[Clinical symptoms and therapy of necrotizing skin and soft tissue infections]. / Klinik und Therapie nekrotisierender Haut- und Weichgewebsinfektionen.

Skin and soft tissue infections are among the most common diseases requiring surgical treatment. The presentation of patients varies from folliculitis to severe necrotizing infections with a fatal outcome. The diagnosis of a necrotizing infection is often difficult. The correct diagnosis is often made after deterioration of the patient's condition in the rapid course of the disease. The early and correct diagnosis and immediate surgery are decisive for the prognosis. Treatment at a specialized intensive care unit and the administration of a broad spectrum antibiotic are pivotal for the survival of individual patients.

[Surgical therapy for hand infections Part 2]. / Chirurgische Therapie von Infektionen der Hand Teil 2.

Due to its function, anatomy, and exposition to multiple pathogens, the hand is highly susceptible to infection. Most of these infections are post-traumatic. Isolates of pathogens from infected hands contain mainly Staphylococcus aureus and ss-haemolytic group A streptococci. But differential diagnosis also includes pyoderma gangrenosum, tumors of the hand, rheumatoid arthritis, and articular gout, as they may mimic hand infections. Infections of the hand can lead to massive tissue damage that needs to be reconstructed. The selection of methods depends on the localization and size of defects and includes primary closure, split- and full-thickness skin grafts, and more complex operations such as local, regional, and distant flaps.

[Surgical therapy for hand infections. Part I]. / Chirurgische Therapie von Infektionen der Hand--Teil I.

Due to its function, anatomy, and exposition to multiple pathogens, the hand is highly susceptible to infection. Most of these infections are post-traumatic. Isolates of pathogens from infected hands contain mainly Staphylococcus aureus and beta-hemolytic group A streptococci. We find Pasteurella canis and P. multocida from cat and dog bite wounds and Eikenella corrodens from human bite wounds. The "fight-bite clenched fist" wound, with penetration of the metacarpophalangeal joint and its high risk of septic arthritis, has always to be suspected when patients present with human bites. The therapy of hand infection is based on three principles: surgical treatment, adequate antimicrobial therapy, and early physiotherapy. Early infectious conditions of the hand, e.g. cellulitis and early paronychia, may be treated without surgery. Antimicrobial treatment must be specific for the pathogen and its resistance to antimicrobial agents. Bite wounds should be treated with beta-lactam antibiotics and beta-lactamase inhibitors. Staphylococci and streptococci can be covered by first and second generation cephalosporins. The increasing resistance of staphylococci to antibiotics has to be taken into account. Infections with anaerobic and gas-producing bacteria are rare but occur predominantly in diabetics and immune-compromised individuals.

[Complex treatment of patients with complicated forms of erysipelas]. / Kompleksnoe lechenie bol'nykh s oslozhnennymi formami rozhi.

The authors made an analysis of variants of treatment strategy and its results in patients with different forms of erysipelas. The use of complex conservative and operative treatment allowed lethality to be reduced from 4 to 1.9%, in patients with severe course of the disease the frequency of complications being reduced to 10%.

[Erysipelas and elephantiasis of the scrotum. Surgical and drug therapy]. / Erysipel und Elephantiasis des Skrotums. Operative und medikamentöse Therapie.

Elephantiasis is the outcome of persistent lymphedema. It is refractory to different therapy modalities. The social approachability of patients with this disease is impaired by severe functional and cosmetic disturbances. The causal relationship between etiology and recurrent disease is demonstrated by two cases. Treatment options are discussed. Radical surgery is decisive for primary success since chronic inflammation and chronic edema support each other. Metabolic equilibrium, disinfecting skin areas and antibiotic prophylaxis are urgent steps in the successful treatment of Erysipelas disease.