) and suppuration of wounds (2-10%) are a consequence of their infection, which is facilitated by poor hemostasis and tissue injury. These complications often develop on the 4-6th day after surgery, and sometimes at a later date.

Infiltrate postoperative suture and abscesses are located above or below the aponeurosis.

Clinical picture and diagnosis of infiltration of the postoperative suture. By palpation in the area of ​​the postoperative incision, a painful compaction with unclear contours is found. The skin over it is hyperemic. Skin temperature is increased.

Treatment of postoperative suture infiltration. Infiltrates abdominal wall subject to conservative treatment. Prescribed with a wide spectrum of action. The wound is blocked with a 0.25-0.5% solution of novocaine with antibiotics, and physiotherapeutic treatment is performed.

Suppurating wounds are opened wide and subsequently treated taking into account the phases of the wound process. After cleaning the wounds, secondary sutures (early or late) are applied. Early secondary sutures are applied on the 8-15th day after surgery on granulating wounds with moving edges. Late secondary sutures are used at a later date for suturing slowly healing wounds with scar tissue that has developed in them. The edges and bottom of the wound are first sparingly excised.

The article was prepared and edited by: surgeon

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Every person has undergone surgery at least once in their life. Operation is perceived need, which relieves pain and discomfort, and often saves lives. Is it any wonder that complex operations sometimes accompanied by various kinds of complications, the most common of which is postoperative infiltration. What is this condition and why is it dangerous? How to identify infiltration and how to treat it? We will answer all your questions.

What is postoperative infiltration

The term infiltrate comes from two words “in” - “in” and “filtratus” - “strained”. Already from the name you can understand that infiltration is painful lump, which occurs at the site of surgery due to the accumulation of elements of blood cells and lymph. The cause of the accumulation of biological fluids is a violation of the integrity of tissues during surgery and subsequent infectious infection due to a decrease in tissue resistance to infections.

Forms of postoperative infiltration

Doctors usually divide infiltration into two forms - inflammatory and tumor. In the first case, lymph and blood particles accumulate in the tissues. This is the most common complication after the operation. However, another form is much more dangerous - tumor, in which not harmless blood and lymph accumulate in the tissues, but actual tumor cells, often malignant. However, sometimes infiltrate refers to swelling that occurs at the site of administration of an antibiotic, anesthetic or other drug in the liquid form. This infiltration is usually called post-injection or “surgical”.

Causes of postoperative infiltration

The complication in question can develop in any person, regardless of gender and age, for example, in a child after a banal tooth extraction, in an adult man who has had his appendix removed, or in a woman who has had genital surgery. The main reasons for this complication include:

• infection that has entered the wound;
• injuries to the operated area;
• layer damage subcutaneous tissue during surgery;
• improper installation of drainage (in overweight patients);
• rejection of suture tissue by body tissues (if the inflammatory process appears several months after the operation, the suture material is to blame).

Other reasons for the appearance of infiltration include allergic reactions of the body, too weakened immunity, as well as chronic or congenital diseases that the person being operated on suffered from.

Why is infiltration dangerous?

Inflammatory postoperative infiltrate has become almost a common occurrence, because it appears in every 5th operated person. Perhaps this is why to many ordinary people such a complication seems frivolous and harmless. However, this impression is deceptive. If detected early and in a timely manner measures taken It’s really very simple to fix the problem, but if you waste time and don’t see a doctor, the infiltrate can develop into an abscess, which can result in an abscess breaking through and blood poisoning. And this is an extremely dangerous condition that threatens the patient’s life! What can we say about the tumor form of the infiltrate, which can even threaten the patient? cancer. Thus, any symptoms of a developing infiltrate should be immediately reported to the attending physician, who will take all necessary measures to eliminate this dangerous condition and will not allow complications.

