Soft tissue infections of the extremities in an orthopaedic centre in the UK

Objectives: To determine the spectrum, and clinical impact of acute extremity soft tissue infections, encountered in the Orthopaedic service of an inner city hospital in UK. Methods: Patients requiring admission for an acute limb soft tissue infection to the Orthopaedic unit of the Manchester Royal Infirmary, UK, between July 1996 and 2001 were identified from our database. Infections involving the groin and axilla, those developing within 30 days of a surgical procedure, and patients with chronic soft tissue ulcers or infections were not considered. Results: Of 142 infections the majority were cellulitis (50%) and superficial abscesses (34.5%). Most were secondary to trauma (31.6%), human or animal bites (20%) and intravenous drug abuse (17.6%). Although most patients were young and otherwise healthy, ten developed significant complications: myonecrosis requiring below knee amputation (1), acute carpal tunnel syndrome (1), osteomyelitis (6), extensive skin loss requiring reconstruction (1), deep vein thrombosis (1). Seven hundred and eighty four hospital inpatient days and 143 operative interventions were devoted to these patients. The estimated cost for each episode of soft tissue infection was £1011. In 25% of cases earlier referral to a surgical service would have been more appropriate. Conclusions: Soft tissue infections of the extremities confer significant morbidity and impose an important burden on medical resources.