title: Study to evaluate the role of severity stratification of skin and soft tissue infections (SSTIs) in formulating treatment strategies and predicting poor prognostic factors.
abstract: BACKGROUND
  Diagnosis of skin and soft tissue infections (SSTIs) is difficult as they commonly masquerade as other clinical syndromes. So, the prospective cohort study was carried out to study the clinical profile, evaluate the existing method of severity stratification of SSTIs and identify factors responsible for prolonged stay and poor outcome in patients with SSTIs.
  
  
  METHODS
  The prospective study was carried out based on clinical profile to evaluate the role of severity stratification of SSTIs in 105 patients attending the surgical outpatient department and surgical emergency. The patients were managed conservatively on oral or intravenous antibiotics and dressing or combined with surgical intervention based on severity stratification. Sometimes radiological investigation helped to know the deep seated abscess and thereby need of early intervention by surgical drainage, fasciotomy and rarely amputation. The data collected, summarised and evaluated using chi-square method.
  
  
  RESULTS
  SSTIs has been categorized into mild, moderate and severe form based on clinical and demographic profile of the patient. The study revealed risk factors that were statistically significant to be male patients of lower socioeconomic groups, temperature above 38 °C, hypotension, TLC > 15000, presence of gangrene, bullae, crepitus, trauma, animal/insect bite, BSA > 9% except when involving hand, head & scrotum, loss of sensation, loss of movement/function of affected part and restriction of joint movement (P < 0.05).
  
  
  CONCLUSIONS
  Based on above findings, an algorithm for severity stratification is formulated for reducing the morbidity and mortality of the patients with SSTIs.
authors: Department of Surgery, Lady Hardinge Medical College, New Delhi, India. Electronic address: dralokty1@gmail.com.
authors: Alok Kumar
authors: AK
authors: Tiwari
authors: Department of Surgery, Lady Hardinge Medical College, New Delhi, India. Electronic address: romeshlal21@gmail.com.
authors: Romesh
authors: R
authors: Lal
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D019115:Fasciitis, Necrotizing / Q000175:diagnosis / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D012874:Skin Diseases, Infectious / Q000175:diagnosis* / Q000628:therapy*; D018461:Soft Tissue Infections / Q000175:diagnosis* / Q000628:therapy*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Fournier's gangrene; Necrotizing fasciitis; Risk factors; Skin and soft tissue infections (SSTIs)