Symptoms of postoperative infiltration

As a rule, complications after surgery do not occur immediately, on about 5-6 days, and sometimes even after one and a half to two weeks. In this case, a person may notice the following signs of a developing inflammatory process:

• a swelling appears at the site of infiltration, which turns red and attracts attention with mild itching;
• a low temperature appears (lasts literally for several days, but it is impossible to bring it down);
• pressing on the inflamed area is accompanied by pain;
• with strong pressure, a noticeable dimple is formed at the point of pressure, which gradually straightens.

Very often, postoperative infiltration occurs after surgery to remove inguinal hernia. In this case, the following unpleasant symptoms signal a developing complication:

• digestive problems appear (usually constipation);
• suffer from aching pain in the abdominal area;
• the skin around the scar becomes red, inflamed and swollen;
• Boils may appear on the inflamed area of ​​skin.

In addition, if a postoperative infiltrate occurs at the site of removal of the inguinal hernia, the patient may complain of frequent headaches and rapid heartbeat.

Post-injection infiltrate

Separately, it is worth mentioning the infiltrate that occurs as a result of the injection, which externally resembles a small lump that appears at the site of drug administration. The reason for this condition is often the lack of professionalism of the medical staff. That is, post-injection infiltrate can occur:

• if incorrect antiseptic treatment before the injection;
• when administering the medicine constantly in the same place;
• when using a needle that is too short or too blunt;
• if the injection site is chosen incorrectly;
• when too rapid introduction medicines.

Finally, we cannot exclude the fact that some people are predisposed to such mini-complications. In some people, infiltration occurs after each insertion of a needle under the skin, while other people never encounter such a condition in their entire lives.

Diagnosis of postoperative infiltration

It will not be difficult for an experienced doctor to identify the infiltrate. As a rule, after examining a swelling with fuzzy and uneven edges, the doctor asks the patient about the intensity of pain and the presence of low-grade fever. However, there are cases when the infiltrate is hidden deep in the tissues, and it is not possible to detect it during a visual examination. In this case, if the patient complains about elevated temperature and aching pains he must be prepared for informative methods diagnostics - ultrasound or computed tomography.

In addition, when an infiltrate is detected, doctors are required to perform another unpleasant but mandatory procedure, namely, a biopsy, since it is important to identify the nature of the cells accumulated in the compaction and exclude a malignant tumor. Only after this the specialist prescribes treatment measures.

Treatment of postoperative infiltrate

The main task of a doctor faced with an infiltrate is to relieve the inflammatory process and prevent the development of an abscess. In this regard, it is necessary to relieve swelling, restore blood flow in the affected area and eliminate pain.

If the infection is caused by bacteria, specialists prescribe antibiotics, and in addition to them, painkillers and anti-inflammatory drugs. In some cases, physiotherapeutic procedures and local hypothermia (artificial temperature reduction) cannot be avoided. Laser therapy, ultraviolet irradiation of the wound, and even mud therapy are well suited to eliminate infiltration. Such procedures are contraindicated only in one case, when a purulent process has begun to develop in the compaction. In such a situation, heating will only accelerate the spread of infection and lead to an abscess.

As soon as the first signs of an abscess appear, doctors drain the exudate or simply open the abscess using laparotomy or laparoscopy. If the postoperative suture itself is inflamed, the doctors' actions are exactly the same - treatment with antibiotics, the use of painkillers and physiotherapy. If such measures do not help, the suture is opened, cleaned of pus, disinfected and sewn back up.

Treatment of infiltration at home

Of course, with recipes alone traditional medicine infiltration is difficult to cure. And the risk of triggering the disease by causing blood poisoning should also stop the patient from self-medicating. However, as an adjunct to primary therapy, Alternative medicine shows itself at its best the best side. The main thing is not to forget to consult a doctor before using this or that product.

To eliminate the infiltrate that appeared due to an unsuccessful injection by a doctor, you can use the usual white cabbage. Just cut the fresh one with a knife cabbage leaf and place it on the resulting lump, securing it on top with polyethylene and a bandage. The next morning you will notice that the size of the swelling has become smaller. Apply this compress at night until the swelling disappears completely.

An alternative way to solve the problem is a cottage cheese compress. To prepare it, just hold the curd mass in a water bath for about 5 minutes, then mold the curd into a cake and place it on the swelling, securing it with gauze on top.

