Treat purulent inflammation. Purulent inflammation: description, causes, types and features of treatment. What are purulent skin lesions

characterized by the formation of purulent exudate. It is a mass consisting of detritus of tissues of the focus of inflammation, cells, microbes. The exudate contains granulocytes, lymphocytes, macrophages, often eosinophilic granulocytes. Purulent inflammation is caused by pyogenic microbes - staphylococci, streptococci, gonococci, typhoid bacillus.

Purulent exudate has a number of qualities that determine the biological significance of this form of inflammation. It contains various enzymes, primarily proteases, capable of breaking down dead and dystrophically altered structures in the lesion, including collagen and elastic fibers, so purulent inflammation is characterized by tissue lysis.

The main forms of purulent inflammation are abscess, phlegmon, empyema, purulent wound.

Abscess

Phlegmon

Purulent, unrestricted diffuse inflammation, in which purulent exudate impregnates and exfoliates tissues. The formation of phlegmon depends on the pathogenicity of the pathogen, the state of the body's defense systems, as well as on the structural features of the tissues in which it arose and where there are conditions for the spread of pus.

Phlegmon can be soft if the lysis of necrotic tissues prevails, and hard when coagulative necrosis of tissues occurs in the phlegmon, which are gradually rejected.

Phlegmonous inflammation can be complicated by thrombosis of blood vessels, resulting in necrosis of the affected tissues. Purulent inflammation can spread to the lymphatic vessels and veins, and in these cases, purulent thrombophlebitis and lymphangitis occur. The healing of phlegmonous inflammation begins with its delimitation, followed by the formation of a rough scar. With an unfavorable outcome, generalization of infection with the development of sepsis may occur.

empyema

This is a purulent inflammation of the body cavities or hollow organs. The reason for the development of empyema is both purulent foci in neighboring organs (for example, lung abscess and empyema of the pleural cavity), and a violation of the outflow of pus in case of purulent inflammation of hollow organs - the gallbladder, appendix, fallopian tube.

festering wound

A special form of purulent inflammation, which occurs either as a result of suppuration of a traumatic, including surgical, or other wound, or as a result of opening a focus of purulent inflammation into the external environment and the formation of a wound surface.

Purulent wounds occur when the integrity of the skin is violated, when there is purulent content in the lumen, and an inflammatory process along the edges. Pathology develops after infection of a clean wound (after a cut, puncture, etc.) or is formed due to an abscess rupture.

Such wounds are also found in the period after surgical operations: even with careful observance of sterility, up to 30% of suppuration is noted during their implementation. The causative agents in them are pyogenic microbes (strepto-, staphylococci, Proteus coli or coli, pseudomonads. Less often - mycobacteria, salmonella, shigella, pneumococci).

presence in the wound of a foreign body, blood clots or pieces of dead tissue;

high levels of microorganisms that are pathogenic.

The main reason for the development of purulent stab wounds is insufficient outflow of fluid from the wound due to a narrow wound channel and a small hole on the skin surface.

Other factors that increase the risk of developing suppuration:

the presence of somatic diseases (healing is slower, the likelihood of suppuration increases);

diabetes mellitus (even minor damage can cause severe suppuration with further spread of the process);

weakened immunity (suppuration takes a sluggish current form, healing is delayed, nearby tissues may be involved in the process);

season (the process of suppuration develops faster in warm weather with high humidity);

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Local symptoms:

the presence of damage to the skin with purulent contents;

regardless of the amount of pus, granulations and areas with dead tissues can form under it.

The color of purulent contents and its consistency depends on the type of pathogen:

yellow or white thick pus - with staphylococcus aureus;

brown-yellow liquidish - Escherichia coli;

brown with a fetid odor - anaerobic microbes;

The appearance of pus in the wound is accompanied by bursting or pressing pain. With the difficult outflow of purulent contents from the wound (during the formation of a crust), the production of pus increases, the affected area becomes inflamed. Throbbing pain appears due to increased pressure in the wound.

The skin around the wound turns red, hot to the touch. In advanced cases, the skin acquires a purple or purple-blue hue. The temperature rises, there is swelling of the tissues around the wound. Physiological functions are impaired (due to severe pain and swelling).

increased sweating;

loss of appetite;

in a laboratory study, leukocytosis, accelerated ESR is noted in the blood, and protein in the urine.

Purulent wounds that have not been previously treated are treated by surgeons. If suppuration occurred after the primary surgical treatment, traumatologists are involved in the treatment. Festering surgical wounds are treated by operating doctors.

Antibacterial drugs are selected taking into account the sensitivity of the pathogen. Treatment of purulent wounds includes:

the appointment of antibacterial drugs;

increased immunity (to increase the production of tissue protective factors and interferon by the body).

When a purulent focus is just being formed, the goal is to thoroughly cleanse the wound, reduce inflammation, and eliminate pathogenic microorganisms. At the next stage, it is important to speed up the regeneration processes.

The greatest effect gives the use of:

synthomycin liniment;

neomycin ointment.

sauerkraut lotions will help remove dried blood and prevent the development of inflammation;
apply fresh garlic paste to the area with a purulent wound for several hours (itching may occur immediately, the wound will gradually begin to clear of pus, the bactericidal properties of garlic accelerate healing);

You can not apply bandages with ointment to an open purulent wound - this makes it difficult for the outflow of pus and contributes to its penetration deep into the tissues. For dressings, gauze pads and bandages should be used (instead of band-aids) to allow air to enter the wound.

To prevent suppuration of wounds, it is necessary:

make timely dressings of existing wounds;
follow all doctor's orders;
use personal protective equipment at enterprises (where provided).

How to cure purulent otitis media at home?

Otitis media is a very common disease that affects both adults and children. Any form of it is a potential threat to health, and possibly human life. After all, the whole danger lies in the proximity of the affected organ to the brain.

Next, let's talk about the treatment of purulent otitis media at home. More specifically, let's find out whether this can be done, and in what cases? And most importantly, we will determine the correctness of such actions in order to protect the body from negative effects as much as possible.

Treatment of purulent otitis at home

Let's start with the fact that there is no way to treat otitis media at home. cannot be an alternative to qualified medical therapy. Inflammation of the ear can cause very serious complications and become chronic with improper treatment or lack of it.

If there is no improvement in well-being within 5 days, or deterioration is observed, then you should immediately seek help from a specialist. After all, it is impossible to know for sure whether a perforation of the eardrum will occur. And suddenly not, due to anatomical features. What then? Pus will look for a way out!

Attention! The patient must be aware of the seriousness of the disease and be aware of their own actions. "Playing doctor" at home with purulent otitis media can end very badly.

The proximity of the hearing organ to the bones of the skull and face, as well as to the brain, characterizes this pathology as rather unpredictable in terms of possible consequences.

Purulent otitis is a form of the disease that does not tolerate self-treatment.

Otitis. Treatment with folk remedies

Otitis media is an inflammation of the middle ear. The middle ear is a tiny cavity that houses a bony mechanism designed to transmit sound waves to the inner ear. Among the reasons that can cause otitis: decreased immunity, hypothermia, penetration of pathogens and viruses. Often, otitis media is a complication of a runny nose or sore throat, the infection can get into the middle ear when coughing or blowing your nose, much less often from the outside, through a damaged eardrum.

