Phlegmon

Phlegmon - purulent inflammation of tissues with a tendency to progress. Depending on the layers that affect the phlegmon, talk about the subcutaneous, subfacial and intermuscular phlegmon. Phlegmon can also form in the mediastinum, retroperitoneal tissue, thoracic and abdominal walls. The causative agent of infection is streptococci, anaerobic and putrefactive microorganisms.

The entrance gate of infection is often a wound. Initially, there is serous tissue infiltration locally, but on the 2nd-3rd day (depending on the type of microbial associations) serous-purulent (streptococci), purulent (staphylococci) or ichorous (putrefactive infection) are separated. The area of ​​infection and neighboring tissues are infiltrated, edematous, the skin is hyperemic. There is pain and soreness in palpation in the same area. If we do not take appropriate measures (extensive incisions for opening connective tissue spaces, removing pus and necrotic tissues), then the inflammatory necrotic process will progress. In some cases, the course of the disease can be fulminant with rapid progression of inflammation, septic events, there may be a risk of artery arteries (bleeding), purulent thrombophlebitis and pulmonary embolism.

Treatment operative, as a rule, under anesthesia. During the operation, all the wounds must be opened, necrotic tissue is excised, the wound must be well drained.

Woody phlegmon (phlegmon Reclus) is the result of infection with weakly virulent microorganisms of the bottom of the mouth and oropharynx. Characteristic is the appearance of a painless, "hard as a board," infiltration of the soft tissues of the neck. When the incision is determined gelatinous tissue and a small amount of dark exudate.

Putrefactive phlegmon is a particularly severe form of the disease. The most important pathogens are Escherichia coli, Proteus, Anaerobes. During the first day there is an increase in temperature, pain and the formation of serous exudate, then quickly joins the necrosis of tissues, resulting in putrefactive decay, hence severe toxic effects. The secret of the wound becomes dirty brown, gets an unpleasant smell. If gas production is detected in the putrefactive secret, they speak of a gas phlegmon (not to be confused with an anaerobic gas infection). Putrefactive phlegmon of the abdominal wall often arises after operations on the colon, imposing unnatural anus, colostomy.

Treatment of putrefactive phlegmon presents significant difficulties. Need for wide cuts, good drainage of the wound, thorough daily dressings with revision of the wound (there may be relapses). The prognosis for a normal phlegmon is favorable. When putrefactive phlegmon is always very serious.