Purulent inflammation. Antibiotics for purulent wounds - which are the most effective, a review of drugs How to treat purulent inflammation of the skin

Purulent inflammation is characterized by a predominance of neutrophils in the exudate, which, together with the liquid part of the exudate, form pus. The composition of pus also includes lymphocytes, macrophages, necrotic cells of local tissue. Pus is a cloudy, creamy yellowish-greenish liquid, the smell and consistency of which varies depending on the aggressive agent. Causes: pyogenic microbes (staphylococci, streptococci, gonococci, meningococci), less often Frenkel's diplococci, typhoid bacillus, mycobacterium tuberculosis, fungi, etc. It is possible to develop aseptic purulent inflammation when certain chemicals enter the tissue. Types depending on prevalence and localization: 1) boil(- this is an acute purulent-necrotic inflammation of the hair follicle (follicle) and the associated sebaceous gland with its surrounding fiber; with an uncomplicated course of the process, the development cycle of the boil lasts 8-10 days; the skin tissue defect is filled with granulation tissue, which then matures with the formation of a scar ); 2) carbuncle(- this is an acute purulent inflammation of several adjacent hair follicles and sebaceous glands with necrosis of the skin and subcutaneous tissue of the affected area; the most dangerous carbuncle of the nose and especially the lips, in which the purulent process can spread to the membranes of the brain, resulting in purulent meningitis); 3) phlegmon(- this is a diffuse purulent inflammation of the tissue (subcutaneous, intermuscular, retroperitoneal, etc.), or the walls of a hollow organ (stomach, appendix, gallbladder, intestine); note: paronychia - acute purulent inflammation of the periungual tissue; felon - acute purulent inflammation of the subcutaneous tissue of the finger; the tendon and bone may be involved in the process, purulent tendovaginitis and purulent osteomyelitis occur; phlegmon of the neck - acute purulent inflammation of the tissue of the neck, develops as a complication of pyogenic infections of the tonsils, maxillofacial system; mediastinitis - acute purulent inflammation of the tissue of the mediastinum; paranephritis - purulent inflammation of the paranephric tissue; parametritis - purulent inflammation of the parauterine tissue; paraproctitis - inflammation of the tissue surrounding the rectum); 4) abscess(- focal purulent inflammation with tissue fusion and the formation of a cavity filled with pus; abscesses can be localized in all organs and tissues, but abscesses of the brain, lungs, and liver are of the greatest practical importance); 5) empyema (purulent inflammation with accumulation of pus in closed or poorly drained pre-existing cavities; note: accumulation of pus in the pleural, pericardial, abdominal, maxillary, frontal cavities, in the gallbladder, appendix, fallopian tube (pyosalpinx)). Outcomes: depends on the prevalence, the nature of the course, the virulence of the microbe and the state of the organism: adverse- generalization of information --- sepsis; when delimiting the process --- abscess --- opens --- release from pus --- granulation tissue in the abscess cavity --- scar; m.b. with thickening of pus in an abscess --- necrotic detritus --- petrification; long flowing inflammation --- amyloidosis.

Purulent inflammation is a fairly relevant topic for discussion, since recently more and more people have begun to turn to doctors with similar problems. The reasons for such a sharp deterioration in the health status of the population can be various factors. We want to talk about them and much more in our article. The collected information is aimed at helping victims of this disease.

What is inflammation

Purulent inflammation is one of the and before we begin to deal with its types, we need to understand what it is. Even the ancient healers determined that this is a protective reaction of the human body to an irritant. Both a virus and a splinter can act as an irritant. There are many terms that characterize this process, but the most basic is phagocytosis, which the famous Mechnikov spoke about, that is, the process of destroying an irritating agent inside the cell.

Causes of purulent inflammation

In medicine, several possible reasons are known when putrefaction begins. Among the most common options are:

• the entry of infections and their toxin into the human body;
• consequences of exposure to external factors such as burns, radiation, frostbite;
• consequences of bruises or other kinds of injuries;
• exposure to chemical irritants;
• internal processes in the body, like or salt deposits.

