Source Control pp 215-216 | Cite as

Invited Commentary

  • H. Harlan Stone


• Although the classification of soft tissue infections as presented is acceptable, my personal preference has been to use a different organization of categories. Cellulitis is a diffuse inflammatory response without areas of necrosis during its earliest phases, is confined to tissue superficial to the deep enveloping fascia, generally is caused by Gram-positive cocci, and is almost uniformly responsive to beta lactam antibiotics. • Abscess, on the other hand, represents a central area of liquefied necrotic material that, in turn, is surrounded by a halo of cellulitis. In general, the infection has been confined by the freshly established granulating wall. Host defenses have limited the process, so all that is needed is drainage. Antibiotics are indicated only if there has been an attendant bacteremia, and only until the abscess has been drained. Responsible pathogens include Gram-positive cocci, Gram-negative rods, or a mixed flora which may also include anaerobes. • Phlegmonis a process that is made up of innumerable small abscesses that have been compartmentalized by soft tissue structures resistant to bacterial enzymatic digestion. Treatment is the same as for an abscess, except that the intervening septi must be divided to create a single confluent cavity. At times it is more practical to excise the entire inflammatory process, such as with sigmoid colectomy for diverticulitis.


Soft Tissue Infection Necrotizing Fasciitis Hyperbaric Oxygen Therapy Soft Tissue Structure Invite Commentary 
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© Springer-Verlag Berlin Heidelberg 2003

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  • H. Harlan Stone

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