Treatment of purulent wounds
In the hydration phase, which is characterized by the delimitation 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 quickest cleaning of the wound.
The following must be ensured.
1. Rest of 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 transfusion of small amounts of blood, improving nutrition, the introduction of staphylococcal toxoid, hyperimmune serums, etc.
5. Creating the maximum outflow of wound contents by wide opening of the purulent foci and draining it.
6. Careful attitude to tissues, wound dressings, as trauma leads to a breakthrough of microbes into the internal environment of the body, absorption of toxins, which is manifested by a sharp increase in temperature, chills, worsening of well-being.
7. In the presence of purulent-necrotic tissue, preparations are shown that can lyse (destroy) non-viable tissue. 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 copious purulent discharge). Enzyme preparations, due to their necrolytic and anti-inflammatory effects, significantly reduce the phase of wound hydration. They are faster cleared of dead tissue and covered with healthy juicy granulations, which allows you to switch to using ointment dressings or to apply 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 microbes in the discharge are sharply reduced, the wound is cleaned of decay products and is filled with granulations. Measures to protect them from injury and secondary infection, i.e. dressings with an indifferent ointment. At this time, dressings with hypertonic, antiseptic solutions cannot be used, since they damage granulation, as a result of which wound healing is delayed.
The art of applying dressings for centuries took shape in a special science - desmurgy. It is important to apply a bandage conveniently and correctly, not only during first aid to the victim, but also during treatment, as this contributes to the faster healing of wounds and reduces the suffering of patients. In recent years, to keep the gauze and topically applied drugs on the wound, a special dressing has been constructed from the Retelast elastic net. It is made of gum and cotton thread and is produced in the form of stocking tape in seven sizes (from 0 to 6), which allows you to quickly apply a bandage to almost any part of the body.
In the treatment of patients with a purulent process, it is important to determine the nature of the general condition disorders and to carry out measures that increase the body's reactivity in case of an insufficient, sluggish reaction and lower it in case of an excessively violent reaction. At the same time, care must be taken to maintain and restore the function of the affected organ. The periods of immobilization and rest should not be delayed, replacing them in the dehydration phase with dosed ones, with gradually expanding volumes of physiotherapy exercises and physiotherapeutic procedures.