Phlegmon - Causes, symptoms and treatment. MF.

Phlegmon - acute purulent inflammation of fatty tissue, which has no clear boundaries. The fat tissue surrounding various organs, nerves and vessels, has a message with a number of located areas. Therefore, the purulent process, arising in one place, can very quickly spread to neighboring areas, causing damage to the skin, muscles, tendons, bones and internal organs.

Depending on the area of ​​the lesions, subcutaneous, subfascial, axillary, retroperitoneal phlegmon, as well as phlegmon of the hand, feet are distinguished. Inflammation of the adrenal gland is called paranephritis, in the rectum - paraproctitis, in the lumbar region - psoy, with a purulent process in adipose tissue around the lymph node develops adenophlegmon.

Causes of the appearance of phlegmon

The immediate cause of phlegmon is the rapid growth of pathogens, such as staphylococcus aureus, streptococcus, Pseudomonas aeruginosa, and also clostridia, Escherichia coli and other microorganisms.

Microbes can penetrate into fatty tissue in various ways. The most common method is due to a violation of the integrity of the skin during trauma, injury, as well as during surgical incisions or when injecting drugs. Also, the infectious agent can get into adipose tissue with blood or lymph flow. At the same time, there is a contact path of infection when a purulent focus is broken from the affected organ in a nearby fatty tissue. An untreated, limited process, for example, an abscess, a carbuncle, can also become common in certain conditions.

As a rule, the body strives to limit any inflammation that has arisen by forming a capsule. In conditions of a decrease in immunity, for example, with exhaustion, prolonged chronic diseases, with alcoholism, the formation of a protective capsule does not occur, and the purulent process initially has a tendency to spread. On the other hand, many bacteria, most often clostridia and nonclostridial flora, in the course of their life, release special substances that dissolve the protective membrane, which also leads to the spread of inflammation.

Symptoms of phlegmon

External manifestations of phlegmon are quite typical. By location, all phlegmons are conventionally divided into superficial ones( tissues are affected to the muscular layer) and deep ones( tissues deeper than the muscle layer, between muscles and fatty tissue located around the internal organs).

For , the surface phlegmon is characterized by intense pain in the area of ​​inflammation, swelling, edema, and compaction. When involved in the pathological process of the skin develops redness, a local increase in temperature.

Superficial phlegmon.

There is also an increase and soreness of closely located lymph nodes - regional lymphadenitis. Very quickly, there are common symptoms of poisoning of the body - an increase in temperature to 38-40 degrees, chills, severe general weakness, dry mouth, thirst.

With deep phlegmon , as a rule, general symptoms predominate over local ones. The body temperature can reach 40-42 degrees, with chills, lethargy, drowsiness. As a result of the toxic effect of microorganisms, the development of a cardiovascular system( blood pressure lowering, cardiac rhythm disturbance, rapidity, then with the progression of the disease, a decrease in the pulse), a respiratory system( respiratory failure, shortness of breath at rest or with insignificant physical exertion)system( reducing the amount of urine until it is completely absent, nausea, vomiting).The presence of deep phlegmon is indicated by an increase in the size of one or another area compared to a symmetrical healthy area, a soreness in sensation.

Deep phlegmon.

A disturbance in the function of a nearby organ can be detected, for example, psoac symptom - involuntary painful flexion and thigh rotation outward when raising a straight leg with phlegmon in the iliac-lumbar region.

Inflammation of the fat around the internal organs is characterized by severe symptoms of poisoning of the body, possibly a violation of the function of this organ in the total absence of external manifestations.

Diagnosis of phlegmon

Diagnosis of superficial phlegmon, taking into account pronounced external manifestations, does not present special difficulties. Deep phlegmons are detected, as a rule, with ultrasound, radiography, computed tomography or magnetic resonance imaging of suspicious areas. In unclear cases, the priority method is the diagnostic puncture( puncture of the tissues to obtain pus from the pathological focus).

Treatment of phlegmon

As a rule, microorganisms causing phlegmon are very aggressive, and only timely access to a surgeon will help prevent the spread of infection and the development of poisoning the body. If phlegmon is suspected, urgent hospitalization is necessary.

If phlegmon is present, it is strictly forbidden:

• Sit at home and wait for the favorable completion of the process;
• Use warming compresses, as this leads to the spread of infection;
• Apply ointments, gels in the area of ​​redness and soreness;
• Drink analgesics before visiting a doctor. Pain is an important sign for determining the location of phlegmon;
• Take aspirin for analgesia. The anesthetic effect is very weak, but the bleeding significantly increases, which can complicate the operation;
• Uncontrolled use of antibiotics, not knowing the nature of the pathogen.

Treatment phlegmon, as a rule, surgical. The main principle of treatment is removal of the purulent focus. Given the location of the inflammation, one or more incisions are made, the pus is removed by washing the area with a large amount of antiseptic solution.

Surgical treatment of phlegmon.

If necessary, rinses are repeated. In the postoperative period prescribe antibiotics and drugs that increase immunity.

Complications of phlegmon

In case of untimely treatment, common complications such as sepsis( the entry of microorganisms into the blood and the spread of infection throughout the body), thrombophlebitis( purulent inflammation of the veins with the formation of thrombi and microabscesses), purulent arteritis( destruction of the artery wall by microorganisms with the development of massive bleeding, which are very difficult to stop), secondary purulent fouling during the spread of the process. Depending on the location, phlegmon also distinguishes specific complications, for example, purulent meningitis( inflammation of the meninges) with the phlegmon of the orbit, or mediastinitis( inflammation of the mediastinum organs) with the phlegmon of the neck.

Prevention of phlegmon

Prevention of the appearance of phlegmon consists in providing timely and quality first aid in case of violation of the integrity of the skin( washing the wound with an antiseptic solution, for example, chlorhexidine, treating the edges of the wound with iodine solution, applying a sterile dressing).

Doctor therapist Sirotkina EV