Bacterial Control

  • Jessica D. Smith
  • Indranil Sinha
  • Douglas L. HelmEmail author


Infections from invasive bacteria cause both acute and chronic skin and soft tissue infections (SSTIs) and are becoming increasingly common. Certain patient populations exhibit higher risk of infection, including patients who suffer from diabetes mellitus, burns, radiation, paraplegia, obesity, immune disorders, and those who smoke. Following the diagnosis of an SSTI, an appropriate treatment plan must be quickly enacted. Common SSTIs that require special considerations include diabetic foot infections, sternal wound infections, lower extremity periprosthetic joint infections, infected burns, previously irradiated implant-based breast reconstruction infections, and infected pressure injuries. Antibiotic therapy remains the mainstay for treatment of these infections. However, surgical debridement must also be considered, in conjunction with antibiotic therapy, to remove necrotic or poorly vascularized tissue and reduce local bacterial load. Surgical debridement is especially useful when treating SSTIs that involve planktonic bacteria and biofilms. All SSTIs are different, and intervention must be tailored to the individual patient; however, the principles of treatment presented in this chapter are generally applicable as considerations for SSTI management.


Soft tissue infection Biofilm Planktonic bacteria Excisional debridement Acute and chronic infection 

Supplementary material

Video 2.1

Debridement of infected right ischial wound (AVI 1022634 kb)


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Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  • Jessica D. Smith
    • 1
  • Indranil Sinha
    • 1
    • 2
  • Douglas L. Helm
    • 1
    • 2
    Email author
  1. 1.Division of Plastic and Reconstructive SurgeryHarvard Medical SchoolBostonUSA
  2. 2.Harvard Medical SchoolBostonUSA

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