Surgical Management of Foot Infections Flashcards Preview

Emergency Med/Trauma > Surgical Management of Foot Infections > Flashcards

Flashcards in Surgical Management of Foot Infections Deck (25)
Loading flashcards...
1
Q

What are good history questions to ask?

A
Onset and duration
Trauma
Contamination
Pain
Last ate or drank
2
Q

ROS questions

A

F/C/N/V
Recent blood glucose

Drug allergies

3
Q

Things to look for on x-ray

A

Gas
Foreign bodies
Osteo

4
Q

Wound without purulence or any manifestations of inflammation

A

Uninfected

5
Q

Cellulitis or erythema 0.5-2cm around area.
Limited to skin or superficial subcutaneous.
No local or systemic complications

A

Mild

6
Q

Erythema greater than 2cm or involving deep structures

NO SIRS

A

Moderate

7
Q

Local infection WITH SIRS

A

Severe infection

8
Q

SIRS is manifested by greater than or equal to 2 of the following:

A
Temp >38, <36
HR >90
RR>20
PaCO2 <32
WBC >12, <4
9
Q

Thick, yellow, and purulent drainage infection

A

MSSA

10
Q

Infection with quicker onset of purulent drainage

A

MRSA

11
Q

Deeper red infection than Staph, not as purulent

A

Strep

12
Q

Infection with a fruity smell and green tinge

A

Pseudomonas

13
Q

Infection with a foul smell and brown/watery discharge

A

Anaerobic

14
Q

What are the main infecting organisms?

A

Staph and Strep

15
Q

These present clinically on open skin, local redness and edema, extreme pain, palpable fluctuance, and fever

A

Abscess

16
Q

What are the 4 D’s of abscess treatment?

A

Decompression
Drainage
Debridement
Drugs

17
Q

When should surgical I&D be done?

A

Within 1-2 days

18
Q

Should antibiotics be given for abscess treatment?

A

IV in hospital until signs of infection are gone

Orally upon discharge

19
Q

Most common OM in podiatry?

A

Direct extension

20
Q

What is the most common type of gas producing infection seen in DM patients?

A

Nonclostridial myonecrosis/nec fas such as GBS

21
Q

Describe the presentation of nonclostridial myonecrosis/nec fasc

A

Slower developing
Skin changes from bronze to blue/back then to hemorrhagic bulla

Sharper/acidic odor

22
Q

Nonclostridial myonecrosis antibiotic treatment

A

Empiric until gram stain back

Surgically debride ASAP

23
Q

Clostridial presentation

A
Sudden onset w/ severe pain
Heaviness
Low grade fever
Skin changes from bronze to blue/black to hemorrhagic bulla
Non-odorous or sweet
Crepitus
Pain is SEVERE
24
Q

Clostridial treatment

A

Penicillin
Aggressive debridement
HBO therapy

25
Q

Surgical keys for Gas infections

A

Get to the OR
Aggressive debridement
Leave open
Take back to OR