Treatment of otitis with folk remedies:

Bread compress for otitis media

An old recipe for the treatment of ears in children. Literally after 10-15 minutes the pain subsides. You need to take a black crust (in the whole loaf) from bread, put it in a colander over a pot of water (water bath), warm it up on both sides. Then apply to the sore ear (like a compress: cellophane, cotton wool and tie with a handkerchief). It is advisable to hold for at least an hour. If the vodka compress “cools down” after 1.5 hours, then the bread compress keeps heat for more than 3 hours and warms up perfectly. And if you do 2-3 days in a row, then the pain will go away for a long time.

Remedy for purulent otitis media

Boil an egg in a “bag”, take out the yolk, take a yellowish liquid from its middle with a pipette and put 2 drops in the ear, tied it with a handkerchief and go to bed. After waking up, it will be much easier. Then take a thin plate of onions. put a leaf of a golden mustache and a little bit of butter on it, roll it up with a flagellum and insert it into your ear. Keep the medicine for 3 hours. Warm up your feet in the evening: add 1 tablespoon of mustard and 2 tablespoons of salt to 5 liters of hot water. Mix everything and warm the legs with this composition until the water cools down. Put on warm socks and lie down under the covers. At night, put a few drops of mummy infusion into the ear: 1 tablet of mummy should be dissolved in 1 tablespoon of vodka and 2-3 drops should be injected into the ear. This tool cleans well from purulent fluid. And in the peeled onion, cut a small hole on top, add a little granulated sugar there and put in the oven until the onion softens. The resulting bitter-sweet liquid (juice) is instilled in 2-3 drops. 7 days to be treated, and the disease will pass.

Onion compresses for otitis media

1. Take a small onion and bake it in ordinary ashes. The bulb should become soft. Now take a thin linen cloth and attach a piece of butter to it, and put an onion on top. Wrap the rag. You have to wait until the temperature of the compress is as hot as you can handle. Then apply to the ear, or so that the bulb is in the ear and hold for 1 minute. Then tie your head with a warm scarf and do not leave the warm room anywhere for several hours. If you do this procedure 2 times a day. The disease passes very quickly.

2. Clear the ear of secretions. Prepare onion juice. Warm the pipette in boiling water and immediately suck onion juice into it. Carefully pour 3-4 drops into the ear. Make a compress. You can put cotton wool moistened with onion juice in a sore ear. Don't forget to remove it when dry. For deep otitis, repeat the procedure several times. At home, for any ear diseases, steam baths from the steam of nettle or yarrow herbs are very effective. Pour 3/4 of water into a sterile bucket. When it boils, throw in a large handful of one of the herbs and remove from heat. To cover with a lid. Choose a comfortable position and start the procedure immediately. Cover your head. Hold the ear over the steam for up to 15 minutes. not more. Steam should not be sharp, hot. After that, you can drip onion juice into your ears. Such steam baths with yarrow are also beneficial for inflammatory eye diseases.

Removing earwax from the ears and relieving ear pain after a cold

Take a linen flap 25 cm long and 4 cm wide, melt the wax in a steam bath (paraffin and candles are worse), dip the flap into the melted wax. When the wax hardens a little, take a knitting needle 3 mm thick and wind the fabric around the knitting needle. Then remove the needle. You should get a tube. One end of the tube must be inserted into the ear, and the other set on fire. When the tube burns out, remove it from the ear. Getting started, you need to take safety measures: cover your hair and shoulders with a towel, choose the angle of the tube so that the melted wax does not get into the ear. This operation is especially effective for sulfur plugs. All the sulfur that accumulates over the years and impairs hearing will “burn out” or be pulled out by fire onto the fabric. If the first time you did not succeed, then you need to repeat the procedure until you get the desired result.

Garlic oil for ear diseases and otitis media

It is especially useful for ear diseases in young children, inner ear infections, oral candidiasis, rashes, genital itching and minor burns. Garlic oil is stored for 3 months in the refrigerator in a dark glass bottle with a tight stopper. Recipe. Fill 3/4 of a glass with finely chopped garlic. transfer to a 0.5 l jar and slowly, in a thin stream, while stirring constantly, pour in 3/4 cup of olive oil. Close the jar with a lid and put it in the sun for 10 days. During this time, gently stir the mixture 2-3 times. On the eleventh day, strain, add 2-3 drops of eucalyptus oil or glycerin, pour into a dark glass bottle with a tight stopper and refrigerate. Instill 3 drops of oil into the ear very slowly and carefully.

Treatment of inflammation of the ears with sophora

Try to be treated with tincture of sophora. 100 g of Japanese Sophora (in crushed form) pour 0.5 liters of vodka. Insist in a dark bottle, in a dark place for one month. Then bury the ears with this tincture. Recovery will come quickly, and you will never have otitis media again.

Laurel from otitis media

Take 5 dry bay leaves and pour them 1 tbsp. boiling water. Bring to a boil, cover with a lid and heat in a water bath for 2 hours. Then leave the broth to cool at room temperature for 45 minutes. After that, strain the broth and squeeze. In a sore ear, you need to drip 8 drops of decoction, and then drink 2-3 tbsp. So do 3 times a day. The course of treatment is 5 days.

In the treatment of otitis, use the following recipes:

a) Cut a hole in a large onion, pour 1 tsp of cumin into it. Close the hole with cotton wool and bake the onion in the oven. Drip the resulting juice into the ears 2-3 drops - for a child, 5-7 drops - for an adult (depending on the severity of the disease) 2-3 times a day.

b) Apply bags with boiled water flowers of elderberry, chamomile or centaury to the ears.

c) Bury a child in a sore ear 2 drops, and an adult - 7-10 drops of juice from fresh basil leaves (2-3 times a day). If you don’t have fresh basil on hand, then you can buy oil from this plants. This oil is an excellent pain reliever, you should definitely have it in your first-aid kit. It will help not only with otitis media, but also with arthritis, sciatica. It is enough to rub the oil into the sore spot, and after a few minutes you will feel relief.

Instillation into the ears is performed only at the first stage of otitis media. Sometimes it happens that such procedures are enough to extinguish inflammation and avoid the formation of pus. General requirement: any drops must be warm, approximately 37 degrees Celsius

Blackroot officinalis treats otitis media

For the treatment of otitis, you can use a plant called black root. Cut 200 g of dry roots and put in a liter bottle or jar. Pour vodka to the top, insist 10 days. With otitis: rub behind the ear more often. You can’t bury it in the ear, you’ll burn it.

Compresses with kombucha treat otitis media

With otitis, compresses with a 10-12-day infusion of kombucha help: moisten gauze, apply it to the parotid region (in front of and behind the ear), cover with polyethylene, cotton wool, wrap with a woolen scarf or scarf. Keep such a compress for 8-9 hours. You can apply a compress with tea vinegar, that is, a 30-day infusion of kombucha. Such a compress is put in the same way as the previous one, and you can keep it all night.

Propolis will remove lumbago in the ears

If during a cold it starts to shoot in the ear, then it is advisable not to delay, but immediately begin treatment. In this case, propolis on alcohol is useful (dissolve 5 g of propolis in 100 ml of alcohol). A flagellum is made from a bandage, dipped in alcohol and inserted into the ear. Lie with that ear up and take a nap. In most cases, everything goes right away.

At the first sign of a backache in the ears, there is another similar recipe:

You need to buy or prepare yourself a 40% propolis tincture so that it is always in your home first aid kit. Mix 1 part of propolis tincture with 4 parts of vegetable (sunflower or olive oil), shake until a light brown emulsion with a pleasant smell is obtained. Shake before use, wet two gauze tubes and insert them into the ears for an hour. In total, 10-12 procedures in one day.

