial prophylaxis for surgery: an advisory statement from the National Surgical Infection Prevention Project. Am J Surg 2005;189:395–404.PubMedCrossRefGoogle Scholar
  74. 74.
    Classen DC, Evans RS, Pestotnik SL, et al. The timing of prophylactic administration of antibiotics and the risk of surgical-wound infection. N Engl J Med 1992;326:281–286.PubMedGoogle Scholar
  75. 75.
    Zaneti G, Giardina R, Piatt R. Intraoperative redosing of cefazolin and risk for surgical site infection in cardiac surgery. Emerg Infect Dis 2001;7:828–831.Google Scholar
  76. 76.
    Mest DR, Wong DH, Shimoda KJ, et al. Nasal colonization with methicillin-resistant Staphylococcus aureus on admission to the surgical intensive care unit increases the risk of infection. Anesth Analg 1994;78:644–650.PubMedCrossRefGoogle Scholar
  77. 77.
    Perl TM, Cullen JJ, Wenzel RP, et al., and the Mupirocin and the Risk of Staphylococcus aureus Study Team. Intranasal mupirocin to prevent postoperative Staphylococcus aureus infections. N Engl J Med 2002;346:1871–1877.PubMedCrossRefGoogle Scholar
  78. 78.
    Bratzler DW, Houck PM, Richards C, et al. Use of antimicrobial prophylaxis for major surgery. Baseline results from the National Surgical Infection Prevention Project. Arch Surg 2005;140:174–182.PubMedCrossRefGoogle Scholar
  79. 79.
    Morris AM, Jobe BA, Stoney M, et al. Clostridium difficile colitis: an increasingly aggressive iatrogenic disease? Arch Surg 2002;137:1096–1100.PubMedCrossRefGoogle Scholar
  80. 80.
    Namias N, Harvill S, Ball S, et al. Cost and morbidity associated with antibiotic prophylaxis in the ICU. J Am Coll Surg 1999;188:225–230.PubMedCrossRefGoogle Scholar
  81. 81.
    Fukatsu K, Saito H, Matsuda T, et al. Influences of type and duration of antimicrobial prophylaxis on an outbreak of methicillin-resistant Staphylococcus aureus and on the incidence of wound infection. Arch Surg 1997;132:1320–1325.PubMedGoogle Scholar
  82. 82.
    Bozorgzadeh A, Pizzi WF, Barie PS, et al. The duration of antibiotic administration for penetrating abdominal trauma. Am J Surg 1999;177:125–131.PubMedCrossRefGoogle Scholar
  83. 83.
    Velmahos GC, Toutouzas KG, Sarkysian G, et al. Severe trauma is not an excuse for prolonged antibiotic prophylaxis. Arch Surg 2002;137:537–541.PubMedCrossRefGoogle Scholar
  84. 84.
    Parienti JJ, Thibon P, Heller R, et al. Hand-rubbing with an aqueous alcoholic versus traditional surgical hand-scrubbing and 30-day surgical site infection rates: a randomized equivalence study. JAMA 2002;288:722–727.PubMedCrossRefGoogle Scholar
  85. 85.
    Kurz A, Sessler DI, Lenhardt R. Perioperative normothermia to reduce the incidence of surgical-wound infection and shorten hospitalization, Study of Wound Infection and Temperature Group. N Engl J Med 1996;334:1209–1215.PubMedCrossRefGoogle Scholar
  86. 86.
    Flores-Maldonado A, Medina-Escobedo CE, Rios-Rodriguez HM, et al. Mild hypothermia and the risk of wound infection. Arch Med Res 2001;32:227–231.PubMedCrossRefGoogle Scholar
  87. 87.
    Melling AC, Ali B, Scott EM, et al. Effects of preoperative warming on the incidence of wound infection and clean surgery: a randomized controlled trial. Lancet 2001;358:876–880.PubMedCrossRefGoogle Scholar
  88. 88.
    Janik J. Electric cautery lowers contamination threshold for infection by laparotomies. Am J Surg 1998;175:263–266.CrossRefGoogle Scholar
  89. 89.
    Brasel KJ, Borgstrom DC, Weigelt JA. Cost-utility analysis of contaminated appendectomy wounds. J Am Coll Surg 1997;184:23–30.PubMedGoogle Scholar
  90. 90.
    Cohn SM, Giannotti G, Ong AW, et al. Prospective randomized trial of two wound management strategies for dirty abdominal wounds. Ann Surg 2001;233:409–413.PubMedCrossRefGoogle Scholar
  91. 91.
    Al-Inany H, Youssef G, Abd ELMaguid A, et al. Value of subcutaneous drainage system in obese females undergoing cesarean section using Pfannenstiel incision. Gynecol Obstet Invest 2002;53:75–78.PubMedCrossRefGoogle Scholar
  92. 92.