Honey will be an excellent remedy for resolving infiltrate. Just mix a spoonful of liquid honey with egg yolk, and add to this mixture a piece butter. Having molded the ingredients into a cake, apply it to the inflamed area overnight, securing it as in previous recipes.

In case of infiltration due to mastitis, help will come watermelon pulp. After heating the red pulp of the watermelon in a water bath, apply it to your chest, covering it with cellophane and a scarf on top. You just have to remember that mastitis - dangerous disease, which means that such therapy must be coordinated with a mammologist.

Infiltration can appear in any person. In itself, such a tumor is not harmful, but without treatment it can cause severe purulent inflammation and lead to unpleasant consequences, which will threaten health and even life. In addition, the insidiousness of the infiltrate is that it may not develop immediately, but months or even years after surgery, manifesting itself as inflammation of the scar. This is why it is important to know the signs of this dangerous complication and do not delay contacting a doctor if you suspect you have an infiltrate.
Good health to you!

Postoperative suture infiltration

We will tell you about the lump that may occur after surgery.

Introduction (or possible post-operative complication)

Carrying out any operation requires following certain rules, every movement and manipulation is of great importance for a person’s life. The rehabilitation period after surgery is also especially important, during which the patient’s strength is restored. Unfortunately, there are also consequences of a sad kind, the so-called complications that require eradication in as soon as possible. One type of such complications can be considered postoperative infiltration.

Postoperative suture infiltration

What is postoperative infiltration?

The infiltrate of the postoperative suture is felt by the patient as a compaction on the skin in the suture area.

Infiltrate (according to adapted data from Wikipedia from Lat. in- “in” and Middle Ages. Lat. filtratio, “filtering”) is a substance that has leaked (and accumulated there), soaked into the tissue (into an environment unusual for it) (cellular elements with admixture of blood and lymph). The term is unusual for the average person to hear, although postoperative infiltration is the most common complication during surgery.

So, why is infiltration dangerous?

Its appearance is associated with the body’s low resistance to infections and viruses penetrating from outside. The body, weakened by disease and surgery, needs recovery, which is impossible without the use of certain rehabilitation methods.

Period of occurrence of infiltration

Suture infiltration often occurs at the site of infection skin after operation. Its appearance can range from two days to two weeks, depending on the degree of infection. However, there are cases when inflammation occurs postoperative scar(even years later) and the infection process may begin. This of course requires intervention qualified specialist(How to find him? Find out by phone: 8-918-55-44-698 ).

Dangerous for every patient

If you don't start timely treatment inflammation, then you may encounter the development of a more dangerous process. The age group at risk for complications is very different (both children and adults), since no one is immune from the operation. It is also important to point out that in any particular case, the manifestations of suture damage vary, because everyone’s body is unique and reacts to inflammation in its own way. Some recover faster, some slower.

Clinical manifestations

Patients experiencing development postoperative complications, may complain of itchy pain in the wound area, fever and general weakness. The skin over the affected area may or may not be red. Sometimes you can observe swelling of the skin.

Factors causing infiltration

The causes of suture infiltration are also varied:

1. Penetration of infection;
2. Weak immunity;
3. Damage to the subcutaneous tissue layer during surgery;
4. Chronic diseases of the patient;
5. Rejection of suture tissue by the body;
6. Improper wound drainage (often found in overweight people).

Remember! All reasons are individual for each individual patient.

Types of postoperative infiltration

Suture infiltration has varieties:

1. Inflammatory. There may be accumulation of blood and lymph in the tissues.

It is worth noting that this type is the most common and, according to doctors, the most “insidious”. What is this connected with? Also with its classification:

- purulent;

- hemorrhagic;

— lymphoid;

- histiocytic-plasma cell.

2. Tumor. In this case, formation may occur at the site of the postoperative suture. cancer cells, which in most cases are malignant;

3. Post-injection. This type complications are associated with the occurrence of swelling after the administration of any anesthetic or injection that can cause allergic reaction. Observed at varying frequencies.

