What is Cellulitis?

Cellulitis is a severe bacterial skin infection. The affected skin becomes inflamed and swollen and is usually warm and painful. Cellulitis typically affects the lower legs but can affect the arms, face, and other body parts. The infection occurs pathogens enter the body via a break on the skin, such as a cut or wound. The condition may spread to other regions like lymph nodes and the bloodstream if not promptly treated, making it life-threatening. Cellulitis spreads rapidly in various body tissues, but it is not contagious from person to person.

Pathophysiology of Cellulitis

Cellulitis typically arises from skin breaks like cuts, insect bits, or uncovered or well-cleaned wounds.

• Bacteria Entry. The break on the skin caused by a cut, insect bit, surgical incision, and wounds lets the bacteria into the skin.
• Bacteria proliferation. When the bacteria enter the skin, they multiply and spread the infection to other tissues.
• The infected skin becomes red, swollen, and tender. Fever may accompany these signs of Cellulitis.
• If Cellulitis infection is not treated, it could reach the inner skin layers up to the bloodstream, lymph nodes, and other body parts.

Statistics & Epidemiology of Cellulitis

The actual prevalence and incidents of Cellulitis are not well known because the cases are not reported to health authorities. However, Cellulitis is a common infection that affects all ages, gender, ethnic and racial groups.

Cellulitis infection is more typically observed in people over the age of 45 years. Averagely, 24.6 cases are diagnosed with Cellulitis per 1000 individuals. Comprehensive epidemiological research on soft tissue, bone, joints, and skin infections showed that 37.3% of patients had Cellulitis. The frequency of hospital visits for soft tissue and skin diseases ranges from 32.1 to 48.1 per 1000 people.

The number of hospital visits for abscesses and Cellulitis rose from 17.3 to 32.5 in a population of 1000. For instance, in general hospitals in the United Kingdom, Cellulitis accounts for approximately 3% of all medical emergency consultations.

It is projected that the prevalence and incidents of Cellulitis will likely increase as the rates of underlying medical conditions like obesity and diabetes continue to rise. Effective prevention and treatment mechanisms are needed to reduce the risk of Cellulitis complications.

Causes of Cellulitis

The most prevalent causes of Cellulitis include:

• Skin injuries. Skin trauma such as abrasion, insect bites, and cuts provide an entry point to the skin for bacteria and increases the chances for Cellulitis.
• Bacterial infection. Bacteria that are the common causes of Cellulitis include Staphylococcus and Streptococcus species. These bacteria enter the skin via a break like a wound or a cut and lead to the spread of the infection.
• Medical conditions. Some medical conditions, such as immunosuppression, diabetes, and peripheral vascular infection, may weaken the immune system and increase the likelihood of contracting Cellulitis.
• The excess fat in people with obesity can compromise blood flow, which may damage the skin and make it vulnerable to skin infections.
• It is a skin infection that causes it to crack and itch. People with Eczema have a high likelihood of developing Cellulitis.
• Intravenous drug use. Drug insertion points are a break in the skin that provides an entry point for the bacteria.

Clinical Manifestations of Cellulitis

The symptoms of Cellulitis are seen and presented on the skin tissue.

• Skin inflammation. The skin becomes inflamed due to the spread of Cellulitis in the inner layers of the skin.
• Fever and chills. Fever and chills may develop when the body tries to fight the infection.
• Abscess with pus. Abscess with pus starts to develop in severe cases of Cellulitis.
• Cellulitis causes throbbing pain or aching of the affected parts.
• Swelling of lymph nodes. The lymph nodes located in the affected areas become tender and swollen.
• Blisters may develop on the skin in severe cases of Cellulitis.
• Redness and swelling. Cellulitis causes the affected areas of the skin to become warm, swollen, red, and tender.
• The body’s response to Cellulitis infection makes the patient fatigued.
• Loss of function. Severe cases of Cellulitis make the affected limb stiff and challenging to move, leading to reduced patient function.
• Skin rashes. The invasion of the pathogens makes the skin develop rashes on the affected skin areas.

Prevention of Cellulitis

The following are some of the effective Cellulitis prevention mechanisms

• Manage underlying health conditions. Any health conditions that affect the immune system, such as diabetes, should be managed effectively to minimize the risk of Cellulitis.
• Note any changes to your skin. If skin texture or appearance changes, like swelling, warmth, or redness, seek medical attention immediately.
• Practice good hygiene. Regularly clean hands and keep wounds, cuts, and scrapes covered and clean until they heal.
• Wear protective clothing. Always wear shoes and other protective gear like gloves when working with sharp objects or in risky areas.
• Evade sharing personal effects. Don’t share towels, razors, and clothing, among other personal things that might spread the bacteria.
• Evade skin irritation. Keep skin moisturized and avoid tight clothes to reduce irritation.