This very effective treatment is also suitable for the prevention of hearing loss.

Beets with honey will remove backache in the ears

When the ear "shoots": Grate red beets on the smallest grater, mix the juice equally with warmed honey and drip half a pipette into both ears. Mix the squeezed beet pulp equally with honey, add flour (preferably rye) and knead a tight cake. Make a hole in the middle of the cake and put it on the ear, spreading the dough around the ear. Top - thin food foil or plastic wrap. Then wrap your ear warmly with a downy shawl or woolen scarf. With such a compress, you can sleep all night. Do this until the pain in the ears completely disappears.

Bay leaf for otitis media

Bay leaf will help from otitis media: 2 tbsp. crushed raw materials pour 0.5 liters of boiling water, leave for about an hour until yellow. In a warm infusion, moisten cotton wool and lay it in the ear. Hold a little, then moisten a clean cotton wool and re-insert into the ear. And so on, while the infusion is warm. Then lay dry cotton wool in the sore ear and tie a scarf. The first two days to do these procedures very often, literally every hour, then less often. After five days, purulent discharge will stop.

Kalanchoe and golden mustache with ear inflammation

Possible reasons

It is believed that any wound resulting from an injury is already infected (it contains bacteria). In order for an infection to develop, several factors are required:

Suppuration of torn-bruised wounds occurs as a result of contamination of crushed tissues and a large number of dead ones. Suppuration of incised wounds is less common (their edges are slightly damaged, the wound channel is often shallow).

the type and location of the wound (less commonly, suppuration develops in the head, cervical region, somewhat more often - on the chest, abdomen, buttocks. Wounds located on the limbs are especially often suppurated);
age and body weight (suppuration occurs less often in young and thin people).

Characteristic symptoms

All manifestations of purulent wounds can be divided into general and local.

greenish or yellowish watery - streptococcus;
yellowish, changing color in the air - Pseudomonas aeruginosa.

General symptoms are due to general intoxication as a result of toxins entering the body from a purulent wound:

body temperature rises;
general weakness;
chills;
headache;
carrying out detoxification measures (to remove toxins from the body, hemodialysis, hemosorption, forced diuresis are used, on an outpatient basis - plentiful drinking);
Vishnevsky's ointments;
tetracycline ointment;

How to cure folk remedies?

If the wound festered, and you do not want to use medications, you can use traditional medicine:

use aloe juice for irrigation of wounds and lotions;
gruel from grape leaves, applied to the wound, will cleanse it of pus during the day (it also has a hemostatic effect);
powder prepared from calamus root can be poured directly onto the wound (has a bactericidal effect);
washed plantain leaves are applied to the wound for 20 minutes (the release of pus from small festering scratches stops and healing begins);
chopped fresh leaves and chamomile flowers are applied to the wound, left for a few minutes. You can prepare a decoction of chamomile, use for lotions. Simultaneously with external use, it is recommended to take an infusion of chamomile inside.

In the presence of purulent wounds, one should refrain from visiting the bath, sauna, swimming pool (in the summer - from swimming and sunbathing). Until the end of the course of treatment, it is not recommended to use essential oils (they can increase the flow of fluid to the affected area).

Prevention measures

treat any scratches, abrasions, cuts and other damage to the skin (with a solution of iodine, brilliant green, hydrogen peroxide, potassium permanganate);
when treating wounds, use sterile instruments;
properly care for the skin;

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Like any other, purulent inflammation is the body's response to the impact of any irritant, aimed at limiting the pathological site, destroying provoking agents and restoring damage.

The inflammatory response consists of three successive phases: injury, swelling, repair. It is the nature of the edema that determines the type of inflammation.

Purulent inflammation develops with the predominance of pathogenic pyogenic bacteria in the edematous fluid (exudate). It can be Pseudomonas aeruginosa and Escherichia coli, staphylo-, gono-, streptococci, Klebsiella, Proteus. The degree of contamination of the lesion with bacteria determines the likelihood and nature of the inflammatory reaction.

Pus is a liquid medium containing in its composition dead blood cells (leukocytes, phagocytes, macrophages), microbes, enzymes (proteases), destroyed and dead tissues, fats, protein fractions. It is the proteases that are responsible for the dissolution of tissues (lysis) in the lesion.

There are the following types of purulent inflammation:

empyema - accumulation of pus in the cavity represented by the walls of the organ;
abscess - a cavity resulting from tissue melting, filled with purulent exudate;
phlegmon - a diffuse purulent lesion of the subcutaneous tissue throughout the vessels, nerves, in the fascia.

Atheroma inflammation

One of the most common benign tumors in the subcutaneous tissues is atheroma. It is formed in the places of the greatest distribution of the sebaceous glands: head, coccyx area, face, neck. Atheroma has the appearance of a rounded formation, is a cavity enclosed in a capsule, containing fat, cholesterol, skin cells.

It occurs as a result of the fact that the excretory duct of the sebaceous gland is clogged. Atheroma can be single, but in most cases there is a multiple distribution of these formations of various sizes. This tumor is painless and, in addition to cosmetic discomfort, does not cause inconvenience.

There are primary (congenital) and secondary atheromas that occur with seborrhea. On palpation, they are dense, moderately painful, have a bluish tint. Secondary tumors are localized on the face, chest, back, neck. After their opening, ulcers with undermined edges are formed.

In ambulatory surgery, atheroma inflammation is a common problem. Predisposing factors for this are the following conditions:

insufficient hygiene;
independent squeezing of acne, especially if antiseptic rules are not followed;
microtrauma (scratches and cuts);
pustular skin diseases;
decreased local immunity;
hormonal disorders;
cosmetic abuse.

Festering atheroma is characterized by soreness, local redness and swelling. At large sizes, fluctuation can be noted - a feeling of fluid flow in an elastic cavity. Sometimes the formation breaks out on its own and fat-like pus is released.

Inflammation of atheroma is treated only surgically. A skin incision is made, the contents are peeled off with the obligatory removal of the capsule. When it is not completely removed, a relapse is possible after the operation. If atheroma is re-formed, inflammation can develop in the same area.

Suppuration of wounds

Wounds arise for numerous reasons: domestic, industrial, criminal, combat, after surgery. But inflammation of the wound is not always purulent. It depends on the nature and location of the damage, the condition of the tissues, age, contamination with microbes.

Factors predisposing to inflammation of the wound surface are as follows:

wound with a contaminated object;
non-observance of hygiene rules;
the use of steroid hormones and / or cytostatics;
excess body weight;
malnutrition;
vitamin deficiency;
elderly age;
decrease in local and general immunity;
chronic skin diseases;
severe somatic diseases;
hot, humid weather;
insufficient drainage of the wound after surgery.

Usually, suppuration of the wound is characterized by the accumulation of purulent inflammatory exudate in the tissue defect. At the same time, hyperemia (redness) and a “warm” edema appear around the edges, due to vasodilation. In the depth of the wound, "cold" edema predominates, associated with impaired lymphatic outflow due to vascular compression.

Against the background of these signs, bursting, pressing pain appears, and the temperature is locally elevated in the affected area. Under a layer of pus, a necrotic mass is determined. Absorbed into the blood, decay products, toxins cause symptoms of intoxication: fever, weakness, headaches, loss of appetite. Therefore, if inflammation of the wound occurs, treatment should be immediate.

