Cellulitis: Surgery, Hospitalization, and Recovery Insights

Surgical and hospitalization issues related to cellulitis?

Hello, doctor.
Yesterday, the emergency physician diagnosed me with cellulitis.
(All my blood tests came back normal, and I did not have a fever.) They prescribed antibiotics for me to take and scheduled a follow-up appointment.
Today, I realized that the follow-up appointment is with the plastic surgery department.
(I had always thought it was with the infectious disease department.) Does this mean that I will need to arrange for surgical debridement? How many days do these types of surgeries typically require for hospitalization? Is the debridement process very painful? If the swelling decreases after taking antibiotics (I’m not sure if that’s a possibility), will I still need surgery? I have these concerns because managing my work leave is quite complicated, (the follow-up appointment happens to fall in the last few days of my annual leave.) I also need to arrange for nursing care.
Additionally, I have had occasional folliculitis issues in the past, but this is my first experience with cellulitis.
At the end of last year, a physician in the allergy, immunology, and rheumatology department determined that I have a lupus erythematosus condition, so I started taking quinine.
How should I continue to take quinine as an immunomodulatory medication? Thank you for your response, doctor.

CH, 50~59 year old female. Ask Date: 2024/02/07

Dr. Zhou Hongzhang reply Plastic Surgery

1.
This issue is quite complex; it fundamentally depends on the condition and the patient's constitution, and it is not static.

2.
Does this mean that surgical debridement must be arranged? ---> No.

3.
If the condition worsens and the infection progresses into the deeper fascia or muscle, surgery may be necessary.

4.
How should quinine, an immunomodulatory medication, be taken next? ---> This should be referred to a rheumatologist for consultation.

5.
Hospitalization for surgery is not always necessary; it all depends on the condition.
If simple oral antibiotics are ineffective, further treatment will be required.

Reply Date: 2024/02/07

More Info

Cellulitis, or蜂窩性組織炎, is a common and potentially serious bacterial skin infection that can lead to significant complications if not treated properly. It typically manifests as a red, swollen area of skin that feels warm and tender to the touch. The infection can spread rapidly, and while it often occurs in the lower legs, it can affect any part of the body.

In your case, the emergency physician has diagnosed you with cellulitis and prescribed antibiotics, which is the standard treatment. The fact that your blood tests came back normal and you do not have a fever is a positive sign, indicating that the infection may not be severe at this point. However, the referral to a plastic surgeon (整形外科) rather than an infectious disease specialist could suggest that there may be concerns about the extent of the infection or the need for surgical intervention.

Surgical Intervention and Hospitalization
Surgical intervention, such as debridement (清創), may be necessary if there is an abscess (a collection of pus) or if the cellulitis does not respond to antibiotic treatment. The decision to proceed with surgery typically depends on several factors, including the severity of the infection, the presence of necrotic (dead) tissue, and the response to antibiotics. If the cellulitis is localized and responds well to antibiotics, surgery may not be required.

If surgery is needed, the length of hospitalization can vary. Generally, patients may need to stay in the hospital for a few days to monitor their recovery and ensure that the infection is adequately controlled. The pain associated with debridement can vary from person to person, but local anesthesia is usually administered during the procedure to minimize discomfort.

Recovery and Antibiotic Treatment
Regarding your question about the possibility of reducing swelling with antibiotics, it is indeed possible. If the antibiotics are effective, you may notice a decrease in swelling and redness. If the cellulitis improves significantly, the need for surgery may be reassessed. However, it is crucial to follow up with your healthcare provider to determine the best course of action based on your progress.

Managing Your Health and Medication
As for your previous diagnosis of having a red rash condition and the use of quinine (奎寧), it is essential to follow your healthcare provider's instructions regarding this medication. Quinine is typically used to treat certain conditions, including malaria, and may have immunomodulatory effects. However, it is not commonly used for cellulitis or skin infections. You should discuss with your physician how to manage your quinine treatment in light of your current condition and any potential interactions with antibiotics.

Conclusion
In summary, while your diagnosis of cellulitis is concerning, the absence of fever and normal blood tests are encouraging signs. The need for surgery will depend on your response to antibiotics and the clinical evaluation by your surgeon. It is essential to maintain open communication with your healthcare providers, follow their recommendations, and attend all follow-up appointments. If you have any concerns about your treatment or recovery, do not hesitate to reach out to your healthcare team for guidance. Your health and well-being are the top priority, and they can provide the best advice tailored to your specific situation.

Similar Q&A

Managing Cellulitis: A 11-Day Hospital Journey and Ongoing Challenges

On October 11, the patient experienced foot pain and sought medical attention at a general orthopedic clinic. The doctor prescribed anti-inflammatory and pain relief medication for three days. By October 14, there was no improvement, and the knee was swollen, making it impossible...

Dr. Liao Zhongxin reply Internal Medicine
Dear readers, 1. I have a general understanding of your (or your family member's) condition; it may be necrotizing fasciitis or severe soft tissue inflammation. This is inherently a serious and challenging condition to manage. 2. First, it is important to assess whether...

Understanding Cellulitis: Common Areas of Infection and Treatment

Cellulitis commonly occurs in areas of the body where the skin is broken or compromised, such as the legs, arms, and face. It can also affect other regions, particularly where there are underlying conditions that predispose the skin to infection.

Dr. Xie Wenhuai reply Surgery
Definition of cellulitis: The subcutaneous fat layer of the human body has a honeycomb-like structure, so when inflammation occurs in this area, it is referred to as "cellulitis." Causes: Bacterial infection is the primary cause. If there is a wound on the skin, bacteri...

Understanding Cellulitis: Treatment Options and Patient Concerns

Hello Doctor: My father was recently hospitalized due to cellulitis. The physician at Hospital A mentioned that they would perform surgery to remove something from the inner thigh, and that he would be able to return home after a week of hospitalization. However, my father is afr...

Dr. Li Junde reply Surgery
Mr. Zilong: Your father has a history of fractures and has been found to have cellulitis. If it is a simple case of cellulitis, antibiotic treatment should be sufficient to control it. However, if an abscess develops, incision and drainage will be necessary. If this is related to...

Effective Post-Treatment Strategies for Wounds After Cellulitis

If you have a wound left from cellulitis, how should it be treated?

Dr. Xie Wenhuai reply Surgery
Cellulitis is usually caused by wound infections (redness, swelling, heat, and pain). After treatment, which includes incision and drainage as well as antibiotics, the redness and swelling subside, and the wound heals. Sometimes, it may recur; if it recurs frequently, considerati...