Skin and soft-tissue infections are common problems in the elderly. In one study of nursing home residents, skin infections accounted for 35% of infections acquired in nursing homes in Maryland (1). The presence of a skin ulcer was the major risk factor for developing an infected ulcer or cellulitis. In addition to the normal changes of the aging skin such as decreased turgor, elasticity, and atrophy, elderly patients often have coexisting peripheral vascular disease or small-vessel disease of diabetes mellitus, which makes them increasingly vulnerable to skin and soft-tissue infections, and may result in delayed healing. The elderly are at risk for all the usual pathogens causing skin and soft-tissue infections but in addition, because of their impaired host defenses and frequent coexisting vascular disease and diabetes mellitus, the elderly are at greater risk of developing necrotizing soft-tissue infection, infected pressure ulcers, and diabetic foot infections (see also Chapter 22). Skin and soft-tissue infections in the elderly consist of the primary pyodermas, erysipelas or cellulitis, necrotizing fasciitis, and the infected ulcer (see Table 1).
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All you need is a proper diet of fresh fruits and vegetables and get plenty of exercise and you'll be fine. Ever heard those words from your doctor? If that's all heshe recommends then you're missing out an important ingredient for health that he's not telling you. Fact is that you can adhere to the strictest diet, watch everything you eat and get the exercise of amarathon runner and still come down with diabetic complications. Diet, exercise and standard drug treatments simply aren't enough to help keep your diabetes under control.