Suppuration of postoperative sutures

The process of inflammation of the postoperative suture occurs, as a rule, on the 3rd-6th day after surgical procedures. This is due to the ingress of pyogenic microorganisms into the site of tissue damage. Bacteria can be brought into the wound primarily (by the subject of injury, poorly processed instruments, by the hands of medical personnel and / or the patient himself) and indirectly from the focus of chronic infection: caries, tonsillitis, sinusitis.

Predisposing factors to the development of the pathological process in the suture area:

insufficient disinfection of medical equipment;
non-compliance with the rules of asepsis, antisepsis;
reduced immunity;
poor drainage of wound discharge;
damage to the subcutaneous tissue (hematomas, necrosis);
low-quality suture material;
non-compliance with hygiene by the patient;
areas of ischemia (lack of blood supply) due to clamping of the vessel ligature.

If inflammation of the suture has developed, then symptoms such as redness and swelling of the skin around, soreness will be observed. First, serous fluid mixed with blood can separate from the suture, and then suppuration occurs.

With a pronounced process of inflammation, fever with chills, lethargy, refusal to eat appear.

A festering surgical suture should be treated only under the supervision of a physician. Incorrect independent actions can lead to the spread of infection, deepening of inflammation and the development of formidable complications up to sepsis. In this case, a rough tortuous scar is formed.

Purulent lesions of the skin and subcutaneous tissue

Pathological processes in the skin and underlying layers are very common in surgical practice. The skin and its appendages are the body's first protective barrier against various adverse effects.

Negative factors provoking the development of skin inflammation are the following:

mechanical damage (scratches, abrasions and cuts, scratches);
exposure to high and low temperatures (burn, frostbite);
chemical agents (household alkalis, acids, abuse of antiseptics and detergents);
excessive sweating and sebum secretion can cause purulent inflammation of the skin;
poor hygiene (especially in obese people);
diseases of internal organs (pathologies of the endocrine, digestive systems;
ingrown nail.

Purulent inflammation of the skin and subcutaneous tissue can be caused by microbes introduced from the outside, and / or representatives of opportunistic flora. Suppurations of the skin are diverse in terms of localization and clinical course.

Furuncle

Suppuration of the hair follicle and sebaceous gland - furuncle. It can be localized in areas of the skin where there is hair. Occurs at any age. Most common in diabetic and/or obese patients.

Clinical manifestations are expressed in typical inflammation: hyperemia, pain, increased local temperature, swelling. Sometimes this condition is accompanied by a reaction of closely spaced lymph nodes.

Complications of furunculosis can be lymphadenitis, abscess, thrombophlebitis (inflammation of the veins), phlegmon, reactive purulent arthritis, sepsis, meningitis.

Carbuncle

Carbuncle is an acute infectious inflammation of several hair follicles with sebaceous glands at the same time. It occurs more often in adults and the elderly. Endocrine disorders play an important role in the development of this inflammation. Typical localization is the back of the neck, back, abdomen, buttocks.

At the site of infection, a dense diffuse edema occurs, the skin becomes purple and painful. There is a necrotic fusion of tissues. The carbuncle is opened in several places, creamy pus is released. The lesion with such inflammation of the skin looks like a honeycomb.

Hydradenitis

Inflammation of the sweat glands occurs mainly with uncleanliness, diaper rash, scratching. In the first place among the provoking factors is shaving the armpits. There are microtraumas of the skin, and the use of deodorant contributes to blockage of the excretory ducts of the glands.

In the area of the armpit, a dense, painful tubercle is formed, the skin becomes purple-cyanotic. As the inflammation develops, the pain intensifies and interferes with movement. There is a fluctuation, the skin in the center becomes thinner, and thick pus breaks out.

With the spread of inflammation to other areas, due to the abundance of lymphatic tissue, a conglomerate of nodes with protruding papillae of the skin is formed - “bitch's udder”. If treatment is not carried out, the process can spread - an abscess or phlegmon is formed. A formidable complication of hidradenitis is sepsis.

Abscess

A cavity of a purulent-necrotic nature, limited by a capsule, is an abscess. It often occurs as a complication of inflammation, pustular diseases on the skin.

The cause of the development of a purulent cavity can be inflammation of a stab wound or injection site, when the outflow of pus is impaired.

Clinically, the abscess is manifested by edema and hyperemia of the skin in the affected area. In the depths of the tissues, a densely elastic painful formation is palpated. The skin over the abscess is hot to the touch. Symptoms of intoxication appear.

When opening an abscess and incomplete emptying or the presence of a foreign body in the cavity, the walls of the capsule do not fully close, and a fistula is formed. A breakthrough of pus can occur on the skin, into the surrounding tissues, into the cavity of the organs.

Phlegmon

A purulent-necrotic process of inflammation, located in the cellular space, without clear boundaries. The causes of phlegmon are the same as with an abscess.

In connection with the development of aesthetic medicine, the formation of phlegmon can be provoked by corrective procedures: liposuction, the introduction of various gels. The places of localization can be any, but the areas of the abdomen, back, buttocks, and neck are more likely to become inflamed. Not uncommon - damage to the tissues of the leg.

Gradually melting the tissues, the phlegmon spreads through the fiber, fascial spaces, destroying the vessels and provoking necrosis. Often phlegmon is complicated by an abscess, hydradenitis, furuncle.

Paronychia and felon

Panaritium - inflammation of the soft tissues, bones and joints of the fingers, less often the foot. Pain with panaritium can be unbearable, deprive of sleep. At the site of inflammation - hyperemia and swelling. With the development of the process, the function of the finger is disturbed.

Depending on the localization of the lesion, panaritium can be of different types:

skin - the formation of suppuration between the epidermis and the following layers of the skin with the formation of a "bubble";
subungual - flow of pus under the nail plate;
subcutaneous - purulent-necrotic process of the soft tissues of the finger;
articular - damage to the phalangeal joint;
tendon - suppuration of the tendon (tendovaginitis);
bone - the transition of a purulent process to the bone, proceeding according to the type of osteomyelitis.

Paronychia - damage to the roller near the nail. The nail bed can become inflamed after a manicure, cutting the cuticle. There is a throbbing pain, redness, separation of pus in this condition.

Treatment

Purulent inflammation of the soft and other tissues of the body deals with surgery. If symptoms appear that indicate a purulent lesion, be sure to consult a doctor. Self-treatment is fraught with the spread of the process and aggravation of the situation. The main directions of treatment:

antibacterial therapy with the use of local anti-inflammatory agents (ointments, solutions) and systemic drugs (Penicillin, Ceftriaxone, Clindamycin, Vancomycin);
antitoxic therapy (intravenous glucose, saline solutions, forced diuresis);
treatment of concomitant chronic pathologies;
immunocorrection (introduction of vaccines, serums, toxoids);
diet food with the exception of simple carbohydrates, flour, fatty, fried and salty;
vitamin therapy;
primary and secondary surgical treatment of wounds (excision and removal of dead tissue, washing and drainage);
physiotherapy after surgery (UVI, laser therapy, magnetic field treatment).

For surgical treatment of wounds, the following methods are used:

physical (laser radiation, plasma flows, vacuum treatment of the inflammation zone);
chemical (various enzyme preparations: Trypsin, Chymotrypsin, Lysosorb);
biological (removal of necrotic tissues by larvae of green flies).

