From the Guidelines
For a patient with lower extremity cellulitis, a clean, dry, non-adherent dressing should be applied to the affected area. The dressing should be changed daily or more frequently if it becomes wet or soiled. Suitable options include non-adherent gauze, petroleum-impregnated gauze, or silicone-based dressings, which protect the skin while allowing for observation of the infection. If the cellulitis is accompanied by open wounds or drainage, an absorbent dressing such as an alginate or foam dressing may be more appropriate to manage exudate. The affected limb should be elevated when possible to reduce swelling and improve circulation. It's essential to monitor the area for signs of worsening infection such as increased redness, warmth, pain, or drainage. The dressing serves primarily as a protective barrier while the underlying infection is treated with appropriate systemic antibiotics, which are the mainstay of cellulitis treatment. Keeping the area clean and protected helps prevent further skin damage and secondary infection while the antibiotics work to resolve the primary infection, as recommended by the Infectious Diseases Society of America 1.
Some key considerations in managing lower extremity cellulitis include identifying and treating predisposing conditions such as edema, obesity, eczema, venous insufficiency, and toe web abnormalities 1. Additionally, elevation of the affected area is crucial as it quickens improvement by promoting gravity drainage of the edema and inflammatory substances 1. The use of topical antiseptics or antimicrobial dressings is not supported by evidence for wound healing in diabetes-related foot ulcers, which can sometimes be associated with cellulitis, and thus their use in cellulitis management should be approached with caution 1.
In terms of specific dressing choices, the most recent and highest quality studies do not provide a clear recommendation for cellulitis specifically, but the principles of keeping the area clean, dry, and protected apply, with the choice of dressing depending on the presence of wounds or drainage. The mainstay of treatment remains systemic antibiotics, with dressing management playing a supportive role in preventing further complications and promoting an environment conducive to healing.
From the FDA Drug Label
Directions adults and children 2 years of age and older: ... may be covered with a sterile bandage The dressing that should be applied to a patient with lower extremity cellulitis is a sterile bandage 2.
From the Research
Dressing Options for Lower Extremity Cellulitis
- Hydrogel dressings are a suitable option for wound management, including lower extremity cellulitis, as they provide a moist environment for wound healing and exhibit high moisture content 3, 4, 5.
- These dressings can be prepared from biopolymers such as cellulose and chitosan, which have non-toxic, biodegradable, and biocompatible properties 3.
- Hydrogel dressings can also be loaded with antibacterial agents to prevent bacterial invasion of wounds 3.
- Additionally, hydrogels can mimic skin structure and induce skin regeneration, making them a promising option for wound management 3, 4.
- Other types of dressings, such as hydrocolloid dressings, may also be used, but their effectiveness depends on the amount of drainage and the specific needs of the patient 6.
Key Characteristics of Hydrogel Dressings
- Provide a moist environment for wound healing
- Exhibit high moisture content
- Can be loaded with antibacterial agents
- Can mimic skin structure and induce skin regeneration
- Have non-toxic, biodegradable, and biocompatible properties