skin infections & wounds Flashcards
given in tetanus prone wounds when the patient’s immune status is unknown or partial
tetanus immune globulin
given in traumatic wounds if tetanus immune status is unknown
tetanus toxoid
what are tetanus prone wounds?
gross devitalized tissue, obvious contamination, frostbite, missile injuries, and injuries >6hrs old
best antibiotic choice for an MRSA infection resistant to vancomycin
linezolid
treatment for severe hidradenitis suppurativa
wide excision with healing by secondary intention
recurrent chronic inflammatory skin condition due to follicular occlusion:
hidradenitis suppurativa
acute purulent infection of the fingertip pad (pulp)
felon
most common organism of infection in felon
staph aureus
what does full thickness skin graft include
epidermis and complete dermis; no subcutaneous tissue
what is primary graft contraction?
degree to which a graft shrinks in surface area after harvesting but before grafting
what is secondary graft contraction?
degree to which a graft shrinks during healing
which has less primary contraction - full thickness or STSG?
STSG
which has less secondary contraction - full thickness or STSG?
full thickness
which has greater rates of engraftment (graft survival)?
STSG
infection spreading along lymphatic channels that presents with red linear streaking proximal to the site of infection and travels toward the regional lymph nodes which may also be enlarged and tender
acute lymphangitis
most common organism and treatment of acute lymphangitis
group A strep; tx with penicillin
mupirocin is indicated for treatment of ___ wound infections
MRSA
how is a full thickness skin graft harvested and repaired?
excised sharply with knife, defatted to encourage uptake; wound is closed primarily
most common pathogen of paronychia
staph aureus
order and stages of healing for skin grafts:
imbibition, inosculation, revascularization
treatment of paronychia (nailbed infection):
incision and drainage of nailbed to evacuate purulence + abx; incision made longitudinally and laterally, parallel to nail bed
characteristics of Hurley I hidradenitis suppurativa:
localized abscesses without sinus tracts or scarring; first line treatment is clindamycin gel
characteristics of Hurley II hidradenitis:
multiple abscesses and sinus tracts separated by normal appearing skin
characteristics of Hurley III hidradenitis:
diffuse disease with multiple interconnected sinus tracts and abscesses involving the entire anatomic area with scarring
form of cellulitis caused by group A strep that causes raised lesions with sharply demarcated borders between infected and normal skin:
erysipelas
skin and soft tissue infection confined to the epidermis that usually involves the face or extremities; consists of discrete vesicular lesions and crusted plaques; usually caused by beta hemolytic strep or staph aureus
impetigo
deep ulcerated form of impetigo
ecthyma
pressure ulcer stage: intact skin that is reddened
stage 1
pressure ulcer stage: blisters or breaks in dermis or partial thickness loss of dermis
stage 2
pressure ulcer stage: full thickness tissue loss with visible subcutaneous fat but no exposed bone, tendon or muscle
stage 3
pressure ulcer stage: exposed bone, joint, muscle, or tendon
stage 4
pressure ulcer stage: covered by slough or eschar, true depth can’t be determined without debridement
unstageable
subcutaneous abscess of the fingertip pulp
felon; treat with I&D and abx
nodular cellulitis that is often mistaken for fungal infection; due to innoculation of bacteria (usually S. aureus) in the wound of immunocompromised patient
botryomycosis
TNF alpha inhibitor shown to have benefits for patients with moderate to severe hidradenitis
adalimumab
clindamycin mechanism of benefit in NSTI
provides coverage for panton-valentine leucocidin toxin (PVL)
histologic features of hidradenitis
follicular hyperkeratosis, plugging, and dilation; lymphocytic perifolliculitis; in chronic phase can demonstrate psoriasform hyperplasia of the interfollicular epithelium or inflammatory infiltrate of dermis and subcutis
medical treatments for hidradenitis:
smoking cessaion zinc gluconate resorcinol sulfur topical methylprednisolone 1 week taper IV ceftriaxone followed by rifampin, moxifloxacin, and metronidazole dapsone or cyclosporine TNF blocker adalimumab
Initial treatment of paronychia:
warm compresses and antibiotics
Surgical treatment of hidradenitis:
total excision of all hair bearing skin with STSG
First line therapy for Hurley stage 1 hidradenitis:
clindamycin gel
