Hot or cold? Treating cellulitis
Lucy Wessinger BSN, RN
Rebecca Marotta MSN, RN
Teresa J. Kelechi PhD, RN

March 2011 
Volume 41  Number 3
Pages 46 - 48
  PDF Version Available!

CARE OF SKIN affected by cellulitis focuses on systemic approaches, such as administration of antibiotics and pain medication, and adjuvant care such as elevation of the affected limb, rest, and, in some instances, application of heat or cold to the affected area. In this article, we'll refresh your knowledge of cellulitis and explore the current evidence on hot and cold adjuvant therapies for caring for patients with cellulitis.An acute infection of the skin and subcutaneous tissues, cellulitis is caused by pathogen invasion into compromised outer layers of the skin such as from a laceration, cracked or dry skin, a puncture wound, or folliculitis.Though treatable, cellulitis can cause physical impairment and significant pain and has a high relapse rate, especially when the patient has a comorbid condition such as diabetes.1 Common risk factors for cellulitis include venous insufficiency, surgical incisions, lacerations, insect and animal (especially cat) bites, and trauma. Without prompt treatment, the infection may result in sepsis, necrosis, or gangrene.2The infected area is characterized by localized pain, erythema, edema, and heat (see A look at cellulitis). Although cellulitis can occur anywhere on the body, it's most common on the lower extremities.3 If the infection is identified and treated early, prognosis for recovery is excellent.A diagnosis of cellulitis is based primarily on clinical judgment and identification of signs and symptoms. Blood cultures may be performed when cellulitis is suspected, but they're positive in only 5% of cases. Needle aspirations from inflamed skin provide variable results, ranging from 5% to 40% positive, and punch biopsies provide positive results in only 20% to 30% of patients.4,5Antibiotics are the mainstay of treating cellulitis, along with adjuvant therapies such as the application of hot or cold compresses.3,4 Current treatment protocols for cellulitis and practice guidelines for the diagnosis and management of skin and

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