    Magann EF, Chauhan SP, Rodts-Palenik D, et al. Subcutaneous stitch closure versus subcutaneous drain to prevent wound disruption after cesarean delivery: a randomized clinical trial. Am J Obstet Gynecol 2002;186:1119–1123.PubMedCrossRefGoogle Scholar
  93. 93.
    Noyes LD, Doyle DJ, McSwain NE. Septic complications associated with the use of peritoneal drains in liver trauma. J Trauma 1998;28:337–46.CrossRefGoogle Scholar
  94. 94.
    Magee C, Rodeheaver GT, Golden GT, et al. Potentiation of wound infection by surgical drains. Am J Surg 1976;131;28:14–20.Google Scholar
  95. 95.
    Barie PS. Are we draining the life from our patients? Surg Infect 2002;3:159–160.CrossRefGoogle Scholar
  96. 96.
    Platell C, Papadimitriou JM, Hall JC. The influence of lavage on peritonitis. J Am Coll Surg 2000;191:672–680.PubMedCrossRefGoogle Scholar
  97. 97.
    Cervantes-Sanchez CR, Gutierrez-Vega R, Vasquez-Carpizio JA, et al. Syringe pressure irritation of subdermic tissue after appendectomy to decrease the incidence of postoperative wound infection. World J Surg 2000;24:38–41.PubMedCrossRefGoogle Scholar
  98. 98.
    Yoshii S, Hosaka S, Suzuki S, et al. Prevention of surgical site infection by antibiotic spraying in the operating field during cardiac surgery. Jpn J Thorac Cardiovasc Surg 2001;49:279–281.PubMedCrossRefGoogle Scholar
  99. 99.
    O’Connor LT Jr, Goldstein M. Topical perioperative antibiotic prophylaxis for minor clean inguinal surgery. J Am Coll Surg 2002; 194:407–410.PubMedCrossRefGoogle Scholar
  100. 100.
    Hebert PC, Wells G, Blajchman MA, et al. A multi-center, randomized, controlled clinical trial of transfusion requirements in critical care. Transfusion Requirements in Critical Care Investigators, Canadian Critical Care Trials Group. N Engl J Med 1999;340:409–417.PubMedCrossRefGoogle Scholar
  101. 101.
    Claridge JA, Sawyer RG, Schulman AM, et al. Blood transfusions correlate with infections in trauma patients in a dose-dependent manner. Am Surg 2002;68:566–572.PubMedGoogle Scholar
  102. 102.
    Offner PJ, Moore EE, Biffl WL, et al. Increased rate of infection associated with transfusion of old blood after severe injury. Arch Surg 2002;137:711–717.PubMedCrossRefGoogle Scholar
  103. 103.
    Hill GE, Frawley WH, Griffith KE, et al. Allogeneic blood transfusion increases the risk of postoperative bacterial infection: a meta-analysis. J Trauma 2003;54:908–914.PubMedCrossRefGoogle Scholar
  104. 104.
    Taylor RW, Manganaro L, O’ Brian J, et al. Impact of allogenic packed red blood cells transfusion on nosocomial infection rates in the critically ill patient. Crit Care Med 2002;30:2249–2254.PubMedCrossRefGoogle Scholar
  105. 105.
    Vincent JL, Baron J-F, Reinhart K, et al. Anemia and blood transfusion in critically ill patients. JAMA 2002;288:1499–1507.PubMedCrossRefGoogle Scholar
  106. 106.
    Latham R, Lancaster AD, Covington JF, et al. The association of diabetes and glucose control with surgical-site infections among cardiothoracic surgery patients. Infect Control Hosp Epidemiol 2001;22:607–612.PubMedCrossRefGoogle Scholar
  107. 107.
    van den Berghe G, Wouters P, Weekers F, et al. Intensive insulin therapy in the critically ill patients. N Engl J Med 2001;345:1359–1367.PubMedCrossRefGoogle Scholar
  108. 108.
    Pittas AG, Siegel RD, Lau J. Insulin therapy for critically ill hospitalized patients: a meta-analysis of randomized controlled trials. Arch Intern Med 2004;164:2005–2011.PubMedCrossRefGoogle Scholar
  109. 109.
    Heyland DK, MacDonald S, Keefe L, et al. Total parenteral nutrition in the critically ill patient: a meta-analysis. JAMA 1998;280:2013–2019.PubMedCrossRefGoogle Scholar
  110. 110.
    Berne JD, Norwood SH, McAuley CE, et al. Erythromycin reduces delayed gastric emptying in critically ill trauma patients: a randomized, controlled trial. J Trauma 2002;53:422–425.PubMedCrossRefGoogle Scholar
  111. 111.
    Marik PE, Zaloga GP. Early enteral nutrition in acutely ill patients: a systematic review. Crit Care Med 2001;29:2264–2270.PubMedCrossRefGoogle Scholar
  112. 112.
