Surgical infections

Description:

Understand inflammatory zayobolevaniye which treatment is carried out by preferential hiruryogichesky methods as a surgical infection. The diseases caused nonspecific (a furuncle, an anthrax, phlegmon, etc.) and speyotsifichesky (bone tuberculosis, etc.) activators concern to them.

Symptoms of Surgical infections:

The surgical infection is divided by a clinical current on: acute (purulent, anaerobic, specific) and chronic (specific, nonspecific). It can be localized: 1) on skin and in hypodermic cellulose; 2) on a chest wall; 3) in a pleural cavity; 4) in a peritoneum and bodies of a belly poyolost, etc.
Disturbance of integrity of fabrics (necrosis, regeneration) nayostupat first of all owing to influence on them of agents, koyotory caused an inflammation. Along with it there occur changes from vessels which are originally narrowed, and then quickly extend. Clinically it is shown by a local gipeyoremiya (reddening) in an inflammation zone. Expanded, porous vessels in surrounding fabrics leave a liquid part of blood, leukocytes, there is a reproduction (proliferation) a kleyotok of local fabrics that leads to formation of a swelling — inflammatory infiltrate. The nerve fibrils passing in this zone are squeezed and irritated due to vospalitelyyony changes that leads to pain reaction. Local increase in a krovenapolneniye and biochemical processes which happen owing to destruction of fabrics, cause local temperature increase. Hypostasis of fabrics and pain bring to a narusheyoniya of function of this body part.
Further the local circulatory disturbance narayostat due to progressing of inflammatory process. Thrombosis of small arteries and veins Razyovivatsya. Effect of bacterial toxins increases that totally causes still big death and regeneration of fabrics (necrosis); at the same time a part of the died fabrics is dissolved. Dissolution of fabrics comes due to release from the died leukocytes of a large amount of the enzymes capable to dissolve proteinaceous bodies (proteolytic enzymes). Thus, from leukocytes, products of a rasyopad of fabrics and an exudate pus which in the absence of an exit outside spreads on surrounding fabrics is formed of vessels, causing their death.
Almost along with process of death of fabrics emergence of the new cells forming a granulyatsionny shaft is noted kotoyory as if surrounds with a barrier an inflammation zone. The obrayozovaniya of a granulyatsionny shaft is the cornerstone reproduction of soyedinitelyyonotkanny cells. At accumulation of pus in the center of an inflammation there can be an otgranicheniye (encapsulation) by its soyedinitelnoyotkanny cover.
The changes observed at an inflammation should not be considered only local reaction of fabrics. At patients a number of the obyoshchy phenomena as result of reaction of all organism to vospaliyotelny process is noted.
In the presence of inflammatory process there are funktsioyonalny changes of the central nervous system (sleeplessness, the general weakness, a headache, irritability etc.). In addition, functions of other bodies, in particular intestines are broken: appetite vanishes, language becomes laid over, dry, the dispepsichesky phenomena are noted. Also the temperature curve is characteristic of a vosyopaleniye. In the evenings temperature povyyoshatsya, in the mornings decreases. Sharp temperature increase is, as a rule, observed at a delay in fabrics of purulent soderyozhimy.
Discrepancy between temperature data and the course of process (low temperature at a heavy purulent infection) yazlyatsya by a bad predictive sign as svidetelyyostvut about areactivity of a condition of an organism.
Increase of pulse usually parallel to rise in temperature. The temperature is higher, the pulse is more often. At areactive sostoyayoniya inverse relation between temperature reaction and pulse is observed: at temperature drop pulse becomes frequent.
Inflammatory process most often is followed by a uveliyocheniye of quantity of leukocytes to 10 000 — 20 000 and more. Odnoyovremenno changes a ratio of different types of leukocytes among themselves: the quantity of lymphocytes decreases (lymphopenia) and the quantity of neutrophils increases (neutrocytosis). At long inflammatory process of SOE about 50 mm of mercury increase. and more. Long inflammatory process can lead to amyloid degeneration of internals. In a zayovisimost from a condition of protective forces of an organism, virulence of the activator and a condition of the central nervous system vospaleyony can proceed with different degree of manifestation: but р m е r-gicheski (average degree of manifestation), and a per of ER of and a cheyoska (violently proceeding process) of an igipoyergicheska or anergically (process with poorly expressed local and general manifestations).
Local purulent surgical infection
Furuncle. The purulent inflammation of a hair sack and a sebaceous gland passing to surrounding cellulose. Emergence of a furuncle is promoted by non-compliance with rules of personal hygiene and a raschesa. Hroniyochesky diseases, especially diabetes, anemia, infectious zayobolevaniye, exhaustion of the patient, psychological pereutomleyony can be the contributing moments. The causative agent of a furuncle is staphylococcus. The furuncle begins with a poyavleyoniya of the roundish painful consolidation of skin reddish (infiltrate) which is slightly raised over skin. At top of a swelling there is a dark or yellowish speck. In dalyyoneyshy on site a speck the site of a necrosis of white color — a furuncle core is formed. After rejection of a core the cavity filled with granulyatsionny fabric obrayozutsya. The general reaction of an organism at a furuncle is expressed a little.

Reasons of Surgical infections:

The purulent infection is caused by pyogenic cocci, and takiyom as a streptococcus, staphylococcus, a pyocyanic stick, etc. Bacteria, getting to fabrics, under favorable conditions quickly breed. Breeding and extending on interfabric cracks, they emit toxic agents — toxins, deystvuyoyushchy on surrounding fabrics both directly, and is reflex, through the central nervous system. Reaction of an organism to implementation of pathogenic microorganisms first of all is shown by development of a local inflammation.

Treatment of Surgical infections:

At furuncles rest is appointed. At odinochyony furuncles with the expressed inflammatory reaction primeyonyat short novocainic blockade according to Vishnevyosky. Under the inflammatory center enter 200 000 — 300 000 PIECES of penicillin, divorced into 5 — 10 ml of 0,25 — 0,5% of solution of a novoyokain. Consecutive novocainic blockade of the prolonged action according to Murayotov is more effective. Under a zone of an inflammation enter 5 — 10 ml of 2% of solution of a novokaiyon. In 5 — 10 min., without taking out a needle, enter 200 000 — 300 000 PIECES of penicillin, divorced into 5 ml of 0,5% of solution of novocaine.
In the course of treatment care of skin around an inflammation zone is important. Skin is wiped with gasoline, alcohol or solution of potassium permanganate. It is better not to apply compresses because of danger of a mayotseration of skin and spread of an infection. Physiotherapeutic procedures give good effect: ultrayofioletovy radiation, UVCh-therapy, etc. The large sizes the furuncles which are not on a face open and delete a core and purulent contents.