Bilateral Lower extremity Cellulits?

  1. I've been seeing alot of my pts coming in with this lately. They have discolored shins/ feet, skin is dry and very scaly and almost looks/ feels like a tree trunk, sometimes there is drainge and other times not. Most of the pts have been on an antiboitic too. For the most part we are putting steriod creams on the legs bid.

    What are other treatments/ nursing measures to take? I was trying to look into this and call the doc on this one pt because she had two types of steriod creams ordered...clobesterol? and TAC. use both together or one?
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    About CoffeeRTC, BSN

    Joined: Jan '03; Posts: 3,743; Likes: 1,817
    RN LTC; from US


  3. by   rn4life2009
    It depends or what the cause of cellutis is. Is it fluid overload or circulation problems. We would wrap them to increase pressure to send fluid back up or is it a infection from mrsa or bites or sores then I differs. Hope this helps.
  4. by   LuxCalidaNP
    Given your description, it might not be cellulitis. Might be complication of venous stasis, and especially if they have a history of dependent or pitting edema, it may be lipodermatosclerosis, which causes scaling and a bark-like texture.
  5. by   shiccy
    The usual thing I see is elevation of extremities and ensuring the extrems are very well moisturized. I have also seen TED hose and/or Jobst stockings (another kind of compression stockings we use)
  6. by   celclt
    vascular browning=venous dz
    + chf?
    I know what you mean-totally looks like their legs could pop!
    Last edit by celclt on Apr 26, '10
  7. by   LouisVRN
    I've seen many different cases of cellulitis, some from blisters from high heels, some from bug bites, some from stasis/lymphadema, others seemingly idiopathic, the main things are to prevent further breakdown based on the cause and prevent any secondary infections.
  8. by   jlcole45
    It also could be venous statis issues, especially since its bilaterial.
    And if the patient has a history of obesity, poor circulation, heart disease, etc...
  9. by   HeatwaveRN
    I think the diagnosis of cellulitis is very general to having reddened lower extremities. Usually the patients are being ruled out for other possible diseases: venous stasis, for example. The patient may be diabetic and/or have CHF. The tree-trunk look probably was a result from diuresing. Edema on the legs that had gotten smaller.
    Anyway, look at skin integrity and probably some antibiotic creams. Leg elevation as well.
  10. by   CoffeeRTC
    Thanks for the replies. To me it looks a little like celulits and venous statis eczema. I've never seen legs so tree truncky....hard and dried skin.