    Gottrupp F. Oxygen in wound healing and infection. World J Surg 2004;28:312–315.CrossRefGoogle Scholar
  113. 113.
    Greif R, Akca O, Horn EP, et al. Supplemental perioperative oxygen to reduce the incidence of surgical-wound infection. Outcomes Research Group. N Engl J Med 2000;342:161–167.PubMedCrossRefGoogle Scholar
  114. 114.
    Pryor KO, Fahey TJ 3rd, Lien CA, Goldstein PA. Surgical site infection and the routine use of perioperative hyperoxia in a general surgical population: a randomized controlled trial. JAMA 2004;291:79–87.PubMedCrossRefGoogle Scholar
  115. 115.
    Fuchs U, Zittermann A, Stuettgen B, et al. Clinical outcome of patients with deep sternal wound infection managed by vacuum-assisted closure compared to conventional therapy with open packing: a retrospective analysis. Ann Thorac Surg 2005;79:526–531.PubMedCrossRefGoogle Scholar
  116. 116.
    File TM. Necrotizing soft tissue infections. Curr Infect Dis Rep 2003;5:407–415.PubMedCrossRefGoogle Scholar
  117. 117.
    Oliver JD. Wound infections caused by Vibrio vulnificus and other marine bacteria. Epidemiol Infect 2005;133:383–391.PubMedCrossRefGoogle Scholar
  118. 118.
    Ebright JR, Pieper B. Skin and soft tissue infections in injection drug users. Infect Dis Clin North Am 2002;16:697–712.PubMedCrossRefGoogle Scholar
  119. 119.
    Cunningham SC, Napolitano LM. Necrotizing soft tissue infection from decubitus ulcer after spinal cord injury. Spine 2004;29:E172–E174.PubMedCrossRefGoogle Scholar
  120. 120.
    Skitarelic N, Mladina R, Morovic M, Skitarelic N. Cervical necrotizing fasciitis: sources and outcomes. Infection 2003;31:39–44.PubMedCrossRefGoogle Scholar
  121. 121.
    Hohlweg-Majert B, Weyer N, Metzger MC, Schon R. Cervicofacial necrotizing fasciitis. Diabetes Res Clin Pract 2006;72:206–208.PubMedCrossRefGoogle Scholar
  122. 122.
    Toran KC, Nath S, Shrestha S, Rana BB. Odontogenic origin of necrotizing fasciitis of head and neck—a case report. Kathmandu Univ Med J 2004;2:361–363.Google Scholar
  123. 123.
    Praba-Egge AD, Lanning D, Broderick TJ, Yelon JA. Necrotizing fasciitis of the chest and abdominal wall arising from an empyema. J Trauma 2004;56:1356–1361.PubMedCrossRefGoogle Scholar
  124. 124.
    Darbar A, Harris LA, Gosbell IB. Necrotizing infection due to Bacillus cereus mimicking gas gangrene following penetrating trauma. J Orthop Trauma 2005;19:353–355.PubMedGoogle Scholar
  125. 125.
    Chhatwal GS, McMillan DJ. Uncovering the mysteries of invasive streptococcal diseases. Trends Mol Med 2005;11:152–155.PubMedCrossRefGoogle Scholar
  126. 126.
    Gillespie SH. New tricks from an old dog: streptococcal necrotising soft-tissue infections. Lancet 2004;363:672–673.PubMedCrossRefGoogle Scholar
  127. 127.
    Wall DB, Klein SR, Black S, de Virgilio C. A simple model to help distinguish necrotizing fasciitis from nonnecrotizing soft tissue infection. J Am Coll Surg 2000;191:227–231.PubMedCrossRefGoogle Scholar
  128. 128.
    Wall DB, de Virgilio C, Black S, Klein SR. Objective criteria may assist in distinguishing necrotizing fasciitis from nonnecrotizing soft tissue infection. Am J Surg 2000;179:17–21.PubMedCrossRefGoogle Scholar
  129. 129.
    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;32:1535–1541.PubMedCrossRefGoogle Scholar
  130. 130.
    Cohen MM, Duncan PG. Physical status score and trends in anesthetic complications. J Clin Epidemiol 1988;41:83–90.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Philip S. Barie
    • 1
    • 2
  • Soumitra R. Eachempati
    • 3
    • 4
  1. 1.Departments of Surgery and Public HealthNew York-Presbyterian Hospital/Weill Cornell Medical CollegeNew YorkUSA
  2. 2.Division of Critical Care and TraumaNew York-Presbyterian Hospital/Weill Cornell Medical CollegeNew YorkUSA
  3. 3.Departments of Surgery and Public HealthWeill Cornell Medical CollegeUSA
  4. 4.New York-Presbyterian HospitalNew YorkUSA

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