FLEGMONA NON-CROATIC NEWBORN

FLEGMON NECROTIC NEWBORN - acute purulent inflammation of the skin and subcutaneous tissue in children of the first weeks of life. The causative agent is the golden hemolytic staphylococcus.

Typical localization phlegmon - lumbosacral, gluteal, interblade area, lateral and anterior thoracic surface. The disease begins sharply with an increase in body temperature to 38 - 40 ° C. Rapidly growing toxicomics, anxiety is replaced by lethargy, the child refuses to eat. Frequent, shallow breathing, tachycardia , muffling of heart sounds are revealed. The skin acquires a gray color, a marble pattern appears on it. There is a limited area of ​​hyperemia and denseness, which is painful on palpation. The skin here is hot to the touch, not going to folds. After 8-12 h, the affected area of ​​the skin increases 2-3 times, its color acquires a cyanotic hue, there is a swelling of the tissues along the periphery. Gradually, a softening appears in the center of the infiltration site. In some cases, skin necrosis occurs, its rejection with the formation of extensive wound defects. The bottom of the wound is gray with the remains of dead fiber, the edges are dug, uneven, granulation is absent.

Treatment is surgical. Under local or general anesthesia, multiple cuts of the skin are made in checkerboard pattern over the lesion and along the border with healthy skin. On the entire surface of the lesion, a bandage with a hypertonic solution and an antiseptic (furacilin, dioxidin) is applied for 2 to 3 hours. For subsequent bandages, the necrotic process is spread and additional incisions are made according to the indications. Later, ointment dressings, ultraviolet irradiation, UHF therapy are used. Intensive care is provided, which includes detoxification, antibacterial and immunostimulating measures.

With a favorable course of the process of rejection of the dead skin, a small wound is formed, which gradually becomes filled with granulations.