Read theprivacy policyandterms and conditions. Misdiagnosed Lower Extremity Cellulitis These findings suggest the currently used severity scoring system is not a robust means of guiding empirical therapy. Patients with severe or necrotising infections should have initial broad spectrum antimicrobial cover to include staphylococci, streptococci, Gram-negative organisms and also an agent with activity against toxin production in group A streptococci, such as clindamycin or linezolid.12,15 Treatment with an agent active against methicillin-resistant S aureus (MRSA) should be considered in patients with a known history of, or risk factors for, MRSA colonisation as well as in those with suspected necrotising fasciitis.12 Recent prospective trials in the USA have suggested that empiric use of agents active against MRSA may not be warranted in the treatment of non-purulent cellulitis.20, There is little evidence to support the historical practice of adding benzylpenicillin to flucloxacillin in the treatment of cellulitis.21 In a randomised double-blinded trial comparing flucloxacillin and clindamycin with flucloxacillin alone, there was no difference in clinical improvement or the resumption of normal daily activities, but there was increased diarrhoea in the clindamycin group.22 Brunn et al found that early antimicrobial escalation (during the first 3days of therapy) did not result in improved outcomes and addressing non-antibiotic factors such as limb elevation and treatment of comorbidities should be considered as an integrated part of the clinical management of cellulitis.23, Outpatient parenteral antimicrobial therapy has become an increasingly important means of delivering ambulatory care. In some cases of cellulitis, the entry point may not be evident as the entry may involve minute skin changes or intrusive qualities of some infectious bacteria. Meshkov LS, Nijhawan RI, Weinberg JM. The revision of this clinical guideline was coordinated by Mica Schneider, RN, Platypus. In most cases, your healthcare provider wont conduct any tests. WebPack the wound with saline-soaked dressings and a bandage WOUND CARE Your surgical wound may need to be cleaned and the dressing changed on a regular basis. Cellulitis can occur from a simple break in the skin allowing bacteria to enter. Hinkle, J., & Cheever, K. (2018). We included 25 studies with a total of 2488 participants. We do not endorse non-Cleveland Clinic products or services. Should only be used for 2-3 weeks, -Moisture management for moderate- high exudate, -Absorbs fluid to form a gel (can be mistaken for slough), -To fill irregular shaped wounds e.g. They include: It is important to note that not all cases of cellulitis are medical emergencies. Untreated cellulitis can lead to life-threatening conditions such as sepsis and gangrene. The symptoms include severe pain, swelling, and inflammation, often accompanied by fever, rigours, nausea, and feeling generally unwell. Elsevier/Mosby. There are many online courses available that offer MHF4U as a part of their curriculum. Nursing management for Cellulitis Assess for pain, noting quality, characteristics, location, swelling, redness, increased body temperature. In: Kelly A, Taylor SC, Lim HW, et al., eds. Copyright 2023 The Cochrane Collaboration. Mild cellulitis is treated as an outpatient with oral penicillin. It is essential for optimal healing to address these factors. You may learn to do this yourself, or nurses may do it for you.
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