What happens at the moment when purulent inflammation of the tissues begins? To understand the essence, let's take the simplest example: hitting a splinter. When it has just entered the skin, it is absolutely impossible to pull it out, but after a while we can easily remove it from the skin along with pus, which has time to collect during this time. What happened, and why did pus collect, how did purulent inflammation begin? A splinter that has entered the skin is perceived by the body as a foreign body and a threat. How does the body react? It increases blood flow to the affected area, blood brings with it many useful elements that work like clockwork, and each of them performs its task:

• the platelet sticks together with its own kind and thus forms a protective layer on the wound;
• erythrocyte supplies the affected area of ​​the skin or organ with oxygen;
• plasma brings nutrients for the speedy healing of the wound;
• white bodies (leukocytes) enter into battle with the foreign body directly.

Where does pus come from? The fact is that in the process of struggle, white blood cells die, their role is to wrap around a foreign body, absorb it and destroy it. But, destroying the enemy, the leukocyte itself is destroyed, while acquiring a yellowish color, this is pus. If, in the process of fighting the irritant, some parts of the skin or organ die off, the leukocyte also embraces the dead parts in order to prevent them from developing the process in the body. Thus, leukocytes pave the way for pus to the top. If you have pain when pressing on a purulent inflammation, it means that the nerve endings were affected here, of which there are a huge number in the body. In this case, you need to carefully examine the affected area so as not to get a complication.

Forms of inflammation

Considering where the process began, and how strong or weak the human immunity is, we can distinguish the following forms of purulent inflammation:

• Abscess - this is the name of a purulent formation that forms in the tissue, while it is isolated in a separate capsule. The formation of an abscess indicates a good one. A protective crust immediately begins to form around it, preventing the spread of infection. Often this is characterized by purulent inflammation of the tooth.
• Phlegmon - characterized by a looser texture of the formation, which most often occurs in the space between the muscles. It is an indicator that a person does not have very good immunity. Most often, the patient is admitted to the hospital to resolve the problem.
• Empyema is a collection of pus in organs with a hollow structure. In this case, the boundaries of the abscess is the natural tissue of the organ.

The course of purulent inflammation

This kind of inflammation is of two types: acute and chronic. Acute purulent inflammation spreads quite quickly, and soon we can observe a splash of exudate outward, either onto the surface of the skin, or into the adjacent organ cavity. A large amount of pus can lead to intoxication of the body, and, as a result, to its exhaustion. Chronic purulent inflammation changes the composition of the cell, and lymphocytes and microphages begin to appear in its composition. Also, this form is characterized by the formation of scars and hardening, but all this is possible only with the wrong decision.

Outcome of the disease

Of course, the outcome of the disease, like any other disease, depends on the correctness of the treatment and the nature of the wound. What should be feared first of all?

• Scarring. Few people are decorated with scars after an unsuccessful fight against inflammation.
• Bleeding. If the disease has reached the lymph nodes, then there may be just such an outcome.
• Gangrene. This is one of the most terrible options, tissue death begins, that is, necrosis.

Purulent inflammation of the skin

Most often, we all encounter this type of inflammation. In what ways can we see it?

• Pyoderma - appears due to improper handling of insect bites, small skin incisions, etc. On the skin it looks like small bubbles around the wound.
• Follicle - in this case, the hair follicle is threatened, it begins to fester.
• A furuncle is a melting of a hair follicle. A dangerous factor is that it very easily develops into a furunculosis disease, when there are already many such formations.
• Carbuncle - also but large, usually treated with surgical methods, after which a large empty cavity remains in the skin, then scars appear at the site of the wound.
• Hidradenitis is a purulent formation in the groin or armpit in the place where the sebaceous glands are located.

Complications

How the decay process ends depends on several important factors:

• the degree of aggression of the irritating element;
• depth of infection penetration;
• quality of immunity of the victim.

After the treatment is over and the cavity with pus has emptied, soft tissue remains in its place, which is then replaced by fresh skin, but scarring is possible. If the treatment was not carried out correctly, then a complication process may begin, which does not reflect very well on the human condition:

• pus can spread to other tissues and organs;
• in the process of decay, the infection can enter the bloodstream, and, as a result, sepsis, bleeding and thrombosis may begin;
• death of the skin and tissues of organs;
• weakening of the immune system and the general condition of the human body, which can lead to underdevelopment of organs.

