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American Association for the Surgery of Trauma (AAST) Grading Scale for Skin and Soft Tissue Infection (SSTI)

Description

The American Association for the Surgery of Trauma (AAST) reported grading scales for a variety of conditions as emergencies in general surgery. One deals with skin and soft tissue infections. The authors are from multiple institutions in the United States.


Patient selection: skin and soft tissue infection (SSTI)

 

Parameters:

(1) clinical features

(2) imaging criteria

 

Clinical Features

Imaging Criteria

Grade

folliculitis, erysipelas, impetigo, simple cellulitis

superficial inflammation, no subcutaneous stranding

I

complex cellulitis (necrotizing, blistering, bullous), skin necrosis

subcutaneous stranding without abscess

II

subcutaneous abscess

well-defined subcutaneous fluid collection with surrounding inflammation

III

fasciitis

inflammation extends to fascia, with or without air along fascia margins; viable muscle beneath fascia

IV

myonecrosis

extension of necrosis into muscle and deeper tissue; air deep to fascia

V

 

Outcomes associated with grade of the infection:

(1) operative intervention

(2) complication severity

(3) ICU care

(4) duration of hospital stay

(5) mortality

(6) hospital readmission


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