Injuries — soft tissue

Summary of changes

Addition: Sub-section on necrotising fasciitis

Medicines 

  • For mild contamination of soft tissue injury: changed antibiotic from amoxicillin-clavulanic acid or cefalexin to di/flucloxacillin or cefalexin. If allergy: changed antibiotic from rofloxacin/clindamycin to trimethoprim-sulfamethoxazole
  • For animal/human bites: changed antibiotic from amoxicillin-clavulanic acid or procaine benzylpenicillin IM, ciprofloxacin and clindamycin. If allergy: amoxicillin-clavulanic acid or cefazolin IV (with med consult), metronidazole and trimethoprim-sulfamethoxazole
  • For spear and knife wounds and if shock or internal bleeding:  added tranexamic acid
  • For major wounds cefazolin and metronidazole IV added, clindamycin if allergic (with med consult)
  • For minor wounds: recommended antibiotics are linked to the soft tissue protocol

Primary references

  1. Children’s Health Queensland Hospital and Health Service (2020) Children’s Health Queensland Paediatric Antibiocard: Empirical Antibiotic Guidelines, accessed 16 June 2021.

  2. Children’s Health Queensland Hospital and Health Service (2020) Management of water-immersed wound infections in children, accessed 16 June 2021.

  3. Children’s Health Queensland Hospital and Health Service (2020) Skeletal, soft tissue and skin infections, accessed 16 June 2021.

  4. Expert Groups for Antibiotic, version 16 (2021) Antibiotic, Therapeutic Guidelines, accessed 24 April 2022.

  5. Queensland Health and the Royal Flying Doctor Service (Queensland Section) (2019) Primary Care Manual Emergency, 10th edition, The Rural and Remote Clinical Support Unit, Torres and Cape Hospital and Health Service, accessed 11 January 2022.