Around the Island

Cellulitis check list

Cellulitis is such a common affliction to our skin and soft tissues that it’s no wonder stories of cures and concoctions abound. Wounds from bruises, bites, gashes, or punctures have remedies dating back to millennia.

Debunked treatments with sea water, butter, and vinegar still exist. The best misinformation I’ve heard so far is to “lick it.”

Our skin, being the largest organ, serves to protect and to beautify us, but also retains vital chemicals and nutrients within our bodies, while regulating the temperature of internal organs. It senses pain and pleasure and comes in a variety of shapes and colors.

The skin, despite its three layers of epidermis, dermis and fat, is so fragile that it’s remarkable that humans make it past the first year of life. When punctured, the barrier provided is weakened, thus allowing blood to flow out and organisms to enter in.

Had it not been for the biofeedback of pain to train behaviors, our trauma would leave us incapacitated. Despite our skins ability to fully regenerate within 27 days, many factors play a role for this to happen. Infections of the skin and soft tissues, known as cellulitis, occur when virus, fungus and bacteria are introduced beyond the waterproof top layer of the epidermis, which is called the stratum corneum.

Let’s take at a few lies we tell ourselves about cellulitis.

Lie #1: Eh, it’s nothing. Scrapes, bites, “jooks”, it’s all the same. My first rule is to wash it off and apply a barrier ointment. My teenager once asked: “What is the point of the grease if I have already washed it off?” to which I replied, “To clog the journey, of course.” The fact that the epidermis is broken, it’s a foregone conclusion that an organism has entered the flesh so before it wiggles its way any deeper, apply a petroleum base barrier protection to halt the current entrance and block future ones. It’s simple and effective.

Quick warning however: Oxygen use with petroleum-based ointments and a heat source (such as a lit cigarette) can become a dangerous combination. Always talk with your doctor prior to starting a new regimen.

Lie #2: There is a scab present, so it’s fine. If your wound is deep, a scab is not what you want to see. “Air dry” and scab presence were once thought to be the hallmark of healing and recovery, so let’s pause and reflect on skin anatomy. Blood vessels run within the fat layer and send little capillary off-shoots up to the dermis layer to feed the skin.

From what we already know, blood is life to the body via the arteries and air is life to the body via the lungs. Blood supply is critical to wound healing and is why wounds heal from the inside out. Deep wounds confirm this fact and it’s why they’re packed and unpacked daily to remove trapped necrosis, allowing new granular tissues to fill the wound bed.

A scab would only have provided a covering to a collection of puss called an abscess.

Lie #3: I need antibiotics. You may need a course of antibiotics to get that infection under control, however, that’s assuming you have a bacterial infection needing systemic treatment and not a fungal infection or a viral infection or protozoan infection. It is also possible that all you need is proper wound care management focused on supporting healthy new tissue growth.

Lie #4: Worst case scenario, I have insurance. Of course, and you will likely receive the latest treatments and best of care. But anyone who has seen an insurance EOB (explanation of benefits), post care, knows that anything can happen, especially with cellulitis. With this diagnosis being so common, insurers would fold under the cost and so have set strict criteria to be met.

Unless your case of cellulites is accompanied with systemic illness that threatens your life for more than three days while under hospital care, you will be treated and released with a tidy co-pay under the status of In-hospital Observation.

So, remember: An ounce of prevention is worth a pound of cure. Try not to get cut. Wear appropriate shoes. Play safe. Do not run with scissors. And unless otherwise advised by your healthcare provider, skip the lotion, and go straight for the petroleum-based barrier ointment on that swollen, dry and cracked skin.

Yes, it’s greasy. That’s the point.