Article
Dermatology
Jan Friederichs, Benedikt Gerl, D. Schneidmueller, Sven Hungerer
Summary: Necrotizing soft tissue infections (NSTIs) share similar pathophysiological features but can have varying clinical courses. Initial wound microbiology is important in the classification of these infections, but the timeline of microbiological colonization during the course of disease is not well defined. This study analyzed the initial and changing wound microbiology in 180 patients with NSTIs and found that certain microbiological pathogens were associated with worse outcomes and higher mortality rates. Enterococci and fungi were particularly indicative of a lethal outcome. The findings suggest that monitoring microbiological changes and identifying specific pathogens can help predict prognosis in NSTIs.
INTERNATIONAL WOUND JOURNAL
(2023)
Review
Emergency Medicine
Massimo Sartelli, Federico Coccolini, Yoram Kluger, Ervis Agastra, Fikri M. Abu-Zidan, Ashraf El Sayed Abbas, Luca Ansaloni, Abdulrashid Kayode Adesunkanmi, Goran Augustin, Miklosh Bala, Oussama Baraket, Walter L. Biffl, Marco Ceresoli, Elisabetta Cerutti, Osvaldo Chiara, Enrico Cicuttin, Massimo Chiarugi, Raul Coimbra, Daniela Corsi, Francesco Cortese, Yunfeng Cui, Dimitris Damaskos, Nicola de'Angelis, Samir Delibegovic, Zaza Demetrashvili, Belinda De Simone, Stijn W. de Jonge, Stefano Di Bella, Salomone Di Saverio, Therese M. Duane, Paola Fugazzola, Joseph M. Galante, Wagih Ghnnam, George Gkiokas, Carlos Augusto Gomes, Ewen A. Griffiths, Timothy C. Hardcastle, Andreas Hecker, Torsten Herzog, Aleksandar Karamarkovic, Vladimir Khokha, Peter K. Kim, Jae Il Kim, Andrew W. Kirkpatrick, Victor Kong, Renol M. Koshy, Kenji Inaba, Arda Isik, Rao Ivatury, Francesco M. Labricciosa, Yeong Yeh Lee, Ari Leppaniemi, Andrey Litvin, Davide Luppi, Ronald V. Maier, Athanasios Marinis, Sanjay Marwah, Cristian Mesina, Ernest E. Moore, Frederick A. Moore, Ionut Negoi, Iyiade Olaoye, Carlos A. Ordonez, Mouaqit Ouadii, Andrew B. Peitzman, Gennaro Perrone, Tadeja Pintar, Giuseppe Pipitone, Mauro Podda, Kemal Rasa, Julival Ribeiro, Gabriel Rodrigues, Ines Rubio-Perez, Ibrahima Sall, Norio Sato, Robert G. Sawyer, Vishal G. Shelat, Michael Sugrue, Antonio Tarasconi, Matti Tolonen, Bruno Viaggi, Andrea Celotti, Claudio Casella, Leonardo Pagani, Sameer Dhingra, Gian Luca Baiocchi, Fausto Catena
Summary: Skin and soft-tissue infections (SSTIs) range from simple superficial infections to severe necrotizing infections. International multi-society collaboration aims to promote global standards of care in SSTIs by providing reasonable approaches to management. An extensive review of English literature led to the sharing of evidence by an international task force.
WORLD JOURNAL OF EMERGENCY SURGERY
(2022)
Article
Computer Science, Information Systems
Sonja Katz, Jaco Suijker, Christopher Hardt, Martin Bruun Madsen, Annebeth Meij-de Vries, Anouk Pijpe, Steinar Skrede, Ole Hyldegaard, Erik Solligard, Anna Norrby-Teglund, Edoardo Saccenti, Vitor A. P. Martins dos Santos
Summary: This study accurately predicts mortality using a machine learning model and lays the foundation for a more extensive clinical decision support system.
INTERNATIONAL JOURNAL OF MEDICAL INFORMATICS
(2022)
Review
Infectious Diseases
Tomas Urbina, Keyvan Razazi, Clement Ourghanlian, Paul-Louis Woerther, Olivier Chosidow, Raphael Lepeule, Nicolas de Prost
Summary: Necrotizing soft tissue infections (NSTIs) are rare and life-threatening bacterial infections characterized by extensive tissue necrosis. Treatment requires broad-spectrum antibiotics, rapid surgical debridement, and management of organ failures. Antibiotic therapy faces challenges such as broad-spectrum activity, toxin reduction, and optimal tissue diffusion.
Article
Surgery
Femke Nawijn, Falco Hietbrink, Andrew B. Peitzman, Luke P. H. Leenen
Summary: Necrotizing Soft Tissue Infections (NSTIs) can present with a wide range of symptoms, from severe to subtle, leading to delays in diagnosis and treatment. Lack of awareness of this heterogeneity among physicians may result in preventable mortality.