Complications of Cellulitis

When Cellulitis is not treated, it can cause severe complications:

• Spread of infection. The bacteria that cause Cellulitis may spread to other body parts, causing more widespread and severe disease.
• Blood infection. The pathogens that enter the bloodstream may contaminate it and affect the surrounding tissue.
• Gangrene is a severe Cellulitis condition that occurs when the blood supply in the body is cut, leading to the death of body tissue.
• Severe cases of Cellulitis can lead to the death of tissues leading to amputation of the affected limb.
• Bone infection. Cellulitis infection may affect skin layers and reach the bones.
• Cellulitis is associated with sepsis (bloodstream infection), a life-threatening condition.
• Untreated Cellulitis can lead to pus (abscess) formation in areas affected.
• Untreated Cellulitis causes damage to the lymphatic system to lymphedema in the affected limb.

Assessment and Diagnostic Findings of Cellulitis

Evaluating Cellulitis infection effectively is significant for administering the proper treatment strategies.

• Wound culture. A wound culture may be carried out to assess the causes of the infection.
• It plays a vital role in detecting the presence of abscesses and ways to treat them.
• Blood tests. Blood tests help in ruling out blood or systemic infection.

Medical Management of Cellulitis

Medical management of Cellulitis primarily focuses on the eradication of the infection.

• The solution for an abscess is drainage, whatever the pathogen is.
• In some cases, pain relievers are prescribed.
• Resting is essential till the Cellulitis symptoms improve. During rest, it is crucial to raise the affected areas to minimize swelling.
• Antibiotic therapy. The efficiency of antibiotics in some patients is more than 90%. Depending on the severity of the infection, the antibiotic treatment may last between 10 to 21 days.

Surgical Management of Cellulitis

Cellulitis infections on the tissue may reach the worst condition necessitating the surgical arrangement.

• Amputation is only necessary when the affected area becomes necrotic or gangrenous.

Nursing Management of Cellulitis

Nursing management of Cellulitis infection depends on its severity in the affected areas.

Nursing Assessment of Cellulitis

Nursing assessment is vital in checking for Cellulitis etiology and causes.

• Physical evaluation. Physical assessment should primarily focus on the affected area.
• Surgical history. The history of previous surgery may have led to wound infection.
• Previous medical history. The presence of comorbid conditions may increase the risk of Cellulitis infection.

Nursing Diagnosis of Cellulitis

• Compromised skin integrity. It is associated with altered primary defense.
• Disrupted sensory perception. It is associated with compromised nerve stimulation.
• Low self-esteem. Associates with disturbed body image.

Nursing Care Planning & Goals for Cellulitis

For the effectiveness of the Cellulitis treatment, the patient will display the following.

• Improved self-esteem indicated by verbalized feelings.
• Maintain physical well-being and optimal nutrition.
• Take part in treatment prevention measures programs.
• Show timely healing of cuts and wounds without complications.

Nursing Interventions

Cellulitis patient care primarily depends on an antibiotic regimen.

• Clean the affected area. Clean and dry the affected area and dress wounds carefully to aid natural body repair.
• Wound care. Utilize appropriate wound covering and barrier dressing to protect the wound.
• Develop a care plan. Engage wound specialists to help create a plan of care for severe wounds.
• Monitor complications. Examine for complications and monitor the healing progress of the wound.
• Secure specimen. Drain wounds to obtain samples and determine the best therapy.

Nursing Evaluation of Cellulitis

The treatment process of Cellulitis is effective if:

The patient shows timely healing of wounds with minimal complications.

The patient indicates increased self-esteem via verbalized feelings.

The patient actively participates in the treatment and prevention measures program.

The patient maintains physical well-being and optimal nutrition.

Discharge and Home Care Guidelines

Patient care should be extended to their home.

• Assist the patient and household members in understanding and adhering to the medical regimen.
• Assist the patient on how to deal with the situation and reduce stress.
• Emphasis on wearing correctly fitting clothes and shoes to minimize circulation and sensation.

Nursing Documentation Guidelines

Various nursing interventions on the Cellulitis patient should be documented for medical and legal purposes. The following details should be noted.

• Causative factors.
• Teaching plan.
• Impact on the patient image.
• Response to teaching, interventions, and actions taken.
• Plan of care modifications.
• Progress or achievement towards set outcomes.
• Wound characteristics.
• Plan of care and people involved