ArticleLangenbeck's archives of surgery2026
Clinical pathways of hospitalized extremity soft-tissue infections: a retrospective study.
Article in Langenbeck's archives of surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundBacterial infections of the skin and soft tissues (SSTIs) are common and should be considered a key differential diagnosis in patients presenting with redness and swelling in these areas. They range from mild superficial cases to severe, complicated forms requiring prompt antimicrobial therapy and, often, surgical intervention. We aimed to describe clinical pathways, diagnostic evolution, treatment strategies, and outcomes in a hospitalized orthopedic/trauma surgery cohort.
methodsWe performed a retrospective single-center analysis of all inpatients treated for extremity SSTIs between January 2020 and December 2023. Extracted variables included demographics, admission and discharge diagnoses, inflammatory markers, imaging, microbiology, surgical procedures, antibiotic regimens and duration, intensive care unit (ICU) utilization, and in-hospital outcomes.
resultsA total of 242 patients were included (mean age 55.7 ± 20.3 years; 40.1% female), with a median length of stay of 7.5 days. ICU care was required in 25/242 10.3%; in-hospital mortality was 7/242 2.9%. Surgical management was required in 134/242 patients (55.4%). Comorbidity burden was substantial (ASA III-IV: 41.3%), and sepsis was documented in 32/242 (13.2%). Diagnostic classification changed between admission and discharge in 80/242 cases (33.1%) of cases. Inflammatory markers declined markedly from admission to discharge (CRP 43.0 [Range: 0.6-640.2, IQR: 13.2-107.5] to CRP: 13.1 [Range: 0.4-541.0, IQR: 4.6-35.2]; leukocytes 11.9 ± 6.09 10/L to 7.68 ± 4.25 10
conclusionsHospitalized extremity SSTIs were characterized by frequent diagnostic reclassification, heterogeneous documentation and imaging pathways, and a high rate of operative management despite overall favorable outcomes. CT was more frequently used in patients with higher inflammatory activity and greater procedural burden. This descriptive association may, at least in part, reflect differences in clinical severity and selection for imaging. The findings support structured reassessment and targeted imaging when anatomical clarification is likely to alter management.
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