The Journal is published online only. The frequency of releases is 4 times a year.                             

The journal publishes the latest research in the field of clinical and basic medicine: pathological physiology, internal medicine and surgery.

Preview

Baikal Medical Journal

Advanced search

CELLULITIS IN THE POSTOPERATIVE PERIOD: A CASE REPORT

Abstract

Relevance. Lower extremity varicose vein disease is the most frequent reason patients seek consultation with a vascular surgeon. The primary treatment for this condition is surgical intervention. Complications of phlebectomy include lymphorrhea, damage to major blood vessels and nerves, thromboembolic complications as well as infectious complications. The incidence of surgical site infections following open vein surgery ranges from 1.5 % to 16 %. However, no reliable statistical data on the frequency of severe infectious complications after phlebectomy are available. Despite their low frequency rate, severe surgical site infections are clinically significant, as their development substantially prolongs hospitalization, necessitates additional therapy, and may adversely affect overall treatment outcomes.

Case descriptions.  This article presents a case of cellulitis that developed in a female patient with varicose vein disease of the lower limbs during the postoperative period following phlebectomy. The appropriately chosen surgical approach, combined with targeted antibiotic therapy based on microbiological test results, led to complete wound healing and full patient recovery.

Conclusion. Deep skin and soft tissue infections are rare complications of phlebectomy, yet they present diagnostic challenges, severe clinical course, and require prolonged treatment. When a deep subcutaneous infection is suspected in the surgical area, urgent additional investigations should be performed. The cornerstone of management involves early surgical intervention combined antibiotic therapy administered considering the results of microbiological tests.

About the Authors

Natalia A. Dvoynikova
Irkutsk State Medical University
Russian Federation

Cand. Sci. (Med.), doctor - clinical pharmacologist



Natalya Yu. Alekseeva
Irkutsk State Medical University
Russian Federation

Dr. Sci. (Med.), professor of the Department of Public Health and Healthcare



Marina G. Bogdanova
Irkutsk State Medical University
Russian Federation

surgeon



Andrey L. Agryzkov
Irkutsk State Medical University
Russian Federation

Cand. Sci. (Med.), Head of the Surgical Department



References

1. Шанаев И.Н. Современные представления о механизмах развития варикозной и посттромботической болезней. Кубанский научный медицинский вестник. 2020;27(1):105-125 [Shanaev I.N. Modern views on the development of varicose and post-thrombotic diseases. Kuban Scientific Medical Bulletin. 2020;27(1):105-125 (In Russ.)]. https://doi.org/10.25207/1608-6228-2020-27-1-105-125

2. Сушков С.А. Осложнения при оперативном лечении варикозной болезни нижних конечностей. Новости хирургии. 2008;16(1):140-151 [Sushkov S.A. Complications of surgical treatment for lower extremity varicose vein disease. Novosti Khirurgii. 2008;16(1):140-151 (In Russ.)]. URL: https://cyberleninka.ru/article/n/oslozhneniya-pri-operativnom-lechenii-varikoznoy-bolezni-nizhnih-konechnostey [access date: 30.06.2025].

3. Роговой Н.А., Янушко В.А., Турлюк Д.В. и др. Поздние осложнения после классической флебэктомии в системе малой подкожной вены. Медицина неотложных состояний. 2018;4(91):110-114 [Rogovoi N.A., Yanushko V.A., Turlyuk D.V. et al. Late complications following classic phlebectomy of the small saphenous vein system. Meditsyna neotlozhnykh sostoyanii. 2018;4(91):110-114 (In Russ.)]. https://doi.org/10.22141/2224-0586.4.91.2018.137867

4. Боренштейн А.И., Юмин С.М., Мишакина Н.Ю. и др. Венозные тромбоэмболические осложнения у больных, перенесших флебэктомию при варикозной болезни нижних конечностей. Флебология. 2012;6(4):11-15 [Borenshteĭn A.I., Iumin S.M., Mishakina N.Iu. et al. Venous thromboembolism after phlebectomy in patients with primary varicose veins. Journal of Venous Disorders. 2012;6(4):11 15 (In Russ.)]. URL: https://www.mediasphera.ru/issues/flebologiya/2012/4/031997-6976201244 [access date: 30.06.2025].