Treatment

Treatment depends on the severity of the disease. Both treatment at home and surgical intervention, as well as treatment in a hospital, are allowed.

Consider the options for possible treatment:

• with an abscess, an incision is made to a person and the cavity where the pus was was washed, the wound is closed from environmental exposure;
• with phlegmon, it is necessary to use drugs after opening abscesses and deep cleaning;
• with epiema, surgical intervention is necessary, when the tissue of the organ is opened, pus is removed, the cavity is cleaned, then enhanced treatment is carried out aimed at raising immunity and healing the wound.

It is important to know that when treating various kinds of abscesses, it is necessary to avoid contact with water, no compresses or massages can be done so as not to provoke the spread of infection. The skin needs to be treated with special means for the same purpose. Zelenka and iodine are the most common alcohol solutions that are used for this purpose.

If you are faced with an elementary splinter, then, of course, you can deal with it at home, but you also need to be very careful. Before removing a splinter, you need to carefully treat both the affected area of ​​\u200b\u200bthe skin and the tool with which you will remove it. After extraction, immediately treat the skin with alcohol and seal the wound with a plaster until healing or the formation of a protective crust.

Antibiotics

The use of antibiotics is allowed only under the strict supervision of the attending physician. Self-medication is not allowed, as this can significantly worsen the patient's condition. Before you start taking the medicine, you need to determine the sensitivity of a person to its components. Of course, it is not recommended to use antibiotics unless they are urgently needed. It is important to remember that the use of antibiotics, especially uncontrolled, can harm the normal functioning of the body. After you have a suspicion of the presence of purulent inflammation, urgently contact a specialist for help. If you have undergone surgery and scars remain, then modern plastic surgery can correct any imperfections.

A skin abscess is an intradermal inflammatory process caused by bacterial flora, most often a combination of various microorganisms. Purulent fusion affects the hair follicle, sweat and sebaceous glands next to it, the surrounding connective tissue. At the same time, it is clearly delimited from healthy structures by a capsule, not having a tendency to spread to the sides, causing a deterioration in the general condition of a person when inflammation products and pyogenic flora enter the blood. Most often, an abscess develops on the scalp, armpits, neck, lower extremities, the area around the anus, and in women also on the labia majora.

Attempts to treat a skin abscess in its initial stages can be made at home. But this is possible if the purulent cavity is not located on the face or neck. With such localization, as well as in violation of the general condition of a person or the presence of diseases such as diabetes mellitus or various types of immunodeficiencies, treatment is carried out in a surgical hospital.

How does a skin abscess appear?

To imagine the processes that lead to disease, consider the structure of the skin.

The integumentary tissue of a person is a two-layer organ. Above is the epidermis - a series of cells that protect against microbes, thermal and chemical damage. The bottom layer is the dermis.

In the lower layer of the dermis, on the border of the skin and subcutaneous tissue, there are hair follicles formed by connective tissue and blood capillaries. They give rise to hair roots that pass through the dermis and epidermis, protruding outward as hair shafts. In the place where the root passes into the shaft, 2-3 sebaceous glands flow into the area between the outer and middle hair membranes. Near the exit of the hair to the surface, the mouth of the sweat gland opens. All this glandular tissue works to form a protective film on the surface of the skin.

In the light of this knowledge, a skin abscess - what is it? This is a purulent inflammation that develops immediately in a large volume of tissues, which affects both the follicle, the sebaceous glands, and the nearby sweat gland. This process develops in stages:

1. In places where the integrity of the skin is broken, bacterial flora enters. A focus of inflammation is formed around this place, accompanied by swelling and redness, as a result, a hill appears around the follicle.
2. In the infected area, the influx of lymph and tissue fluid increases. These fluids try to clear the site of infection.
3. The immune system is activated, which tries to simultaneously kill bacteria and delimit the focus of inflammation from healthy tissues. As a result, pus is formed - a mixture of leukocytes and other immune cells, dead bacteria, and proteins.
4. Increasing in volume, this content increases interstitial pressure, and when it reaches a critical value, the abscess breaks. At this stage, complications associated with the ingress of foreign proteins and infection into the blood can develop.
5. After opening the abscess, a crater remains, which is gradually tightened. If purulent inflammation has penetrated into the layers lying below the skin, a scar forms as a result of healing.

