Skin and soft tissue infections include the skin as well as fascia, muscles, ligaments, tendons, synovial membranes, fat, blood vessels, nerves, and fibrous tissues. They range from superficial infections to deep infections with a necrotizing clinical course. These infections can promptly progress with severe systemic complications, requiring rapid management, and proper surgical and medical treatment. This manuscript provides recommendations based on current practice guidelines for diagnosis and treatment of surgically relevant skin and soft tissue infections in adults. Furthermore, it deals with a clinical guide of immediate identification of life threatening necrotizing clinical courses, detection of pathogens and the use of appropriate surgical, antimicrobial, and adjuvant treatment options.