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Bursitis


Inflammation of periarticular mucous bags, the causative agent of which may be any pyogenic microbes, but more often staphylococci and streptococci. Conditions for their development creates a chronic injury. In this regard, individual bursitis (elbow, shoulder, etc.) are classified as occupational diseases. Microbes penetrate into the mucous bags of small skin abrasions or through the lymphatic pathways from a purulent focus that has arisen near (furuncle, carbuncle, osteomyelitis). Under the influence of mechanical irritation, serous accumulates, and with the addition of infection purulent exudate, the bag gradually stretches, reaching the size of a large tumor.
When serous effusion in the round cavity of the mucous bag contains a viscous liquid yellow, rich in protein. Initially, the walls of the cavity are thin and without pronounced inflammatory changes. But gradually they become thicker due to the proliferation of connective tissue, protrusions and cords form, and chronic bursitis develops.
In case of purulent exudate, an acute inflammatory process occurs, which, upon necrosis of the bag wall, moves to the surrounding soft tissues with the formation of subcutaneous or intermuscular phlegmon. The skin above the swelling is swollen, inflammatory, its temperature is elevated. Palpation marked tenderness. The function of the nearby joint is not limited, the movements are painless. General symptoms are absent or slightly expressed.
The course is chronic with periods of exacerbation. With the spontaneous opening of the abscess, a long non-healing fistula remains.
Treatment:
The patient limb is immobilized. In order to accelerate the resorption of exudate, dry heat, UHF, dressings with Vishnevsky ointment, etc. are used. Antibiotics are administered. In some cases, with prolonged treatment, puncture the cavity with suction of the exudate and the introduction of antibiotics into it.
In case of purulent bursitis, surgery is indicated - opening the abscess of the mucous membrane of the bag and removing the pus with subsequent rehabilitation of the wound. Healing usually occurs extremely slowly, for a long time a serous-purulent fluid is released from the wound.
It is more rational to resort to removing the mucous bag without opening its lumen. The incision is made on the side of the bag, the wound is left open or sewn up after the preliminary introduction of antibiotics into the cavity.