Why does skin purulent inflammation develop

A skin abscess develops as a result of pathogenic microorganisms entering the skin tissues. This happens due to trauma, friction or severe contamination of the skin. Especially often this situation in men occurs when shaving the face, axillary areas. In women, the cause of infection in the skin is also shaving the legs, as well as hair removal or frequent friction during hygiene measures in the genital area. Festering hematomas, cysts can cause pathology. Often, skin abscesses appear at the site of intradermal (less often), subcutaneous (more often) injections that were not performed according to the rules.

Local and systemic factors increase the likelihood of infection entering the skin. The locals include:

• increased sweating ();
• hyperactivity of the sebaceous glands (this is typical for conditions accompanied by an increase in the content of male sex hormones in the blood);
• penetration of a foreign object under the skin.

Systemic risk factors - mainly those that cause a decrease in immunity:

• long-term treatment with steroid hormones (dexamethasone, prednisolone, for example, in lupus erythematosus or rheumatoid arthritis);
• diabetes;
• after chemotherapy;
• against the background of hemodialysis sessions in chronic renal failure;
• with HIV infection;
• unbalanced diet;
• hypothermia;
• Crohn's disease and ulcerative colitis.

The infection that is the real cause of a skin abscess is the flora that is in the air, on human skin, in the secretion of sweat or sebaceous glands, vaginal secretions, or particles of physiological functions remaining on the skin. Most often it is Staphylococcus aureus. It is the most dangerous microbe: it tends to quickly spread into the blood, and from it into the internal organs, causing abscesses to appear in them. An abscess can also cause:

1. streptococcus;
2. the proteus family;
3. coli;
4. most often - a combination of staphylococcal, streptococcal flora and Escherichia coli.

Skin abscess symptoms

In its development, the disease goes through several stages, which differ in their external manifestations.

At the first stage, redness, dense and painful, appears at the site of injury, injection or former hematoma. At first, it is small, but gradually increases in size, reaching even 3 cm. In the middle of this infiltrate (seal) there is always a hair.

After 3-4 days, the center of the seal softens and a yellow or white abscess appears in its place, the redness around which no longer spreads, but everything is also hot to the touch and painful. At this stage, the condition may worsen: the temperature rises (sometimes up to 40 ° C), appetite decreases, and weakness appears.

Most often, the abscess spontaneously opens, purulent masses stand out from it. This is accompanied by an improvement in the condition of both the tissues at the site of formation (they lose pain), and a decrease in temperature, the disappearance of symptoms of intoxication. If complications have developed at this stage, then even after spontaneous opening of the purulent cavity, there is no improvement.

When the rejection of pus has occurred, the wound remaining in this place heals. If the inflammation has affected only the skin layers, after healing, a small light or dark spot remains, which soon disappears. In case of destruction of deeper layers, or if the abscess was located in place over the bone, a scar remains due to healing.

Features of localization of some skin abscesses

Facial abscess occurs very often. This is the most common localization of the abscess, since the skin of the face is the richest in sebaceous glands. Most often, abscesses appear on the lip, nose, in the area of ​​\u200b\u200bthe ear canal. Located in the region of the nasolabial triangle, they are dangerous for the spread of infection into the cranial cavity. Like an abscess of the scalp, its facial localization is often accompanied by a headache, fever, and general malaise. Here, similar symptoms, unlike abscesses of other localization, do not always mean the development of complications, but still require an examination.

Local symptoms of a skin abscess on the leg are as described above. In addition to them, inflammation of the lymph nodes and lymphatic vessels often develops, through which lymph flows from the source of infection.

Diagnostics

The fact that a formation on the skin discovered by a person is a skin abscess, a surgeon, therapist or dermatologist can already say during the initial examination. But in order to prescribe the correct treatment, the doctor will need to open the formation and sow its contents on various nutrient media in order to determine the pathogen and its sensitivity to antibiotics. Simply performing a puncture (puncture) of the abscess for the purpose of sowing is impractical - this way you can spread the infection to the underlying tissues.

