Severe and complicated soft tissue infections: A single-centre case series

TÜRE YÜCE Z., Unuvar G. K., Esmaoglu A., Ulu-Kilic A., Coruh A., DOĞANAY M.

Journal of Wound Care, vol.32, no.8, pp.492-499, 2023 (SCI-Expanded) identifier identifier

  • Publication Type: Article / Article
  • Volume: 32 Issue: 8
  • Publication Date: 2023
  • Doi Number: 10.12968/jowc.2023.32.8.492
  • Journal Name: Journal of Wound Care
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, MEDLINE
  • Page Numbers: pp.492-499
  • Keywords: complicated soft tissue infection, hyponatraemia, necrotising soft tissue infection, sepsis, soft tissue abscess, soft tissue infection, wound, wound care, wound dressing, wound healing
  • Lokman Hekim University Affiliated: Yes


Objective: To assess the demographic and clinical characteristics, laboratory findings, and economic burden of patients with a diagnosis of complicated skin and soft tissue infection (cSSTI). Method: The demographic and clinical characteristics, laboratory findings, surgical interventions, cost of treatment, and outcome of patients diagnosed with cSSTIs between January 2017 and December 2019 were retrospectively analysed. Results: A total of 24 patients with cSSTIs were included in the study. The median age was 53 (22-85) years, and 14 (58%) were female. The most common comorbidity was diabetes (54%). On admission, 75% of patients presented with sepsis, and 70% had a high-grade Laboratory Risk Indicator for Necrotising Fasciitis (LRINEC) score. The causative microorganism was isolated from 21 (87%) patients, and the multidrug resistance rate of Gram-negative bacteria was 50%. The median number of debridements was 3 (1-12). In all, 11 patients were followed up in the intensive care unit, and the mortality rate was 29%. The presence of confusion (p=0.025), causative Gram-negative microorganisms (p=0.009), hyponatraemia (p=0.034), the need for intensive care (p=0.001), anti-meticillin-resistant Staphylococcus aureus antibiotics (p=0.023) and the rate of antibiotic changes during treatment (p=0.019) were significantly higher in the non-survival patient group. Hyponatraemia was a significant independent risk factor for mortality (p=0.048). The median cost of per-patient treatment was $9453 USD in the non-surviving and $1536 in the surviving group. Conclusion: It is important to know possible factors and local resistance rates at the beginning of empirical antibacterial and surgical treatment. The presence of hyponatraemia, sepsis and a high LRINEC score can be considered to be the mortality predictors. Declaration of interest: No financial or non-financial benefits have been received or will be received from any party related directly or indirectly to the subject of this article. The authors declare that they have no relevant conflict of interest to declare.