The occurrence of an abscess

The most dangerous consequence can be considered a rapid inflammatory process or an inflammatory process complicated by the development of suppuration - an abscess. At untimely treatment a rupture of the abscess in the area of ​​the postoperative suture is possible, which can provoke the penetration of pus into the patient’s blood. And this is a direct threat to human life.

A specialist will help

Providing quality medical care is the key to preserving human life. Since the occurrence of suture infiltration occurs after surgery, maximum efforts are required from any specialist to prevent its development. You need to be especially careful when rehabilitation period, and also need to be aware of individual characteristics the body of each patient. Since some patients who have strong immunity are less prone to complications.

Diagnostic measures

The patient himself may notice the appearance of a lump on the skin after discharge. But in conditions medical institution a doctor's examination is required. He can use the method of palpation (feeling the tumor) and, if necessary, perform a tissue biopsy. When especially difficult cases inflammation, it is important to conduct an ultrasound or CT scan.

Treatment of infiltrate

Treatment of postoperative suture infiltration is recommended to be carried out under supervision experienced specialist(which one exactly? We will try to suggest - 8-918-55-44-698 ). To stop the inflammatory process, doctors can use methods of physiotherapy, ultraviolet irradiation of the wound (contraindicated when suppuration develops), and also widely use anti-inflammatory and painkillers medical supplies. All of them are used according to the decision of a specialist and only in clinical settings.

Infiltrate abdominal cavity characterized by an unnatural compaction of accumulated blood, lymph, and human cells. This is a section of living tissue, characterized by the existence of cellular elements usually unusual for it, increased in size and with strong density; and sometimes a tissue area infiltrated with some substance introduced artificially: antibiotics, alcohol, anesthetic solutions. Often the infiltrate begins after the introduction of a subcutaneous or intramuscular injection, when the main factors of its formation are the following:

• incorrectly chosen injection site;
• administering an injection using a blunt needle;
• performing several injections in the same place;
• using the wrong needle to give injections, i.e. hypodermic or intramuscular injections you need to select short needles;
• neglect of the rules of asepsis.

Infiltration is the accumulation of cellular elements mixed with lymph and blood in the tissues of the body. In many cases, an infiltrate in the form of a tumor and inflammation is observed.

The tumor infiltrate is structured from tumor cells of different types and is a manifestation of infiltrating tumor enlargement. When an infiltration seal forms, the tissue changes color, expands in volume, becomes denser, and can become painful.

The inflammatory infiltrate consists of many morphonuclear leukocytes, erythrocytes, lymphoid cells, histiocytes and plasma cells. These types of infiltrates can melt and disappear, but only with the formation of a cavity, abscess or scar. Infiltration in the abdominal cavity occurs the following types: lymphoid, inflammatory, post-infectious, tumor, postoperative infiltrate.

Etiology of the phenomenon

Infiltration in the abdominal cavity is mainly a consequence of certain diseases caused by the inflammatory process. Due to excess blood or lymph content in internal organs human there is a process of accumulation of biological fluids. This kind of fluid may contain blood elements, proteins, minerals, extinct cells, painful microorganisms that cause inflammation in humans. Based on the composition of the liquid, there is the following division:

• serous, fluid from blood serum;
• hemorrhagic, that is, bloody fluid;
• fibrinous, from leukocytes;
• purulent fluid.

There are cases when, if appendicitis is not removed in a timely manner, a tumor appears with internal inflammation, as well as cases of detection of postoperative infiltration of the abdominal cavity several weeks after surgery. In these cases, the cause of the formation of seals is the use of anesthetics, the use of antibiotics, alcohol, etc. Infiltration of the scar can be facilitated by the use of low-quality threads for sutures after operations, even after a couple of years. In cases of distribution malignant tumors tissues grow, increase in volume, forming a painful tumor infiltrate. Various infectious diseases, characterized by a decrease immune system humans, can lead to lymphoid compactions of the abdominal organs.