In case of a general violation of the condition: an increase in temperature, the appearance of a cough, a decrease in appetite or a decrease in the amount of urine, diagnostics (ultrasound, X-ray and laboratory) of the condition of the kidneys, liver, lungs are performed.

Treatment

Therapy at home

Often, treatment of a skin abscess is possible at home. To do this, it is recommended to first conduct a test with the Dimexide preparation, diluting it four times with boiled water and applying it to the skin of the inner side of the forearm. If after 15 minutes there is no visible redness, blistering or itching, this drug can be used to treat a purulent process. For this:

1. Dilute "Dimexide" ("Dimethyl sulfoxide") 3-4 times with boiled water.
2. Wet the sterile gauze with the solution (it will be hot).
3. Attach gauze to the abscess, cover with polyethylene on top.
4. Fix the compress with a bandage or gauze bandage.

To improve the effect, and in the absence of an allergy to antibiotics, you can sprinkle gauze with Penicillin, Ceftriaxone, Gentamicin or Ampicillin before applying cellophane.

You can do the same with:

a) saline solution: 1 tsp. salt in a glass of boiled water;

b) baked onion peel;

c) fresh grated raw potatoes;

d) grated laundry soap, which is mixed with 2 parts of warm milk, is boiled for 1.5 hours on low heat until the consistency of sour cream. After cooling, it can be used.

Such compresses, in addition to those with baked onion peel, are used throughout the day, with a change in the composition to a new one every 3-4 hours. Onions are applied for 1 hour 3 times a day.

Attention! Compresses should not be warm!

Surgical removal

Treatment of a skin abscess by a surgeon is carried out in cases where:

• skin abscess appeared in a patient with diabetes mellitus;
• an abscess appeared on the face, especially in the region of the nasolabial triangle;
• the boil does not go away within 3 days or there is a tendency to increase it;
• increased body temperature;
• the abscess is not opened;
• new skin abscesses appeared;
• localization of the abscess - on the spine, in the buttocks or around the anus.

In these situations, the doctor resorts to opening the abscess with a scalpel, under local anesthesia. The cavity of the abscess is washed from pus with antiseptics, but then it is not sutured to prevent re-suppuration, and a piece of a sterile glove is inserted there, through which the pus will come out. After such a small operation, antibiotics are prescribed in tablets.

characterized by the formation of purulent exudate. It is a mass consisting of detritus of tissues of the focus of inflammation, cells, microbes. The exudate contains granulocytes, lymphocytes, macrophages, often eosinophilic granulocytes. Purulent inflammation is caused by pyogenic microbes - staphylococci, streptococci, gonococci, typhoid bacillus.

Purulent exudate has a number of qualities that determine the biological significance of this form of inflammation. It contains various enzymes, primarily proteases, capable of breaking down dead and dystrophically altered structures in the lesion, including collagen and elastic fibers, so purulent inflammation is characterized by tissue lysis.

The main forms of purulent inflammation are abscess, phlegmon, empyema, purulent wound.

Abscess

Phlegmon

Purulent, unrestricted diffuse inflammation, in which purulent exudate impregnates and exfoliates tissues. The formation of phlegmon depends on the pathogenicity of the pathogen, the state of the body's defense systems, as well as on the structural features of the tissues in which it arose and where there are conditions for the spread of pus.

Phlegmon can be soft if the lysis of necrotic tissues prevails, and hard when coagulative necrosis of tissues occurs in the phlegmon, which are gradually rejected.

Phlegmonous inflammation can be complicated by thrombosis of blood vessels, resulting in necrosis of the affected tissues. Purulent inflammation can spread to the lymphatic vessels and veins, and in these cases, purulent thrombophlebitis and lymphangitis occur. The healing of phlegmonous inflammation begins with its delimitation, followed by the formation of a rough scar. With an unfavorable outcome, generalization of infection with the development of sepsis may occur.

empyema

This is a purulent inflammation of the body cavities or hollow organs. The reason for the development of empyema is both purulent foci in neighboring organs (for example, lung abscess and empyema of the pleural cavity), and a violation of the outflow of pus in case of purulent inflammation of hollow organs - the gallbladder, appendix, fallopian tube.

festering wound

A special form of purulent inflammation, which occurs either as a result of suppuration of a traumatic, including surgical, or other wound, or as a result of opening a focus of purulent inflammation into the external environment and the formation of a wound surface.

