Nursing Home Soft Tissue Infections

Skin and soft tissue infections, or SSTIs, are the third most common infection in nursing homes. This article will cover how soft tissue infections affect nursing home residents, their causes, prevention practices, and legal implications for the facility. 

What is a Soft Tissue Infection?

Soft tissue infections are infections of the skin, muscles, and tissues beneath the skin. They can be uncomfortable, painful, and dangerous, especially for elderly people.

Common soft tissue infections in nursing homes include:

• Cellulitis – Soft tissue bacterial infections that commonly affects the legs.
• Abscesses  – Soft tissue infections with pockets of pus that cause painful pressure buildup.
• Infected wounds – Soft tissue infections that begin as pressure ulcers, venous ulcers, diabetic wounds, surgical, and other wounds.

Causes of Soft Tissue Infections

The skin is a natural barrier that protects the body from outside influences, such as injuries and harmful microorganisms. Once the skin is cut, scraped, punctured, operated on, or hurt in any other way, it becomes an entry point for bacteria or viruses that can lead to soft tissue infections. 

Pathogens can also enter from nearby infected tissue, such as bone infections from pressure ulcers. 

Common culprits behind skin and soft tissue infections include:

• S. pyogenes
• Vibrio vulnificus
• Aeromonas hydrophila
• MRSA
• S. aureus
• Group A streptococci
• Pseudomonas aeruginosa (common in burn victims)

Common Symptoms

Common symptoms of a soft tissue infection include the following:

• Redness
• Swelling
• Pain
• Warmth
• Pus

Risk Factors in Nursing Homes

There are several risk factors for the development of skin and soft tissue infections in nursing homes. Risk factors for skin infections include the age of nursing home patients, their health condition, the use of medical devices and catheters, and poor hygiene. 

Elderly Residents

Nursing home residents are usually elderly people who are more likely to have weakened immune systems and chronic health conditions. 

As people age, their immunity weakens, making it more difficult for the body to fight skin and soft tissue infections and heal from injuries. Their skin is thinner and more fragile, making wounds, like pressure ulcers, more likely to occur. 

Regarding health conditions, skin and soft tissue infections are more common in people with neuropathy (numbness), peripheral vascular disease (circulation disorder), diabetes mellitus, and diseases of the lymph system.

Skin Infections

Older adults are more prone to skin injuries, as they’re often immobilized, suffer more falls and fractures, need more surgeries, or undergo invasive medical procedures such as catheterization more often. These can lead to soft tissue infections.

Bedsores or pressure ulcers, surgical wounds, and other resulting skin injuries increase infection risk as they leave open areas that allow bacteria and viruses to enter.

Poor Hygiene

Poor hygiene, which is usually a sign of neglect, can exacerbate skin and soft tissue infections. Unwashed bedsheets, clothes, and towels, as well as long periods between bathing times, can endanger the health of the residents’ skin and spread bacteria. 

Neglect is more likely to affect patients who need assistance with daily activities related to hygiene, residents with incontinence issues, and residents with limited mobility or cognitive issues. Not moving immobile residents increases the risk of residents developing pressure ulcers.

Catheters and Medical Devices

Using catheters, feeding tubes, IV lines, and wound drains is a common source of infection in a nursing home. These devices break the skin or enter the urinary tract, creating a direct pathway for microorganisms. 

They can quickly cause a serious soft tissue infection without proper handling, cleaning, and monitoring. Soft tissue infections can also be due to the spread of bacteria from other infections.

Malnutrition and Dehydration

When nursing home residents suffer from neglect or severe illnesses, they can experience malnutrition and dehydration. These factors can substantially damage the immune system, make skin more fragile and likely to tear, and slow down wound healing. A weakened immune system makes residents more likely to develop pressure ulcers or soft tissue infections.

That’s why a more balanced diet and water intake are crucial in treating soft tissue infections.

Common Soft Tissue Infections in Nursing Homes

Because of the above-mentioned risk factors, skin and soft tissue infections affect nursing home patients more frequently than other populations. The most notable types include cellulitis, infected wounds, abscesses, and necrotizing fasciitis.

Cellulitis

Cellulitis is one of the most common soft tissue infections. It usually affects the skin and subcutaneous fat. It is usually located in the lower legs, but it can also affect the arms, the face, or other areas of the body. The skin looks discolored, swollen, and stretched, sometimes with fluid-filled blisters and a lumpy-looking surface. 

Cellulitis is a bacterial infection, so the affected person may have a fever. These soft tissue infections can spread to the lymph nodes and bloodstream and quickly become life-threatening.

Infected Wounds

Skin and soft tissue infections can happen if the residents have high-risk wounds, such as:

• Pressure ulcers – Nursing home patients usually develop pressure ulcers when they’re bedridden or immobilized and left in the same position for a long time. Pressure ulcers slowly get worse as time passes if they are not properly treated. Infections and necrosis can appear in later stages. 
• Vascular ulcers – These wounds are caused by poor circulation, they heal slowly, and they’re prone to infection. This soft tissue infection is common in people with diseases that cause poor circulation, such as diabetes mellitus, or who already have a high chance of pressure ulcer development.
• Surgical wounds – Surgical incisions can become infected if not kept clean, especially in individuals with slower healing or compromised immune systems.
• Diabetes ulcers – Diabetes slows down healing and reduces immunity, usually causing wounds on the legs and feet. The weakened immune system makes it harder for soft tissue infections to heal, including pressure ulcers.
• Other injuries  – Open fracture wounds, cuts, herpes zoster wounds, and burns can also lead to soft tissue infections. 

