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Necrotic flaps may become infected, but with proper care and antibiotic therapy the tissue seems to recover and the results may be quite good. ● Not all antiseptics cause tissue injury. There are ways to deliver antiseptics in slow-release preparations; this helps keep the bacterial burden down. ● Surgical debridement is an excellent way to start treating infection in a wound. ● ● ● ● ● ● ● ● Hyperbaric oxygen therapy may be helpful in highly contaminated wounds. The only sign of necrotizing fasciitis is often exquisite tenderness, without any skin surface changes.
The wound is now left open to heal by secondary intention. 43 Granulating wound after amputation. This patient with diabetes mellitus required ray amputation of the second and third toe. The photograph shows the appearance of the granulating wound a week after surgery. One of the problems that will be encountered in this case is that other parts of the foot will now have to sustain greater pressure during ambulation and, therefore, will be subject to ulceration. 44 Complication of back surgery.
Culture from the abscess grew both P. aeruginosa and S. aureus. The patient had to be hospitalized and required intravenous (IV) antibiotics and extensive surgical debridement. Slow-release antiseptics such as iodine or silver-based ones can be a helpful adjunctive therapy in this case. 3 An infected tumor. This patient had cutaneous T-cell lymphoma. The skin tumor shown here ulcerated and became infected. The photograph shows a purulent wound that appears to be covered by a film-like membrane.