Suppuration of a cut, an abscess, a furuncle - rarely anyone managed to never encounter such phenomena in their life, the cause of which can even be a microtrauma. A common practice is the treatment of suppuration by surgery, and purulent surgery is one of the most ancient medical practices. At the same time, folk remedies for abscesses can quickly heal small wounds at home, they can even save a human life if medical help is not available. It should be noted that this applies only to subcutaneous inflammation - the internal purulent process requires urgent surgical intervention.

What is an abscess?

The formation of a subcutaneous abscess occurs as follows:

• Due to a violation of the integrity of the skin, an infection enters the body, primarily staphylococcal.
• A capsule is formed at the site of infection, preventing further infection of the tissues. This manifests itself in the form of hardening, redness, soreness.
• Exudate accumulates inside the capsule, formed by dead microorganisms, leukocytes and destroyed tissues.
• After about a week, the formed pus breaks through the capsule and comes out. The process of scarring of the wound and tissue repair begins.

However, if the suppuration is located deep, and the wound channel was narrow, pus can penetrate deep into the tissues. This leads to sepsis, the treatment of which is long, serious and not always successful.

That is why medicine is often guided by the rule: "you see pus - immediately open it." The capsule is opened under local or general anesthesia, after which the wound is cleaned and sanitized, drainage is installed to drain the exudate and a sterile dressing is applied, which changes during regular examination. After the inflammation stops, the drainage must be removed and drugs that promote skin healing should be applied. Such treatment is the most radical and successful. However, a small suppuration located near the surface of the skin can be cured at home, especially if obtaining surgical care is difficult.

Pharmaceuticals

It must be remembered that any damage to the skin, except for that caused by a sterile instrument, is associated with infection. Therefore, if there are signs of suppuration and inflammation, it is necessary to prevent the closure of the wound by constantly moistening it with hydrogen peroxide or simply salt water. In order to cope with the infection and draw out the pus, there are many effective medications. Almost all of them are available in any pharmacy and are affordable. At home, you can treat an abscess with drugs such as:

• Ointment Vishnevsky (balsamic liniment).
• Ichthyol ointment.
• Levomekol.
• Streptocid ointment.
• Synthomycin ointment, etc.

Before applying the ointment, you need to treat the surface of the skin with hydrogen peroxide or furatsilin, and after applying the ointment, cover it with a clean bandage. Change the ointment and bandage according to the instructions for use of this tool.

Folk remedies

For centuries, most people had to treat suppuration on their own, so among folk remedies there are many of those whose effectiveness has been proven by time. It is important that many of them (onions, garlic, cabbage, honey, etc.) are common foods, which allows you to treat an abscess without spending time and effort. The most accessible means to draw out pus "away from civilization" are:

• warm tea brew;
• raw onion, cut into slices;
• young birch leaf;
• or ;

At home, you can also apply to an abscess:

• fresh cabbage leaf;
• grated onion, better mixed with honey;
• grated carrots, potatoes or beets;
• leaf pulp or;
• mashed.

The therapeutic application of these funds must be changed as it dries, it can be worn constantly. The beneficial substances contained in these plants will help draw out pus, relieve inflammation and accelerate the recovery of damaged tissues. To avoid skin burns, onions are applied in the morning and evening for no more than two hours, then washed off with water. A milder effect has a baked or boiled onion. Roasted garlic also draws out pus well.

Homemade ointment for boils

To prepare a homemade anti-abscess ointment, you need to mix raw yolk with honey and butter (a tablespoon each) and add flour (even better - cosmetic clay) to this mixture so that you get a soft dough that needs to be stored in the refrigerator. A lozenge of this mixture should be applied to the wound and changed three times a day, continuing the treatment after the wound begins to clear.

If an internal abscess is located on the finger, especially under the nail, it should be periodically steamed in hot water, to which salt, soda, and alcohol tincture of calendula are added (a teaspoon per glass).