{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,26]],"date-time":"2025-11-26T10:29:29Z","timestamp":1764152969691,"version":"3.46.0"},"reference-count":16,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2020,5,14]],"date-time":"2020-05-14T00:00:00Z","timestamp":1589414400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2020,5,14]],"date-time":"2020-05-14T00:00:00Z","timestamp":1589414400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2020,5,14]],"date-time":"2020-05-14T00:00:00Z","timestamp":1589414400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Frequently, surgical intervention is needed to treat soft tissue sepsis (STS). Ideally, most STS should be managed at the lowest level of surgical care close to the patient's home and a well\u2010functioning surgical service will be able to deliver this safely and effectively. This study interrogates the burden of STS in the province of KwaZulu\u2010Natal and reviews at which level in the health system the operative management of STS is being dealt with.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study describes the operations for soft tissue sepsis conducted at all regional and tertiary hospitals in KwaZulu\u2010Natal province for the period of 1\u00a0July to 31 December 2015. All procedures for soft tissue sepsis were identified for closer review.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Between 1\u00a0June and 31 December 2015, a total 6302 soft tissue\u2010related procedures were performed in the regional and tertiary hospitals of KZN. The breakdown by anatomical region was as follows, 618 (9.8%) head and neck surgeries, 895 (14.2%) chest and back, 277 (4.4%) abdominal wall, 818 (13%) pelvis\/perineal\/buttock and 3070 (48.7%) extremity\u2010related surgeries. There were a further 815 (12.9%) soft tissue\u2010related procedures where the anatomical region was unspecified. Of the soft tissue procedures, 3943 (62.6%) were for the management of soft tissue sepsis. The anatomical regions involved included 316 (8%) head and neck, 485 (12.3%) chest and back, 194 (4.9%) abdominal wall, 589 (14.9%) pelvic, perineal and buttock, 2054 (52.1%) extremity and 365 unspecified operations. Peri\u2010anal sepsis contributed 315 (8%), breast sepsis contributed to 372 (9.4%) of all soft tissue sepsis and amputations of extremities 658 (16.7%) of septic soft tissue procedures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>There is a significant burden of soft tissue sepsis requiring surgical treatment each month at regional and tertiary hospitals in KZN. This is made up of breast sepsis, peri\u2010anal sepsis and diabetic foot sepsis. This burden is being managed at an inappropriate level of care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00268-020-05510-5","type":"journal-article","created":{"date-parts":[[2020,5,14]],"date-time":"2020-05-14T14:13:45Z","timestamp":1589465625000},"page":"2526-2532","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Soft Tissue Sepsis Places a Massive Burden on Regional and Tertiary Surgical Services in KZN Province South Africa"],"prefix":"10.1002","volume":"44","author":[{"given":"Vincent","family":"Ehlers","sequence":"first","affiliation":[{"name":"Department of Surgery, Pietermaritzburg Metropolitan Hospitals Complex Grey's Hospital 201 Townbush Road, Private Bag X9001 3200 Pietermaritzburg South Africa"},{"name":"Department of Surgery, College of Health Sciences, Nelson R Mandela School of Medicine University of KwaZulu\u2010Natal Pietermaritzburg KwaZulu\u2010Natal South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C.","family":"Kohler","sequence":"additional","affiliation":[{"name":"Department of Surgery, Pietermaritzburg Metropolitan Hospitals Complex Grey's Hospital 201 Townbush Road, Private Bag X9001 3200 Pietermaritzburg South Africa"},{"name":"Department of Surgery, College of Health Sciences, Nelson R Mandela School of Medicine University of KwaZulu\u2010Natal Pietermaritzburg KwaZulu\u2010Natal South Africa"},{"name":"South African Global Surgery Society Johannesburg South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natasha","family":"Di Rago","sequence":"additional","affiliation":[{"name":"Department of Surgery, Pietermaritzburg Metropolitan Hospitals Complex Grey's Hospital 201 Townbush Road, Private Bag X9001 3200 Pietermaritzburg South Africa"},{"name":"Department of Surgery, College of Health Sciences, Nelson R Mandela School of Medicine University of KwaZulu\u2010Natal Pietermaritzburg KwaZulu\u2010Natal South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aida","family":"Tefera","sequence":"additional","affiliation":[{"name":"Epidemiology Unit KZN Department of Health Natalia 330 Langalibalele (Longmarket) Street Pietermaritzburg 3201, P\/Bag X9051 3200 Pietermaritzburg South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth","family":"Lutge","sequence":"additional","affiliation":[{"name":"Epidemiology Unit KZN Department of Health Natalia 330 Langalibalele (Longmarket) Street Pietermaritzburg 3201, P\/Bag X9051 3200 Pietermaritzburg South Africa"},{"name":"School of Nursing and Public Health University of KwaZulu\u2010Natal Mazisi Kunene Road 4041 Glenwood, Durban South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Damian","family":"Clarke","sequence":"additional","affiliation":[{"name":"Department of Surgery, Pietermaritzburg Metropolitan Hospitals Complex Grey's Hospital 201 Townbush Road, Private Bag X9001 3200 Pietermaritzburg South Africa"},{"name":"Department of Surgery, College of Health Sciences, Nelson R Mandela School of Medicine University of KwaZulu\u2010Natal Pietermaritzburg KwaZulu\u2010Natal South Africa"},{"name":"Department of Surgery University of the Witwatersrand Johannesburg South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,5,14]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(15)60160\u2010X"},{"volume-title":"Surgical care at the district hospital","year":"2003","author":"World Health Organisation","key":"e_1_2_8_3_1"},{"key":"e_1_2_8_4_1","unstructured":"Declaration of Alma\u2010Ata: International Conference on Primary Health Care Alma\u2010Ata USSR(1978)https:\/\/www.who.int\/publications\/almaata_declaration_en.pdf. 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