A Structured Approach to Skin and Soft Tissue Infections (SSTIs) in an Ambulatory Setting

Abstract

The skin is the largest, and arguably, the most vulnerable organ in the human body. Scratches and scrapes, bites and puncture wounds, impetigo and erysipelas-all these disruptions can lead to pain, swelling, and/or systemic symptoms. In this article, which is based on the Infectious Diseases Society of America's 2014 guidelines and the World Society of Emergency Surgery and Surgical Infection Society of Europe's 2018 consensus statement, a structured approach to skin and soft tissue infections (SSTIs) is reviewed, comparing treatment for suppurative and non-suppurative infections, and then discussing specific conditions commonly seen in Primary Care and Urgent Care facilities.

Keywords: MRSA; antibiotics; drainage; immunodeficiency; inflammation; necrosis; purulence; resistance; trauma.

Figure 1

Infectious processes by depth. Soft tissue structures and layers of the skin are also marked (adapted from Figure 5.2 of Anatomy and Physiology, 2013, via OpenStax College; licensed through Creative Commons–https://commons.wikimedia.org/wiki/File:501_Structure_of_the_skin.jpg).