Abscesses

Abscesses or boils are skin and soft tissue infections that look like localized lumps of pus under the skin. They can affect any part of the body, including your skin, mouth, or around your organs.

Staphylococcus bacteria, including MRSA, usually cause abscesses, but viruses and fungi can also cause them. Once the body detects an infection, it sends white blood cells to fight it off. As a result, some of the tissue dies, and pus forms to fill the empty space. 

Other wounds, such as pressure ulcers can also cause abscesses. Pressure ulcers can become infected, making it possible to have pressure ulcers that are also abscesses. Abscesses need to be treated with antibiotics, and the pus needs to be drained. 

Necrotizing Fasciitis

Necrotizing fasciitis, also known as the flesh-eating disease, is a rare but life-threatening soft tissue infection. It is caused when bacteria such as Streptococcus pyogenes or Clostridium enter a wound and release toxins that destroy tissue. Risk factors include poor wound care, diabetes, weak immunity, cancer, and other chronic illnesses. 

Proving Nursing Home Liability

Nursing homes should be a safe place for each resident. If they do not keep them safe from infections, they should be held liable for their negligence. Here is what family members should understand about determining liability. 

Duty of Care

Nursing homes have a legal duty of care for all patients under their roof. This includes preventing, monitoring, and maintaining wounds to prevent venous, diabetic, or pressure ulcer development. 

Duty of care is understood as reasonable care as expected by industry standards. 

Breach of Duty

Any failure to provide proper hygiene, wound care, and infection control that harms a resident can be considered a breach of duty.

For example, a patient with diabetes mellitus has issues with leg ulcers, and the nursing home doesn’t monitor or clean the wounds. The diabetes ulcers get infected and result in sepsis.

In this case, the nursing home breached its duty and caused damages, which may constitute negligence, 

Burden of Proof

The key in nursing home injury cases is that the burden of proof is on the plaintiff. This means you must demonstrate the facility directly caused the injury through actions or inactions. You will need evidence that shows a direct link, such as:

• Medical records
• Photographs of unsanitary conditions
• Evidence of understaffing and neglect
• Witness and expert testimonies

Preventing Soft Tissue Infections

Preventing soft tissue infections is possible, and it’s covered in detail by federal and state nursing home regulations. Prevention includes proper hygiene, infection control protocols, early detection and treatment, and sufficient trained staff. 

Proper Hygiene Practices

Many cases of infected wounds, such as those at surgical sites and pressure ulcers, have occurred because of poor hygiene. In addition to proper wound care, standards require the staff to wash hands frequently, bathe residents, trim their nails, and moisturize their skin to reduce the risk of skin injuries. 

Infection Control Protocols

Nursing homes must create and implement infection control and prevention protocols among residents and staff. Common infection control measures include cleaning and disinfection, hand hygiene, isolation of infected residents, and using PPE. 

Early Detection and Treatment

Treating soft tissue infections typically involves using oral antibiotics combined with diligent wound care. As some infections develop and progress rapidly, the staff must be well-trained to notice the early signs.

Nursing home patients who do develop infections need fast medical attention, as any delay can lead to further complications such as sepsis and death. 

Adequate Staffing and Training

Many nursing homes suffer from understaffing and a lack of training, especially if their corporate ownership structure prioritizes profit over resident well-being. Staff members in such homes are often stretched thumb, overworked, and physically unable to dedicate enough time to each patient. 

This can harm nursing home patients who are at a higher risk of suffering a soft tissue infection, leaving them with poor quality care.  

Seeking Legal Help

If someone you care about has suffered from skin and soft tissue infection due to a nursing home’s negligence, you should always seek legal help. At the Nursing Home Law Center, you can receive advice and guidance on how to proceed in your case. 

Why You Need a Lawyer

A nursing home injury lawyer can help you hold the facility accountable. We can help you file a personal injury lawsuit and recover compensation for the suffering your loved one has endured. 

Our services include investigating and gathering evidence, dealing with legal procedures, interviewing witnesses, negotiating with insurance companies, and representing you in trial if needed. 

Getting Compensated for Damages

Plaintiffs in nursing home neglect cases usually get compensation for the following types of damages:

• Medical expenses – This includes ongoing and future medical bills for surgery, rehabilitation, and other costs. 
• Pain and suffering – Victims or survivors receive compensation for the physical pain resulting from the infection. 
• Emotional distress – The pain from soft tissue infections is often followed by fear, anxiety, and isolation, all of which may be compensated for. 

Secure Expert Legal Representation! 

Don’t hesitate to ask for help—each state has a statute of limitations that gives you a deadline for filing nursing home neglect cases. Our nursing home abuse attorneys can help your loved ones recover compensation for their pain and suffering.

Nursing home patients and their families can contact us for a free consultation at (800) 926-7565 or through our online form.