With conservative therapy, the following drugs are used:

antiseptics (Povidone-iodine, Miramistin, Etacridine, Chlorhexidine);
water-soluble ointments (Dioxidin, Methyluracil);
creams (Flamazin, Argosulfan);
draining sorbents (collagenase);
aerosols (Lifuzol, Nitazol).

In the period of regeneration (healing) after surgery, the following means are used:

dressings with antibacterial ointments (Levomekol, Tetracycline, Pimafucin), stimulants (Vinilin, Actovegin, Solcoseryl);
special wound dressings against inflammation and for healing (Vokopran);
preparations based on natural polymers (Algipor, Kombutek).

Purulent inflammation of various parts of the body is common and has many different forms. The course of the process can be smooth or bring terrible complications leading to death. Therefore, treatment should be approached comprehensively and the full range of prescribed therapeutic measures, preventive measures to prevent the secondary occurrence of the disease should be carried out.

Purulent inflammation

It is characterized by the formation of serous cell exudate with a predominance of leukocytes (neutrophils). Neutrophils disintegrating in tissues (in a state of dystrophy and necrosis) are called bottom bodies. Serous exudate and purulent bodies form purulent exudate.

Pathogenesis. Associated with the damaging effect of pyogenic factors on the neurovascular apparatus and physico-chemical parameters in the focus of inflammation, increased porosity of the vessels of the microvasculature and active emigration of leukocytes - the formation of purulent exudate.

Depending on the localization, there are:

The accumulation of pus under the epidermis is called a pustule, purulent inflammation of the hair follicle, the sebaceous gland with adjacent tissues is called a furuncle.

The course can be acute and chronic.

Focal purulent inflammation with the formation of a cavity filled with pus.

Macroscopically has the appearance of an inflamed focus of a rounded shape, has a dense texture with a tense surface and a fluctuation in the center. In chronic course, a connective tissue capsule is formed, an encapsulated abscess is formed. At autopsy, a limited cavity with pus and a purulent membrane surrounding it of a dark red, reddish-yellow or gray-white color are found. The consistency of pus is thick, creamy (benign) or has the appearance of a cloudy watery liquid with a small content of purulent bodies (malignant). There may be fistulas around the abscess, or fistulas.

Microscopically characterized by the presence in inflammatory foci of hypremic vessels and purulent infiltrates, leukocytes with their transformation into purulent bodies, young connective tissue cells - granulation tissue - fibrous connective tissue membrane, dystrophic and necrotic processes in altered cellular and tissue elements.

This is an accumulation of pus in the natural cavity of the body (pericardial, pleural, abdominal, articular, etc.) as a result of purulent inflammation of its serous membranes (purulent pericarditis, pleurisy, peritonitis, etc.).

Macroscopically pus of different consistency is found in the cavity. The serous membranes are unevenly reddened, dull, swollen, ulcerated, with punctate and spotted, sometimes striped hemorrhages and a purulent mass on the surface.

Microscopically note the plethora of vessels of the serous membrane, exudation and emigration of leukocytes and diapedesis of erythrocytes, stratification of connective tissue fibers with purulent exudate, the presence of infiltrates consisting of purulent bodies, histeocytes and macrophages, individual lymphocytes, desquamated mesothelial cells.

Acute diffuse (diffuse) purulent inflammation, in which purulent exudate spreads between tissue elements. It develops in organs with loose connective tissue (muscle tissue, under the capsule and in the stroma of organs, mucous membranes, etc.)

Macroscopically It has the appearance of a diffuse swelling that does not have clear boundaries of a doughy (soft phlegmon) or dense (hard phlegmon) consistency of a bluish-red color. A cloudy, purulent liquid flows from the cut surface. Dead tissue is gradually shed.

Microscopically note inflammatory hyperemia, the accumulation of purulent exudate between the expanded tissue elements, cell necrosis and the breakdown of connective tissue and muscle fibers (Zenker necrosis of skeletal muscles).

Meaning and outcome. There may be complete or incomplete tissue regeneration. Or under adverse conditions, encapsulation.

Purulent inflammation on the skin

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Medical reference book → Purulent inflammation on the skin

- why these problems arise, how to treat them and how to treat them, we will talk in this article.

Stages of purulent inflammation on the skin

Inflammatory diseases of a purulent nature have two stages of development:

In this case, the second stage in terms of the prevalence of the process can be gangrenous, phlegmous or abscessing.

Types of purulent inflammations on the skin

Consider the main purulent skin diseases.

Furuncle. The hair follicle during the period of acute purulent inflammation involves surrounding tissues (for example, adipose tissue or sebaceous gland) into it. The cause of this disease is most often staphylococcus aureus or white, penetrating deep into the injured areas of the skin (abrasions, wounds, cracks). If only one hair follicle is inflamed, they usually talk about folliculitis (these include sycosis of the beard, teenage acne). Furuncles that appear in the plural are called furunculosis.

Serous inflammation quickly develops into a necrotic stage: first, a hyperemic skin tubercle appears, touching which is very painful, and the intensity of the pain is increasing. After two or three days, the boil increases to the maximum, the purulent pustule inside bursts. If you remove the crust, a whitening purulent-necrotic core will be visible. The next 3-5 days, the necrotic area is rejected and a scar is formed at the site of the wound.

At the initial stage of the development of a boil, a doctor can prescribe antibiotics and antiseptics, it is also recommended to treat the problem area locally: with alcohol, iodine, apply bandages containing antiseptics, the focus of inflammation can be chipped with a solution of antibiotics and novocaine, UHF therapy is indicated.

After "ripening", the boil is opened, the rod is removed, and then dressings with proteases are used, with a sorbent - hypertonic solution. It will not be superfluous to use an ointment for purulent wounds on a hydrophilic basis (for example, levomekol, reparef-1 and others). You can speed up the process of rejection of the rod by locally acting on it with powders with salicylic acid.

Surgeons do not recommend using ichthyol ointment for boils: it can clog the sweat and sebaceous glands and contribute to the spread of the inflammatory process. In case surgery is needed, ichthyol must be removed from the skin, and this is not easy and rather painful.

A furuncle is not just a pimple that can be cured with Vishnevsky ointment. This disease can become dangerous at any time, leading to sepsis or meningitis. In no case do not postpone a visit to the doctor if a boil appears on the face!

Carbuncle. Several hair follicles, located nearby, are drawn into acute purulent inflammation of the surrounding sebaceous glands and fatty tissue. The pathogenesis and etiology of boils and carbuncles are similar: these are related diseases, the difference lies in the number of affected hair follicles.

The purulent focus of the carbuncle opens after “ripening” with numerous holes, from where purulent-necrotic masses come out, from above it resembles a honeycomb.

The main difference between a carbuncle and a boil is the general condition of the patient. Almost always there is weakness, fever up to degrees, sleep disturbance, leukocytosis. Pain of high intensity, skin color is blue-purple, lymphadenitis or lymphangitis is often manifested, thrombophlebitis is possible. The most dangerous carbuncles appear in the head and face.

Carbuncle is always treated in a hospital, patients are prescribed antibacterial detoxification therapy. At the first stage of the development of this disease, doctors tend to give the inflammation an abortive course, the methods of treatment are almost the same as for a boil.

