Jahangir Sarwar Khan, Junaid Alam Khan, Hamid Hassan, Faisal G Bhopal, Mohammad Iqbal.
Surgical audit of skin and soft tissue infections.
J Rawal Med Coll Jan ;9(1):26-9.

Background: To identify common predisposing factors for skin and soft tissue infection, the common organisms responsible for infection, and their sensitivity pattern to commonly used antibiotics. Methods: This prospective study was conducted in Surgical Unit-II, Rawalpindi -General Hospital from July 2000 to June 2002. One hundred patients who presented with skin and soft tissue infection were included in the study. Details of patients were recorded in a proforma. History of fever and rigors/chills was recorded. History of intake of antibiotics was specifically asked. Routine investigations and specific investigations depending upon site of infection were performed. In all such patients pus was taken prior to administration of antibiotics to identify causative organism and their sensitivity pattern. Then patients were shifted to operation theater for incision and drainage / debridement. Broad-spectrum antibiotics were started, which were changed according to culture sensitivity reports. Results: Commonest age group affected among male patients was 11 years to 20 years whereas in females it was 21 years to 30 years. Trauma was commonest predisposing factor, seen in 25 patients. Fever was the commonest symptom present in 69 patients. History of antibiotics intake was present in 16 patients. Investigations revealed average T.L.0 of 10123/cu mm. 16 patients were diabetic. Commonest organism isolated was Staphylococcus aureus (45 patients) and no growth found in 30 patients. Sensitivity pattern revealed highest incidence of resistance in penicillin`s, intermediate in quinolones and lowest among cephalosporin. Histopathology showed evidence of tuberculosis in 6 patients. Conclusion: Skin and soft tissue infections are more common in individuals below 30 years of age. Accurate and quick diagnosis and treatment are imperative to prevent significant morbidity and mortality. All sorts of trauma should be avoided and diabetes should be controlled to avoid skin and soft tissue infections. Cephalosporins are the most effective treatment in majority of patients while a significant percentage are resistant to penicillin.

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