5. Болдин Б.В., Богачев В.Ю., Голосницкий П.Ю. и др. Ятрогенные повреждения сосудисто-нервного пучка и лимфатических коллекторов бедренного треугольника при флебэктомии. Амбулаторная хирургия. 2023;20(1):16-36 [Boldin B.V., Bogachev V.Yu., Golosnitskiy P.Yu. et al. Iatrogenic damage to the vascular-nerve bundle and lymphatic collectors of the femoral triangle during phlebectomy. Ambulatornaya Khirurgiya. 2023;20(1):16–36 (In Russ.)]. https://doi.org/10.21518/akh2022-005

6. Pittaluga P, Chastanet S. Lymphatic complications after varicose veins surgery: risk factors and how to avoid them. Phlebology. 2012;27 Suppl 1:139-42. https://doi.org/10.1258/phleb.2012.012s12

7. Шевченко Ю.Л. Ошибки, опасности и осложнения в хирургии вен: Рук. для врачей. СПб.: Изд-во Питер Ком;1999:320 [Shevchenko Yu.L. Errors, Hazards and Complications in Venous Surgery: A Guide for Physicians. Saint Petersburg: Peter Com Publishing; 1999:320 (In Russ.)].

8. Hubmer M.G., Koch H., Haas F.M. et al. Necrotizing fasciitis after ambulatory phlebectomy performed with use of tumescent anesthesia. J Vasc Surg. 2004;39(1):263-5. https://doi.org/10.1016/j.jvs.2003.07.014

9. Smith SR, Aljarabah M, Ferguson G, Babar Z. Necrotizing fasciitis following saphenofemoral junction ligation with long saphenous vein stripping: a case report. J Med Case Rep. 2010;4:161. https://doi.org/10.1186/1752-1947-4-161

10. Шулутко А.М., Османов Э.Г., Крылов А.Ю., Натрошвили А.Г. Обширные нагноительные процессы после комбинированной флебэктомии. Хирургия. Журнал им. Н.И. Пирогова. 2019;12:54-59 [Shulutko A.M., Osmanov É.G., Krylov A.Iu., Natroshvili A.G. Extensive purulent processes after combined phlebectomy. Pirogov Russian Journal of Surgery. 2019;(12):54‑59 (In Russ.)]. https://doi.org/10.17116/hirurgia201912154

11. Гельфанд Б.Р., Кубышкин В.А., Козлов Р.С., Хачатрян Н.Н. Хирургические инфекции кожи и мягких тканей: российские национальные рекомендации. 2-е перераб. и доп. изд. Москва:Изд-во МАИ;2015:109 [Gelfand B.R., Kubyshkin V.A., Kozlov R.S., Khachatryan N.N. Surgical Skin and Soft Tissue Infections: Russian National Guidelines. 2nd edition, revised and updated. Moscow:MAI Publishing House;2015:109 (In Russ.)].

12. Профилактика инфекций области хирургического вмешательства. Клинические рекомендации. Н. Новгород: Изд-во: «Ремедиум Приволжье»;2018:72 [Prevention of Surgical Site Infections. Clinical Guidelines. N. Novgorod:Remedium Privolzhye;2018:72 (In Russ.)].

13. Hashem N.G., Hidayat L., Berkowitz L., Venugopalan V. Management of skin and soft-tissue infections at a community teaching hospital using a severity-of-illness tool. J Antimicrob Chemother. 2016;71(11):3268-3275. https://doi.org/10.1093/jac/dkw263

14. Абельская И.С., Галицкая С.С., Слободин Ю.В. и др. Инфекции кожи и мягких тканей: подходы к антибактериальной терапии. Медицинские новости. 2023;9(348):63–68 [Abelskaya I.S., Galitskaya S.S., Slobodin Yu.V. et al. Skin and Soft Tissue Infections: Approaches to Antibacterial Therapy. Medical News. 2023;9(348):63–68 (In Russ.)]. https://doi.org/10.34883/PI.2024.27.2.008

15. Петухова И. Н., Дмитриева Н. В. Что нового в лечении инфекций мягких тканей и раневых инфекций? Роль биопленок. Злокачественные опухоли. 2015;4 (2):35-38 [Petukhova I.N., Dmitriyeva N.V. Advances in the Management of Soft Tissue and Wound Infections: The Role of Biofilms. Zlokachestvennye opukholi. 2015;4(2):35-38 (In Russ.)]. https://doi.org/10.18027/2224-5057-2015-4s2-35-38

16. Sartelli M., Guirao X., Hardcastle T.C. et al. 2018 WSES/SIS-E consensus conference: recommendations for the management of skin and soft-tissue infections. World J Emerg Surg. 2018;13:58. https://doi.org/10.1186/s13017-018-0219-9


Review

For citations:


Dvoynikova N.A., Alekseeva N.Yu., Bogdanova M.G., Agryzkov A.L. CELLULITIS IN THE POSTOPERATIVE PERIOD: A CASE REPORT. Baikal Medical Journal. 2025;4(3).

Views: 15


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 2949-0715 (Online)

Irkutsk State Medical University

Irkutsk Scientific Center for Surgery and Traumatology