FRONTIERS IN SURGERY
(2021)
Review
Pharmacology & Pharmacy
Thi Phuong Nga Hoang, Muhammad Usman Ghori, Barbara R. Conway
Summary: Skin and soft tissue infections are common conditions that often require medical intervention. With the rise of antibiotic resistance, antiseptic agents are being considered as potential alternatives for prevention and treatment, with traditional formulations still having room for further development.
Article
Infectious Diseases
Therese M. Duane, Jared M. Huston, Morgan Collom, Adam Beyer, Sara Parli, Sara Buckman, Mark Shapiro, Amy McDonald, Jose Diaz, Jeffrey M. Tessier, James Sanders
Summary: This study provides an update on the Surgical Infection Society guidelines for the treatment of complicated skin and soft tissue infections, focusing on antimicrobial options and duration of therapy. Most recommendations remain unchanged, but there is increased support for adjuvant antimicrobial therapy after drainage of complex abscess.
SURGICAL INFECTIONS
(2021)
Review
Infectious Diseases
Florencia Mariani, Estela Maria Galvan
Summary: Polymicrobial biofilms create a complex environment where different microorganisms can interact in various ways and alter the outcome of diseases. This review article explores the microorganisms commonly found together with Staphylococcus aureus in skin and soft tissue infections, such as Pseudomonas aeruginosa, Escherichia coli, Enterococcus spp., Acinetobacter baumannii, and Candida albicans. The molecular mechanisms and impact of these polymicrobial interactions on pathogenesis and antimicrobial susceptibility are also discussed.
Article
Immunology
Dara L. Horn, Emma A. Roberts, Jolie Shen, Jeannie D. Chan, Eileen M. Bulger, Noel S. Weiss, John B. Lynch, Chloe Bryson-Cahn, Bryce R. H. Robinson
Summary: This study found beta-hemolytic streptococci to be highly prevalent in NSTIs, with clindamycin resistance more common than previously described. The presence of beta-hemolytic streptococci, particularly clindamycin-resistant strains, was associated with a greater risk of limb loss in patients.
CLINICAL INFECTIOUS DISEASES
(2021)
Article
Immunology
Jamie L. W. Rhoads, Tina M. Willson, Jesse D. Sutton, Emily S. Spivak, Matthew H. Samore, Vanessa W. Stevens
Summary: This study found a decrease in the incidence of SSTIs in the outpatient setting over time. Treatment of SSTIs varied depending on the presenting ambulatory location, with poor adherence to guidelines in regard to the use of anti-MRSA therapies. Further research is needed to understand the impact of guideline nonadherence on patient outcomes.
CLINICAL INFECTIOUS DISEASES
(2021)
Article
Immunology
Patrick Chung Kay Tam, Brendan Kennedy, Anushia Ashokan
Summary: This study retrospectively analyzed the effect of early surgery combined with empiric antimicrobials on mortality in necrotizing soft tissue infections (NSTIs). The results showed that early surgery independently reduced 30-day mortality, and the choice of empiric antimicrobials did not further enhance this effect.
OPEN FORUM INFECTIOUS DISEASES
(2023)
Review
Surgery
Jaco Suijizer, Kang Jing Zheng, Anoulz Pijpe, Farha Nasroe, Annebeth Meij-de Vries
Summary: The aim of this review was to assess whether skin-sparing debridement (SSd) is noninferior to en bloc debridement (EBd) regarding general outcomes. Results showed that patients treated with SSd did not have increased mortality rate, length of stay (LOS), or complication rate compared to those treated with EBd. However, the current available evidence is of insufficient quality to conclude whether SSd is noninferior to EBd for all assessed outcomes.
JOURNAL OF SURGICAL RESEARCH
(2021)
Article
Surgery
Manuel Castillo-Angeles, Jennifer W. Uyeda, Anupamaa J. Seshadri, Ramsis Ramsis, Barbara U. Okafor, Stephanie Nitzschke, Erika L. Rangel, Noelle N. Saillant, Ali Salim, Reza Askari
Summary: This study found that sarcopenia is associated with an increased risk of in-hospital mortality in patients with necrotizing soft tissue infections (NSTIs).
JOURNAL OF SURGICAL RESEARCH
(2022)
Article
Surgery
Christine Castater, Elliot Bishop, Adora Santos, Mari Freedberg, Phillip Kim, Christopher Sciarretta
Summary: Diabetes can have various physiological effects, including increased infection rates, impaired wound healing, and higher risk for complex soft tissue infections. Clinicians and surgeons should be highly suspicious of severe infection in patients with diabetes, especially those with uncontrolled diabetes.
SURGICAL CLINICS OF NORTH AMERICA
(2023)
Article
Emergency Medicine
Kai-Hsiang Wu, Po-Han Wu, Chih-Yao Chang, Yen-Ting Kuo, Kuang-Yu Hsiao, Cheng-Ting Hsiao, Shang-Kai Hung, Chia-Peng Chang
Summary: This study evaluates the characteristics of infectious fluid in soft tissue infection and suggests that biochemical tests and Gram stain smear can be useful in distinguishing necrotizing soft tissue infection (NSTI) from cellulitis.
WORLD JOURNAL OF EMERGENCY SURGERY
(2022)