Symptomatic manifestations

Symptoms characterizing the progression of abdominal infiltrate are:

• stupid, It's a dull pain in the abdominal area;
• the appearance of a dent when pressed, straightening rather slowly;
• increased body temperature;
• problems associated with the digestive process;
• constipation, bowel dysfunction;
• swelling of the affected area of ​​the body;
• redness of the affected area;
• overfilling blood vessels blood;
• the appearance of nodes mixed with lymph and blood;
• in particular severe cases fever is noted.

Depending on what disease the patient develops, the manifestations of this pathology can be very different. If you notice the above symptoms, you should immediately consult a doctor for examination.

Diagnostic measures

Diagnosis of abdominal infiltration involves identifying the cause, conditions, as well as the period of limitation for the onset of the disease. The following factors can indicate the veracity of the diagnosis: the patient’s body temperature, clear contours of the infiltrate, strong painful sensations when examined by hand, there is no pus in the compacted part of the body.

During the examination, you should pay attention to the following symptoms:

• mild intoxication;
• the appearance of unexpressed dents when pressed, such signs may well signal the presence of a disease.

Often, purulent foci in the places where the seals are located prevent the diagnosis of infiltration. By using histological examination the nature and type of the disease can be detected. Infiltration due to appendicitis is determined during examination by a doctor, which does not require special examination. If there is a suspicion of abscess formation, then an echographic examination is mandatory, which can accurately determine the structure of the infiltrate, as well as cystic formations in the form of capsules containing purulent liquid.

Principles of treatment

Treatment of abdominal cavity infiltration is carried out by combining physiotherapeutic and anti-inflammatory medicines. In cases where purulent appearance the infiltrate forms phlegmon, then it is carried out surgery without fail. And if there is no pus in the infiltration or is present in small quantities, then a physiotherapeutic method of treatment is used, which promotes the resorption of the seal, and an anti-inflammatory and analgesic method to eliminate pain.

Anti-inflammatory therapy is effective in cases of infiltration without pus and promotes normal blood circulation in the compacted area and eliminates congestion.

When we're talking about about purulent form, methods with a thermal effect are prescribed only on the fifth day after UHF therapy or SUF irradiation. In this case, antibiotic electrophoresis plays an antibacterial role, and calcium electrophoresis is prescribed to delineate the source of inflammation. Tumor or purulent formations require surgery and application conservative method treatment including:

• physiotherapy;
• local hypothermia;
• taking antibiotics;
• compliance with bed rest.

Therapy of appendiceal infiltrate is carried out only under inpatient clinical conditions. Typically used antibacterial drugs, it is important to follow the diet prescribed by your doctor and limit physical activity. This treatment usually requires 2 weeks. To prevent the subsequent occurrence of such symptoms, the doctor recommends surgery to remove the appendix after 3 months.

When the cavity around the appendix is ​​filled with purulent fluid, an operation is performed to extract the pus, but the appendix is ​​not removed. The patient recovers after the appendix is ​​removed several months after surgery to drain the pus.

What is Inflammatory infiltrate

To indicate similar forms inflammatory diseases Many authors use the terms “incipient phlegmon”, “phlegmon in the infiltration stage”, which are contradictory in meaning, or generally omit the description of these forms of the disease. At the same time, it is noted that forms of odontogenic infection with signs of serous inflammation of the perimaxillary soft tissues are common and in most cases respond well to treatment.

With timely initiation of rational therapy, it is possible to prevent the development of phlegmon and abscesses. And this is justified from a biological point of view. Overwhelming majority inflammatory processes should end and undergo involution at the stage of swelling or inflammatory infiltrate. The option with their further development and the formation of abscesses, phlegmon is a disaster, tissue death, i.e. parts of the body, and when spreading purulent process into several areas, sepsis - often death. Therefore, in our opinion, inflammatory infiltrate is the most common, most “expedient” and biologically based form of inflammation. In fact, we often see inflammatory infiltrates in the perimaxillary tissues, especially in children, with pulpitis and periodontitis, regarding them as reactive manifestations of these processes. Variants of the inflammatory infiltrate are periadenitis and serous periostitis. The most important thing for a doctor in assessing and classifying these processes (making a diagnosis) is recognizing the non-purulent stage of inflammation and the appropriate treatment tactics.

