Infective Skin Conditions

***This page is under review***

Both acute and chronic infective conditions of the skin and subcutaneous tissues are often referred to plastic surgery when it is considered likely that surgical intervention may be required.

Acute soft tissue infections should be referred urgently via the A&E departments and will normally be managed on a medical ward unless there is evidence of an aggressive, necrotising infection that will require surgical debridement.

Hidradenitis is a chronic infection affecting the apocrine sweat gland found in the axillae, groins and inframammary folds. It is almost universally associated with a poor diet, smoking and obesity. These factors should be addressed before patients are referred for consideration of surgical intervention.

Established disease often results in scar tissue with sinuses that combine to make recurrence inevitable. Surgery is often the only adequate way to deal with this situation although many of these patients are not ideal candidates for an operation. Excision of a small troublesome area of disease with direct closure is preferred when possible and is often effective in reducing the incidence of future recurrence. In some cases however, it proves necessary to excise the entire sweat gland area of the axilla and reconstruct the defect with local flaps or skin grafts. Such wounds are highly prone to delayed healing and other wound healing complications.