Cellulitis

What Is Cellulitis?

Cellulite is defined as the spreading inflammation of the subcutaneous and cellular tissue. It may sometimes progress to suppuration or gangrene. In the cases, where cellulites progresses into gangrene, there widespread sloughing of tissues also occurs.

This condition is commonly known as “Hospital gangrene and it may even progress and it may even fatal. But if the extension of disease occurs even when treatment I s given, then the part affected with cellulites is excised with the help of a diathermy knife.

The Clinical features of cellulites depend upon the virulence of the organism and the extent of infection. Redness, itching and stiffness are the common features, seen at the site of inoculation. Then after sometime, tenderness and in duration, that is pain and swelling is noted. The general features of infection are well marked and in some marked and in some cases septicemia or pyaemia may also develop.

First of all, the treatment consists in attending to the general health of the patient and then a course of penicillin or other chemotherapy is prescribed. If pus is noted, then free incisions are given in the axis of the limb and down to the deep fascia. Baths of 5 percent hypertonic saline are also given to facilitate lymphatic drainage and antiseptic dressings are also useful in the cases of cellulites.

Causes of Cellulitis

The main reason for the development of cellulites is Streptococcus organisms. The organisms mainly enter the tissues through an accidental wound or through graze or scratch or may enter as the result of an operation. Moreover, if the systemic diseases like diabetes renal inefficiency, or the person is alcoholic then the cellulites spread rapidly and extensively.

Cellulites of Pelvis: It mainly occurs due to lacerations of the cervix due to disease or injury to any of the pelvic organs, such as rupture of the bladder. Infection commonly occurs upon the side of the pelvis, which results in the induated swelling above Pouport’s ligament. It the swelling appears above Poupart’s ligament and deep oedema or softening is noted, then the abscess is incised and drained extraperitoneally.

Cellulitis may occur in special situations like scalp, orbit, neck, pelvis etc :-

(a) Cellulites of Orbit: - This occurs due to wounds or spread of infection from air sinuses present nearby. The eyeball itself sometimes becomes infected. Proptosis and impairment ocular movements are the common features.

(b) Cellulites of Scalp: It occurs due to infection of the subaponeurotic layer of the areolas tissue. Necrosis of bone or thrombosis of emissary veins may occur. If pus is felt, then incisions, parallel to the arteries are given.

(c) Cellulites of Neck: It occurs commonly due to complicated wounds, tonsillitis or mastoiditis. Ludwig’s angina is a term used for Submaxillary cellulits. The two main dangerous conditions of cervical cellulites are oedema of the glottis along with asphyxia and me disabilities.

Treatment of Cellulitis

First of all, the treatment consists in attending to the general health of the patient and then a course of penicillin or other chemotherapy is prescribed. If pus is noted, then free incisions are given in the axis of the limb and down to the deep fascia. Baths of 5 percent hypertonic saline are also given to facilitate lymphatic drainage and antiseptic dressings are also useful in the cases of cellulites.

Cellulitis may occour in special places like scalp, orbit,neck, pelvis etc:-

(a) Cellulites of Orbit: - This occurs due to wounds or spread of infection from air sinuses present nearby. The eyeball itself sometimes becomes infected. Proptosis and impairment ocular movements are the common features.

(b) Cellulites of Scalp: It occurs due to infection of the subaponeurotic layer of the areolas tissue. Necrosis of bone or thrombosis of emissary veins may occur. If pus is felt, then incisions, parallel to the arteries are given.

(c) Cellulites of Neck: It occurs commonly due to complicated wounds, tonsillitis or mastoiditis. Ludwig’s angina is a term used for Submaxillary cellulits. The two main dangerous conditions of cervical cellulites are oedema of the glottis along with asphyxia and me disabilities.

(d) Cellulites of Pelvis: It mainly occurs due to lacerations of the cervix due to disease or injury to any of the pelvic organs, such as rupture of the bladder. Infection commonly occurs upon the side of the pelvis, which results in the induated swelling above Pouport’s ligament. It the swelling appears above Poupart’s ligament and deep oedema or softening is noted, then the abscess is incised and drained extraperitoneally.

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