The purulent-necrotic stage requires surgical intervention. After excision of tissues affected by necrosis, swabs containing sodium chloride, 10%, are placed on the wound. The ointment that draws out pus helps well: dioxicol, levomekol and others. Vishnevsky's ointment, the use of which was very popular not so long ago, is now used less frequently.

A timely visit to the doctor with the development of a carbuncle will protect you from a lot of unpleasant consequences.

Abscess. Focal purulent inflammation of the tissues causes them to melt, after which the so-called pyogenic capsule is formed, which separates the purulent masses from healthy organs and tissues.

The cause of an abscess is also often staphylococcus aureus, as well as Proteus, Escherichia or Pseudomonas aeruginosa, and other microorganisms. In most cases, an abscess develops in muscle tissue or under the skin, although it can form in any tissue or organ due to infection through a hematoma, injury, purulent process, gray. Foreign bodies and injections can also contribute to the appearance of an abscess.

If the necessary measures are not taken in time, the abscess will progress, the purulent cavity may break through, the consequences are unpredictable.

The serous-infiltrative stage of the abscess involves antibiotic treatment, physiotherapy, compresses help well, it is possible to use a short novocaine blockade with antibiotics. Surgical treatment is required at the purulent-necrotic stage of abscess development, while general anesthesia is used. In the postoperative period, in addition to other drugs and procedures prescribed by the doctor, it is advisable to use ointments that have a dehydrating effect, this is again levomekol. During regeneration, biostimulants are indicated: helium-neon laser, metabolites, various multicomponent ointments, physiotherapy.

Phlegmon. Acute purulent inflammation occurs in adipose tissue, and, unlike an abscess, this inflammation has an unlimited character. The pathogenesis and etiology of abscess and phlegmon are almost identical.

The exudative inflammatory process quickly becomes purulent-necrotic, the fiber undergoes purulent or putrid fusion, while there is no purulent capsule that could prevent the penetration of inflammation into other tissues and organs.

Patients with phlegmon are, as a rule, in a serious condition: intoxication, leukocytosis, throbbing pain of high intensity, signs of septic shock, edema. Treatment of phlegmon is carried out only in a hospital, before surgery, infusion therapy is performed.

After the operation, drainage and tamponade (as with an abscess), intensive antibiotic therapy, increased immunity, and general detoxification of the body are indicated. Despite the high level of modern science, the likelihood of deaths with phlegmon remains.

Treatment of purulent inflammations on the skin

For the treatment of harmless purulent diseases, it is necessary to decide which ointment is able to draw out pus and which ointment is advisable to apply in the case of interest to you.

Balsamic liniment according to Vishnevsky is a drug traditionally used to treat such problems. Its main component is birch tar. On the one hand, it is able to improve blood circulation in tissues affected by a purulent disease, it can dry, soften and disinfect the desired areas. Most often, Vishnevsky's ointment is applied to tampons, dressings or compresses to treat wounds and ulcers. A gauze bandage with this ointment will help the maturation of the abscess, you need to keep it for 8-10 hours, then dry the skin and wipe it with alcohol.

On the other hand, Vishnevsky's ointment for boils or acne can help by accelerating spontaneous opening if the abscess is close to the surface and the wound has not yet formed. In such cases, the erupted furuncle heals quickly. But if the focus of purulent inflammation is located deep in the subcutaneous tissue, then there is a risk of involving nearby tissues in the pathophysiological process. Modern doctors (and especially surgeons) strongly advise not to engage in any self-treatment, but immediately go to the doctor.

Ichthyol ointment, the use of which we have already briefly considered above, has the same properties as Vishnevsky's ointment, has similar pros and cons. It is applied to the damaged area, a gauze bandage is applied over it (it can be glued with a plaster), then left for a while. A categorical contraindication for the use of both drugs is only individual intolerance to any of its components.

Historically, it so happened that for the treatment of boils and similar purulent skin diseases, people most often use traditional medicine.

A short list of folk remedies for pulling pus:

baked onion
baked onion + grated laundry soap
cabbage leaf
beeswax
warm salt baths
aloe leaf
essential oils of chamomile and lavender

What can be said in conclusion? This article is intended for a thoughtful reader who understands well that in the event of any purulent skin disease, first of all, you should consult a doctor.

What is purulent inflammation called?

TREATMENT FOR INFLAMMATORY PROCESSES. ASEPTIC AND PURULENT PROCESSES

Clinically, inflammation is manifested by five signs: redness, swelling, pain, fever (fever) and impaired function. These symptoms are due to changes in the nervous system, blood vessels, cellular elements and humoral environment.

The vascular reaction is accompanied by the expansion of blood and lymphatic vessels, the functioning of the smallest vessels, which were empty in healthy tissue.

The liquid part of the blood that goes beyond the blood vessels fills the interstitial gaps and spaces, leading to the formation of swelling. The inflammatory exudate contains not only the liquid part of the blood, lymph, but also a significant number of cells of vascular (vasogenic) and tissue (histiocytes) origin, as well as proteins (albumin, globulins, fibrinogen). As a result, osmotic and oncotic pressure increases in the lesion.

Pain is caused by the accumulation of acid products of impaired metabolism, increased interstitial pressure, and exposure to protein breakdown products.

Forms and nature of inflammation. According to the predominance of one or another process, inflammation can be exudative, proliferative, alternative. Based on the severity of protective-adaptive and compensatory-restorative processes, the general and local reactions of the body, norm-ergic, hyperergic and hypoergic inflammation are distinguished.

Normergic inflammation is characterized by the fact that a normal reaction occurs to a common stimulus, the nervous system functions normally, and destruction processes are minimally manifested with pronounced protective processes.

Hyperergic inflammation proceeds rapidly with a predominance of destructive processes over regenerative-restorative ones and is observed in a sensitized organism.

Hypoergic inflammation proceeds with a weak severity of general and local responses and does not correspond to the strength of the impact. It is observed in animals with impaired metabolism, old, emaciated, etc.

By localization, inflammation can be superficial and deep, limited, diffuse and progressive.

According to the duration of the course, inflammation can be acute (lasting 1-2 weeks), subacute (two to four weeks) and chronic (more than four weeks).

Inflammation is divided into aseptic and infectious. By the nature of the exudate, aseptic inflammation can be serous, fibrinous, serous-fibrinous, hemorrhagic, ossifying. Infectious inflammation can be purulent, putrefactive, specific infectious (actinomycosis,1 botryomycosis, tuberculosis, etc.) and anaerobic.

Serous inflammation develops after moderate mechanical, physical, chemical trauma. It is accompanied by the formation of serous exudate. Liquid, transparent or slightly turbid serous exudate contains a small amount of blood cells and local tissue cells, metabolic products and cell decay, as well as 3-5% protein.

Fibrinous inflammation occurs with more severe tissue damage and anatomical formations lined with synovial, serous membranes (joint, tendon sheath, abdominal cavity, etc.). The exudate contains many formed elements and fibrin.

Serous-fibrinous inflammation is observed when anatomical cavities (joints, tendon sheaths, synovial bags, etc.) are damaged and is characterized by the presence of fibrin flakes in the serous exudate.

Purulent inflammation is accompanied by the formation of purulent exudate (pus). Purulent exudate is a cloudy liquid of gray, grayish-white, yellowish-gray, grayish-green liquid or creamy consistency. Pus contains a huge number of living and dead leukocytes, various cells of the reticuloendothelial system and cells of dead tissue. In pus, living and dead microbes, cell decay products, various enzymes released during cell destruction and secreted by microbes, proteins and their decay products, salts, etc. are found.

