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Treatment of purulent wounds


In the phase of hydration, which is characterized by separation and melting of dead cells and tissues and the presence of an active inflammatory process, it is important to suppress the activity of microorganisms and contribute to the rapid cleansing of the wound.
It is necessary to ensure the following.
1. Rest to the affected organ (immobilization, rare dressings).
2. The use of antiseptic substances both locally in the wound, and inside or intramuscularly.
H. Detoxification of the body.
4. Stimulation of immunobiological reactions, primarily by enhancing the phagocytic activity of leukocytes, which is achieved by transfusions of small amounts of blood, improving nutrition, the introduction of staphylococcal toxoid, hyperimmune serums, etc.
5. Creation of the maximum outflow of wound contents by wide dissection of the suppurative focus and its drainage.
6. Careful treatment of tissues and wounds caution ligation, as the injury leads to the breakthrough of microbes in the internal environment of the body, absorption of toxins, which is manifested by a sharp increase in temperature, chills, deterioration of health.
7. In the presence of purulent-necrotic tissues, drugs capable of lysing (destroying) non-viable tissues are shown. As such agents, proteolytic enzymes of animal and bacterial origin are used, applied topically in the form of solutions or powder (in the presence of abundant purulent discharge). Enzyme preparations due to their necrolytic and anti-inflammatory effects significantly reduce the phase of wound hydration. They are cleared more quickly from dead tissue and covered with healthy juicy granulations, which allows you to switch to the use of ointment dressings or to the imposition of an early secondary suture.
When inflammation subsides and regeneration develops, therapeutic measures should mainly be aimed at enhancing this process. In this phase (dehydration), a strong wound barrier has already been created, the number and virulence of the microbes in the discharge is drastically reduced, the wound is cleared of decomposition products and filled with granulations. Showing measures to protect them from injury and secondary infection, i.e. dressings with indifferent ointment. At this time, it is impossible to apply dressings with hypertonic, antiseptic solutions, since they damage granulations, as a result of which wound healing is delayed.
For centuries, the art of dressing was shaped into a special science - desmurgia. It is convenient and correct to apply a bandage not only for first aid to the injured, but also during treatment, since this contributes to the rapid healing of wounds and reduces the suffering of the sick. In recent years, a special dressing made from elastic net "retastast" has been designed to hold gauze and topical medications used locally on the wound. It is made of gum and cotton thread and produced in the form of a stocking tape of seven sizes (from 0 to 6), which allows you to quickly apply a bandage on almost any part of the body.
In the treatment of patients with a purulent process, it is important to determine the nature of violations of the general condition and to take measures to increase the body's reactivity with an insufficient, sluggish reaction and lowering it with an excessively violent reaction. At the same time, care must be taken to preserve and restore the function of the affected organ. The terms of immobilization and dormancy should not be delayed, replacing them in the dehydration phase with metered, with gradually expanding volumes of physical therapy and physiotherapeutic procedures.