What causes Inflammatory infiltrate

Inflammatory infiltrates constitute a group diverse in etiological factors. Studies have shown that 37% of patients had traumatic genesis diseases, in 23% the cause was an odontogenic infection; in other cases, infiltrates occurred after various infectious processes. This form of inflammation is observed with the same frequency in all age groups.

Symptoms of Inflammatory Infiltrate

Inflammatory infiltrates occur both due to contact spread of infection (per continuitatum) and the lymphogenous route when a lymph node is damaged with further tissue infiltration. The infiltrate usually develops over several days. The temperature of patients can be normal or low-grade. In the affected area, swelling and compaction of tissues occur with relatively clear contours and spread to one or more anatomical areas. Palpation is painless or slightly painful. Fluctuation is not detected. The skin in the area of ​​the lesion is of normal color or slightly hyperemic, somewhat tense. All soft tissues of this area are affected - skin, mucous membrane, subcutaneous fat and muscle tissue, often several fascia included in the infiltrate lymph nodes. That is why we prefer the term “inflammatory infiltrate” over the term “cellulite,” which also refers to such lesions. The infiltrate can resolve into purulent forms of inflammation - abscesses and phlegmons, and in these cases it should be considered as a prestage of purulent inflammation, which could not be stopped.

Inflammatory infiltrates may have a traumatic origin. They are localized in almost all anatomical parts of the maxillofacial region, somewhat more often in the buccal and area of ​​the floor of the mouth. Inflammatory infiltrates of post-infectious etiology are localized in the submandibular, buccal, parotid-masticatory, submental areas. The seasonality of the occurrence of the disease is clearly visible (autumn-winter period). Children with an inflammatory infiltrate are often admitted to the clinic after the 5th day of illness.

Diagnosis of Inflammatory infiltrate

Differential diagnosis of inflammatory infiltrate carried out taking into account the identified etiological factor and duration of the disease. The diagnosis is confirmed by normal or low-grade fever body, relatively clear contours of the infiltrate, absence of signs of purulent melting of tissues and sharp pain on palpation. Other, less pronounced, distinctive features serve: absence of significant intoxication, moderate hyperemia of the skin without revealing tense and shiny skin. Thus, the inflammatory infiltrate can be characterized by a predominance of the proliferative phase of inflammation of the soft tissues of the maxillofacial area. This, on the one hand, indicates a change in the reactivity of the child’s body, on the other, serves as a manifestation of natural and therapeutic pathomorphosis.

The greatest difficulties for differential diagnosis represent purulent foci localized in spaces delimited externally by muscle groups, for example in the infratemporal region, under m. masseter, etc. In these cases, an increase in symptoms acute inflammation determines the process forecast. In doubtful cases, the usual one helps diagnostic puncture lesion.

At morphological study A biopsy from the inflammatory infiltrate reveals cells typical of the proliferative phase of inflammation in the absence or a small number of segmented neutrophilic leukocytes, the abundance of which characterizes purulent inflammation.

Infiltrates almost always contain accumulations of yeast and filamentous fungi of the genus Candida, Aspergillus, Mucor, and Nocardia. Epithelioid cell granulomas form around them. Fungal mycelium is characterized dystrophic changes. It can be assumed that the long phase of productive tissue reaction is supported by fungal associations, reflecting possible phenomena dysbacteriosis.

Treatment of Inflammatory Infiltrate

Treatment of patients with inflammatory infiltrates- conservative. Anti-inflammatory therapy is carried out using physiotherapeutic agents. A pronounced effect is achieved by laser irradiation, bandages with Vishnevsky ointment and alcohol. In cases of suppuration of the inflammatory infiltrate, phlegmon occurs. Then spend surgery.

Which doctors should you contact if you have Inflammatory infiltrate?

Infectious disease specialist

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