Therapeutic measures in inflammatory processes. Treatment for inflammatory processes should be aimed at identifying and eliminating the causes, normalizing the course of inflammation, activating protective and regenerative processes, stimulating the overall defenses of the body and the activity of all its systems.

Treatment of acute aseptic inflammation. Give rest to the sick animal and the affected organ during the first hours. The animal must be released from work, transferred to a stall, provided with a separate machine with plentiful soft bedding; apply immo-bilizing cotton-gauze dressings.

In the first hours after the onset of the disease, cold is prescribed. It reduces pain, slows down the development of inflammatory edema. Cold procedures are prescribed intermittently to prevent hypothermia of the body and the development of venous congestion. For therapeutic purposes, cold compresses, foot baths, dry cold (heaters, bags of ice, snow), cold clay are prescribed. Cold is combined with a moderate pressure bandage (if the area of \u200b\u200bthe body allows). This prevents an abundant exit of blood, lymph in the tissue and reduces pain.

From the second day, heat is prescribed. Thermal procedures reduce pain, improve blood circulation, and accelerate the resorption of exudate. Soprevayuschie compresses, hot compresses, hot baths, paraffin therapy, various physiotherapy procedures (light therapy, electrotherapy) are used. On the 4-5th day, with a decrease in pain, massage is prescribed along with thermal procedures. Massage accelerates the resorption of inflammatory exudate, enhances blood circulation and improves metabolic processes in the tissues of the pathological focus, reduces the pain response.

In the treatment of acute aseptic inflammatory processes, pathogenetic therapy is used (povocaine blockade, intravenous administration of novocaine solution).

Treatment of chronic aseptic rights of the process. Therapeutic measures are aimed at improving blood and lymph circulation and resorption of the inflammatory infiltrate, proliferate. For this purpose, massage, thermal procedures, cauterization, irritating ointments and liniments are used.

Treatment of acute purulent inflammation. In the first 1-2 days, the animal is given rest and locally wet-drying alcohol dressings, warming compresses are prescribed. Widely used means of etiological therapy (antibiotics, chemical antiseptics) and pathogenetic therapy (novocaine blockade).

If it is not possible to interrupt the development of the inflammatory process and there is an accumulation of purulent exudate in separate foci, then they resort to surgical treatment - opening the lesion and removing the purulent exudate.

surgical infection. There are purulent, putrefactive, anaerobic and specific (actinomycosis, brucellosis, necrobacteriosis, etc.) surgical infections

Purulent infection. The causative agents of purulent infection in animals are aerobic microbes (staphylococci, streptococci, Pseudomonas aeruginosa, Escherichia coli, etc.). They constantly live on the skin and mucous membranes of animals, on harness and animal care items. Various traumatic injuries of the skin and mucous membranes contribute to the penetration of microbes into the animal's body.

In animals, the clinical development of a purulent infection often manifests itself in the form of an abscess, phlegmon, furuncle, carbuncle, purulent arthritis, purulent myositis, etc., and less often in the form of sepsis.

Putrid infection. The causative agents of putrefactive infection are facultative anaerobes. They grow and multiply on dead tissues with a lack of oxygen; they do not penetrate into healthy tissues. A putrefactive infection is characterized by putrefactive decay of dead tissues with the formation of a fetid exudate of a gray-bloody, gray color. This foul-smelling exudate is called ichorous. Putrefactive microbes often develop simultaneously with staphylococci, streptococci, and anaerobic infections. Most of the causative agents of putrefactive infection do not release toxins, but due to their high enzymatic ability, they actively break down the proteins of dead tissues Putrid infection develops in wounds with extensive tissue damage with the formation of niches and pockets, as well as the ability to penetrate and develop endogenously with intussusceptions, intestinal strangulation, and wounds .

With a putrefactive infection, a strong inflammatory edema develops, the affected tissues become flabby black-brown in color. The animal is depressed, the body temperature rises significantly, disturbances in the cardiovascular system (frequent weak pulse, deafness of heart tones) are noted.

In the treatment of wounds, pathological processes complicated by putrefactive infection, dead tissues are removed, oxygen is provided with long wide incisions and the cavities are washed with strong oxidizing agents (3% hydrogen peroxide solution, 1-3% potassium permanganate solution). Carry out general antiseptic and symptomatic treatment.

anaerobic infection. Anaerobic infection is caused by pathogens from the so-called group of four. These pathogens are soil anaerobes and are ubiquitous, constantly living in the intestines, on the body of the animal. They are found in large numbers in manure, soil contaminated with animal feces, etc. Under adverse conditions, these microbes form spores that can remain outside the body for years.

Anaerobic infection develops as a complication of gunshot, bruised and lacerated wounds, and sometimes with minor damage to the skin and mucous membranes, after intramuscular injections of solutions and vaccines.

Anaerobic microbes that enter the wound may develop; only under certain conditions: 1) in the presence of crushed tissue in the wound, insufficient blood supply to this area due to vascular damage and lack of oxygen; 2) if the surgical treatment of the wound is performed after 10-12 hours from the moment of injury, foreign bodies are left in the wound, pockets, niches are not eliminated, tight tamponade is applied; 3) in the absence of immobilization in case of wounds, fractures of the limbs.

Usually, anaerobic surgical infection develops relatively rarely.

Clinical signs of anaerobic infection in most cases appear on the 2-3rd day. The animal's body temperature rises, the pulse quickens. The inflammatory process develops rapidly and progresses rapidly. Local temperature is increased only at the beginning of the disease, and then decreases due to vascular thrombosis and compression by inflammatory edema. A gray liquid exudate with an unpleasant odor is plentifully released from the wound.

Tissue edema during anaerobic infection spreads rapidly and reaches a significant size. Often the development of infection is accompanied by the formation of gases. With the development of intoxication, the pulse quickens, weakens, and the body temperature decreases, which is an unfavorable sign.

Clinically, anaerobic infection, depending on the predominance of the development of one or another microbe, can take a gaseous, edematous, or mixed form.

The prognosis for anaerobic infections in most cases is unfavorable.

For treatment, it is necessary to open the focus with several wide deep incisions and provide oxygen access, exudate drain. The wound is washed with strong oxidizing agents (1-2% potassium permanganate solution, 3% hydrogen peroxide solution), tampons and dressings are not used on the wound. Carry out general antiseptic therapy.

Prevention of anaerobic infection is the timely and thorough surgical treatment of wounds. Animals with an anaerobic infection must be isolated, and when processing them, observe personal prevention measures. With extensive and crushed wounds, they resort to specific prophylaxis by administering anti-ganlrenous serum.

It is characterized by the formation of serous cell exudate with a predominance of leukocytes (neutrophils). Decaying in the tissues of neutrophils (in a state of dystrophy and necrosis) are called bottom bodies. Serous exudate and purulent bodies form purulent exudate.

Depending on the localization, there are:

Abscess

empyema

Phlegmon

The accumulation of pus under the epidermis is called a pustule, purulent inflammation of the hair follicle, the sebaceous gland with adjacent tissues is called a furuncle.

The course can be acute and chronic.

Abscess.

Focal purulent inflammation with the formation of a cavity filled with pus.

Empyema.

Phlegmon.

