Navigating the Healthcare setting with Cellulitis

Abstract

Cellulitis is a common infection of the skin that has high rates of recurrence. It is one of the most common potentially preventable reasons for admission to hospital in Australia. Barriers to managing cellulitis and its recurrence from patients’ perspectives are an area which may provide further insight to this disease and its management.

A systematic review of the guidelines for the management of cellulitis was undertaken to determine the range and quality of guidelines that address recurrence and non-pharmacological management. Databases including Medline, Embase, CINAHL, SCOPUS and BMJ were searched. AGREE II was used to assess the quality underpinning the guidelines development. Ten guidelines that included non-pharmacological recommendations were identified. Non-pharmacological recommendations included, elevation, compression and oedema management, education of patients and risk factor management. Patients’ experiences in navigating the healthcare setting were investigated to understand the impact of the healthcare setting on cellulitis management. Twenty-two participants were interviewed about their experience with cellulitis from January 2021 to July 2022. Themes identified were: 1) navigation of health care; 2) Engagement with health care services; and 3) The impact of knowledge. Results highlighted challenges participants face with respect to diagnosis and treatment as well as access to treatment due to perceived lack of knowledge and experience of health care practitioners. A lack of formal consistent information was also discovered. Participants’ experiences beyond the acute phase of infection were also explored. Themes identified: 1) navigation of health care; 2) engagement with health care services; and 3) the impact of knowledge. The burden of managing the chronic effects of cellulitis was carried by patients and further support and guidance around cellulitis management would benefit those living with recurrent cellulitis and their caregivers.