Acute purulent diffuse inflammation of cellular spaces (subcutaneous, intermuscular, retroperitoneal, etc.). In contrast to the abscess process has no clear boundaries. Pathogens are usually staphylococci and streptococci, but can also be caused by other pyogenic microbes that penetrate cellulose through accidental damage to the skin, mucous membranes, or the hematogenous route. Phlegmon can also be caused by the introduction under the skin of various chemicals (turpentine, kerosene, gasoline, etc.). It is an independent disease, but it can be a complication of various purulent processes (carbuncle, abscess, sepsis, etc.). The inflammatory exudate spreads through the tissue, passing from one fascial to the other through the openings for the vascular-first bundles. Pushing the tissues apart, squeezing and waving and destroying the vessels, pus leads to tissue necrosis.
By the nature of the exudate emit serous purulent, purulent-hemorrhagic and putrid forms of phlegmon. Depending on the location, epi - and subfascial (intermuscular) are distinguished.
A number of localizations phlegmon bears special names. Thus, the inflammation of the periephric cellulose is called paranephritis, the near-intestinal cellulose is paraproctitis, etc. The subcutaneous cellulose is most often inflamed, which is associated with its weak resistance to infection and frequent injuries.
Symptoms and course:Characterized by the rapid appearance and spread of painful swelling, spilled redness of the skin over it, high temperature (40 ± C and above), pain, impaired function of the affected part of the body. Further, the swelling turns into a dense infiltrate, which then softens and a symptom of fluctuation appears. For phlegmon is usually heavy.
Often there are malignant forms, when the process progresses rapidly, capturing large areas of subcutaneous, intermuscular tissue and is accompanied by severe intoxication.
In case of secondary development of phlegmon (osteomyelitis, purulent arthritis, purulent pleurisy, peritonitis, etc.), it is necessary to identify the main disease.
Phlegmon that has arisen in the first place can lead to a number of complications (lymphadenitis, lymphangitis, erysipelas, thrombophlebitis, sepsis, etc.). The extension of the process to the surrounding tissue leads to the development of purulent arthritis, tendovaginitis and other purulent diseases. Face phlegmon may be complicated by progressive thrombophlebitis of the face and purulent meningitis.
Treatment:Patients with phlegmon must be hospitalized. At the beginning of the disease, conservative treatment is permissible: bed rest is prescribed, rest is provided for the patient's limb, large doses of antibiotics are administered intramuscularly, abundant drinking, milk-vegetable diet, heart remedies, and painkillers are prescribed. The tissues around the cellulitis are cut off with a solution of antibiotics in novocaine, locally - dry heat, UHF. The process may stop: an abscess or a limited phlegmon. The treatment is completed by dissection and drainage.
With progressive phlegmon, delaying surgery is unacceptable. If there is no improvement after surgery and general treatment, the presence of a local or general complication should be suggested (further progression of cellulitis, thrombophlebitis, erysipelas, purulent leakage, septic condition).
In severe condition due to the threat to the life of the patient is rare, but it may be necessary to amputation of the limb.