Macroscopically It has the appearance of a diffuse, not having clear boundaries of swelling of a doughy (soft phlegmon) or dense (hard phlegmon) consistency of a bluish-red color. A cloudy, purulent liquid flows from the cut surface. Dead tissue is gradually shed.

Meaning and outcome. There may be complete or incomplete tissue regeneration. Or under adverse conditions, encapsulation.

An abscess (abscess, abscess) is a purulent inflammation, accompanied by tissue melting and the formation of a cavity filled with pus. It can be formed in muscles, subcutaneous tissue, bones, internal organs or in the surrounding tissue.

abscess formation

Abscess Causes and Risk Factors

The cause of an abscess is a pyogenic microflora that enters the patient's body through damage to the mucous membranes or skin, or is introduced with blood flow from another primary focus of inflammation (hematogenous route).

The causative agent in most cases becomes a mixed microbial flora, which is dominated by staphylococci and streptococci in combination with various types of coli, for example, Escherichia coli. In recent years, the role of anaerobes (clostridia and bacteroids), as well as associations of anaerobic and aerobic microorganisms in the development of abscesses, has significantly increased.

Sometimes there are situations when the pus obtained during the opening of an abscess, when sown on traditional nutrient media, does not give rise to microflora. This indicates that in these cases the disease is caused by uncharacteristic pathogens, which cannot be detected by conventional diagnostic methods. To a certain extent, this explains the cases of abscesses with atypical course.

Abscesses can occur as an independent disease, but are more often a complication of some other pathology. For example, pneumonia can be complicated lung abscess, and purulent tonsillitis - paratonsillar abscess.

With the development of purulent inflammation, the body's defense system seeks to localize it, which leads to the formation of a limiting capsule.

Forms of the disease

Depending on location:

subphrenic abscess;
paratonsillar;
peripharyngeal;
soft tissues;
lung;
brain;
prostate;
periodontal;
intestines;
pancreas;
scrotum;
Douglas space;
appendicular;
liver and subhepatic; and etc.

Subcutaneous tissue abscesses usually end in complete recovery.

According to the features of the clinical course, the following forms of abscess are distinguished:

Hot or spicy. It is accompanied by a pronounced local inflammatory reaction, as well as a violation of the general condition.
Cold. It differs from the usual abscess in the absence of general and local signs of the inflammatory process (fever, redness of the skin, pain). This form of the disease is characteristic of certain stages of actinomycosis and osteoarticular tuberculosis.
Leaky. The formation of a site of accumulation of pus does not lead to the development of an acute inflammatory reaction. The formation of an abscess occurs over a long period of time (up to several months). It develops against the background of the osteoarticular form of tuberculosis.

Abscess symptoms

The clinical picture of the disease is determined by many factors and, above all, by the location of the purulent process, the cause of the abscess, its size, and the stage of formation.

Symptoms of an abscess localized in superficial soft tissues are:

puffiness;
redness;
sharp soreness;
an increase in local, and in some cases, general temperature;
dysfunction;
fluctuation.

Abscesses of the abdominal cavity are manifested by the following symptoms:

intermittent (intermittent) fever with a hectic type of temperature curve, that is, subject to significant fluctuations during the day;
severe chills;
headache, muscle and joint pain;
lack of appetite;
severe weakness;
nausea and vomiting;
delay in passing gases and stools;
tension in the muscles of the abdominal wall.

When an abscess is localized in the subdiaphragmatic region, patients may be disturbed by shortness of breath, cough, pain in the upper abdomen, aggravated at the time of inspiration and radiating to the shoulder blade and shoulder.

With pelvic abscesses, reflex irritation of the rectum and bladder occurs, which is accompanied by the appearance of tenesmus (false urge to defecate), diarrhea, frequent urination.

Retroperitoneal abscesses are accompanied by pain in the lower back, the intensity of which increases with flexion of the legs in the hip joints.

The symptoms of a brain abscess are similar to those of any other volumetric formation (cysts, tumors,) and can vary over a very wide range, ranging from a minor headache to severe cerebral symptoms.

A lung abscess is characterized by a significant increase in body temperature, accompanied by severe chills. Patients complain of pain in the chest, worse when trying to take a deep breath, shortness of breath and dry cough. After the opening of the abscess in the bronchus, a strong cough occurs with abundant sputum discharge, after which the patient's condition begins to improve rapidly.

Abscesses in the oropharynx (retropharyngeal, paratonsillar, peripharyngeal) in most cases develop as a complication of purulent tonsillitis. They are characterized by the following symptoms:

severe pain radiating to the teeth or ear;
sensation of a foreign body in the throat;
spasm of the muscles that prevents the opening of the mouth;
soreness and swelling of regional lymph nodes;
increase in body temperature;
weakness;
nasal voice;
the appearance of an unpleasant putrefactive odor from the mouth.

Diagnosis of an abscess

Superficially located abscesses of soft tissues do not cause difficulties in diagnosis. With a deeper location, it may be necessary to perform an ultrasound and / or diagnostic puncture. The material obtained during the puncture is sent for bacteriological examination, which allows to identify the causative agent of the disease and determine its sensitivity to antibiotics.

Abscesses of the oropharynx are detected during an otolaryngological examination.

Abscesses can occur as an independent disease, but more often they are a complication of some other pathology. For example, pneumonia can be complicated by a lung abscess, and purulent tonsillitis can be complicated by a paratonsillar abscess.

Diagnosis of abscesses of the brain, abdominal cavity, and lungs is much more difficult. In this case, an instrumental examination is carried out, which may include:

Ultrasound of the abdominal cavity and small pelvis;
magnetic resonance or computed tomography;

Abscess treatment

In the initial stage of development of an abscess of superficial soft tissues, anti-inflammatory therapy is prescribed. After maturation of the abscess, it is opened, usually on an outpatient basis. Hospitalization is indicated only in severe general condition of the patient, the anaerobic nature of the infectious process.

As an aid in the treatment, as well as for the prevention of complications of subcutaneous fat abscesses, it is recommended to use Ilon ointment. The ointment should be applied to the affected area under a sterile gauze bandage or patch. Depending on the degree of suppuration, the dressing should be changed once or twice a day. The duration of treatment depends on the severity of the inflammatory process, but, on average, to obtain a satisfactory result, you need to apply the ointment for at least five days. Ointment Ilon K is sold in pharmacies.

Treatment of lung abscess begins with the appointment of broad-spectrum antibiotics. After receiving the antibiogram, the antibiotic therapy is adjusted taking into account the sensitivity of the pathogen. If there are indications, in order to improve the outflow of purulent contents, bronchoalveolar lavage is performed. The ineffectiveness of conservative treatment of an abscess is an indication for surgical intervention - resection (removal) of the affected area of the lung.

Treatment of brain abscesses in most cases is surgical, as they can lead to dislocation of the brain and cause death. A contraindication to the removal of abscesses is their localization in deep and vital structures (subcortical nuclei, brain stem, thalamus). In this case, they resort to puncturing the abscess cavity, removing the purulent contents by aspiration, followed by washing the cavity with an antiseptic solution. If multiple flushing is required, the catheter through which it is passed is left in the cavity for a while.

Prevention

Prevention of the development of abscesses is aimed at preventing the entry of pathogenic pyogenic microflora into the patient's body and includes the following measures:

careful observance of asepsis and antiseptics during medical interventions, accompanied by damage to the skin;
timely conduct of primary surgical treatment of wounds;
active rehabilitation of foci of chronic infection;
increasing the body's defenses.

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