Lower Limb Cellulitis

Cellulitis

Cellulitis is a common but potentially serious bacterial skin infection; mainly to the deep layers of the skin. It can affect any part of the body but mainly occurs in the legs.

The main signs and symptoms include heat, redness and swelling to a specific area which can increase in size over a short period of time.

Why am I at risk of getting cellulitis?

You may have skin injuries including:

• skin cut for surgery
• insect and animal bites
• puncture to your skin from an object i.e. a screw.

• Some medical conditions can increase your risk, including but not limited too:

• Diabetes
• Peripheral Artery disease
• Lymphedema
• More common in middle ages and above
• Weakened immune system
• Obesity
• Other skin conditions including eczema

How might cellulitis affect me?

The movement to your affected joint can be limited in the early stages because of the swelling and pain but it is important to move regularly as comfort allows to reduce any potential for stiffness. 

How is cellulitis treated?

The treatment for cellulitis can be a mix of Intra-venous antibiotics (administered into the veins so it can get into the bloodstream immediately) and/or oral antibiotics (taken by the mouth) and this will be determined by the Consultant/Doctors on the ward.

How can I manage pain, swelling, and recovery?

• Pain: Continue to take your pain relief as advised. If you feel that this is not adequate, please speak to the ward staff or your GP if you are already home.
• Swelling: You may have wrist pain and swelling for 3-6 month after your injury. Swelling is often worse at the end of the day.       
• Elevation: You will also find it helpful to elevate (have your limb raised) your affected area frequently in the day to help reduce the swelling.This will reduce the swelling around the wrist and fingers.
• Physiotherapy: When the cellulitis settles, you should regain your movement of the affected area. Please complete the exercises in the booklet to help.
• Skin Hygiene: If you have any breaks to the skin, it is important to keep them clean and dry. Your nurse will help you to manage this whilst you’re on the ward. Wash your hands regularly to help keep the area clean.

Will I have further (follow up) appointments?

We do not routinely refer for Physiotherapy but please speak to the Physiotherapist on the ward if you have any questions or concerns. Once you have completed your course of antibiotics, the cellulitis should settle and you should regain your movement to the affected area. The GP will sometimes follow you up once you’ve left the hospital. You will be advised in hospital if you need anything specific.

Exercise Programme

Early movement of the toes, ankle, knee and hip is important to prevent stiffness.

Start these exercises day 1 after your injury.

1. Toe and ankle movements

1. Keep your toes and ankle moving regularly.
2. Lie or sit with your knee straight.
3. Pull your toes and foot up  towards you and then point your foot down as far away from you as you can.
4. Then move your ankle round in a circle

Repetitions___        Frequency___ 

2. Bend and straighten your knee

• Sitting in a chair. Fully straighten your leg.
• Slowly bend back to the starting position.

Repetitions___ Frequency___  Hold for ___

3. Bending your hip

• Lying on your back on your bed and keeping other leg straight.
• Bring your heel towards your bottom, then slide heel and straighten leg

Repetitions__          Frequency__

Exercise Program 1 week from injury

4. Standing exercises

• Stand holding onto a stable surface for support.
• A. Lift your affected leg out to the side. Keep your body upright and don’t let your leg come forwards during the movement.
• Lower your leg back down slowly.
• B. Then complete the same by bringing the leg behind you. Keep your body upright then lower your leg back to the start position
• C. Then bend your knee up in front of you. Keep your body upright then lower your leg back to the start position

Repetitions__          Frequency__

How do I know if the cellulitis is worsening?

You may have an increase in your temperature and feel generally unwell. The redness and swelling may spread further around the arm. You may find your pain in that area gets worse.

Will smoking or vaping slow down my healing?

Smoking will slow down your healing. We would advise that you stop smoking while your cellulitis settles. Talk to your GP or go to Smokefree for more information.

How can I get a certificate to say that I am fit to work?

You can get a fitness for work statement from the ward doctors or your GP if you are home.

When can I start driving?

When you have full movement to control the pedals and can perform an emergency stop pain free. Always test your ability to drive in a safe environment first.