Abscess

Absces.JPG (4213 bytes) Limited accumulation of pus in tissues and various organs.

The cause is the penetration into the tissues of pyogenic microbes (through abrasions, injections, wounds). Microorganisms can get in the result of accidental wounds or are recorded during medical manipulations (injections, subcutaneous injections), performed without observing the rules of asepsis.

The abscess can develop in case of acute purulent inflammation of any organ (lung), skin and subcutaneous tissue, in particular, in case of furunculosis, carbuncle, phlegmon, lymphadenitis, etc. It can form on the spot of hemorrhage or hematoma (suppuration of the hematoma). Frequent abscesses due to hematogenous metastasis with a common purulent infection (metastatic abscesses). When the substances that cause necrosis, such as turpentine, kerosene, etc., enter the tissue, an "aseptic" abscess appears.

Symptoms and course.

Abscesses, which can be caused by all kinds of microflora, vary in size and location. Usually occur in the center of an inflammatory infiltrate, only metastatic abscesses are located far from the main inflammatory focus. The shape of their cavity is from simple rounded to complex with numerous pockets and blind strokes. Above the abscess are visible swelling and redness (redness) of the skin, which is not observed only when it is deeply located. In acute inflammation, the symptom of fluctuation, or swelling, is very important. It is explained by the presence of fluid (pus), enclosed in a cavity with elastic walls, which transmit a shock in the form of a wave in all directions. Symptom is absent, when the wall is very thick, and the abscess is small and is in the depth. Confirm the diagnosis can be a trial puncture of the cavity with a thick needle for the presence of pus.

With a chronic abscess, the above signs of acute inflammation may be almost completely absent. With metastatic abscesses, the severity of the condition is due to underlying suffering. Sores of subcutaneous tissue usually flow favorably. Breakthrough abscess in any cavity (joint, pleura, etc.) is a serious complication. Especially dangerous are the abscesses located in the internal organs (liver, lungs) and near the large veins. Possible consequences of their breakthrough are purulent pleurisy, peritonitis or the passage of inflammation to the vein wall with the development of progressive thrombophlebitis.

Treatment.

Purulent-inflammatory processes (before the formation of a purulent cavity) are treated with conservative methods, local and parenteral use of antibiotics. Small abscesses with malovirulent flora can be cured by repeated punctures with suction of pus and administration of a solution of antibiotics. The indications and urgency of the operation are determined by the degree of intoxication. With a small abscess can be limited to a single incision, repeated ones are required with a significant accumulation of pus and swells. The incisions must correspond to the direction of the skin folds, and on the limbs - be determined by the lines of flexion of the joints, i.e. By its position and size ensure a good outflow of pus. Deep abscesses are opened with a preliminary trial puncture. After getting pus from the needle, it is left in place as a conductor, along which the incision is made. Patients with an abscess with a pronounced general reaction are hospitalized in a purulent surgical department.