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Cellulitis and Soft Tissue Infections > Non-drug Therapy Author: Dennis L. Stevens, PhD, MD; Lawrence J. Eron, MD, FACP
Editorial changes - 2009-11-03
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Rationale:

  • Compression dressings effectively combat the increase in interstitial fluid pressure which retards resolution of cellulitis.
  • Negative pressure reduces the amount of proteolytic enzymes and other substances that retard wound healing.
  • Hyperbaric oxygen increases bactericidal activity of leukocytes, but a course of hyperbaric treatments is very expensive.

Evidence:

  • The use of leg elevation and compression dressings hastens reduction of leg erythema and swelling (21).
  • Negative pressure wound dressings accelerate wound healing and were found to outperform hydrogels and alginates in the treatment of diabetic foot infections (71; 72).

Comments:

  • Hyperbaric oxygen therapy remains a controversial topic (73; 74). Arguments in favor and against hyperbaric treatments have emphasized the need for controlled trials to answer the question of its cost-effectiveness (75; 76).
  • When using compression dressing, be certain that the patient does not have arterial insufficiency.
FAQs
Dennis L. Stevens, PhD, MD has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations. Lawrence J. Eron, MD, FACP has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations.
Steven E. Weinberger, MD, FACP, Acting Editor, PIER, has stock holdings in Glaxosmithkline and Abbott.

The information included herein should never be used as a substitute for clinical judgment and does not represent an official position of ACP. Because all PIER modules are updated regularly, printed web pages or PDFs may rapidly become obsolete. Therefore, PIER users should compare the date of the last update on the website with any printout to ensure that the information being referred to is the most current available.
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