What is an abscess? This is a pus-filled cavity that is located in the muscles or subcutaneous fat. Pathogenic viruses or bacteria cause this pathological condition. As a result of the accumulation of a large amount of pus, the lesion area begins to increase, and there is a risk of an abscess breaking through with the release of pus into nearby healthy fiber. This leads to the development of an extensive inflammation called phlegmon.
In addition, a running abscess provokes neuritis, which contributes to the occurrence of osteomyelitis. Is this pathology treated conservatively, how is the opening of an abscess? Consider this in more detail.
Causes of the abscess
Purulent disease occurs as a result of getting into a weakened or damaged organ of a pathogenic infection, which begins to multiply rapidly. The body at this time actively fights inflammation and limits the inflamed area. As a result of this, a purulent capsule appears.
The infection penetrates the soft tissues as a result of a violation of the skin, which occurs due to injuries, cuts, wounds, frostbite, burns, open fractures. The following pathogens contribute to the occurrence of an abscess:
- staphylococci;
- streptococci;
- Mycobacterium tuberculosis;
- Pseudomonas aeruginosa ;
- clostridia;
- E. coli.
An abscess can occur due to the fact that under the skin, along with the drug, the infected contents were injected or there was an infusion of medications that are intended only for intramuscular injection. This leads to the development of aseptic necrosis of fiber and purulent inflammation of the soft tissues.
Sometimes an abscess can occur as a result of previous diseases: pharyngitis, tonsillitis, pneumonia, osteomyelitis, ingrown toenails.
Possible outcomes of an abscess
What can happen after this purulent cavity has arisen? The outcome of such an ailment is as follows:
- a breakthrough outward or inward (into the abdominal or articular cavity);
- a breakthrough in the organs (intestine, stomach, bladder or bronchi).
As soon as the abscess breaks through, the size of the purulent capsule decreases, after which the ulcer begins to heal. But if the pus does not come out completely, then inflammation often occurs repeatedly or may become chronic. Therefore, the abscess must be opened to remove accumulated pus.
Technique
An abscess should be opened as soon as possible if it is already more than four days old and the head of the capsule is already ripe. This process is carried out as follows: first, the area of inflammation is treated with an antiseptic solution and anesthetized with lidocaine. Using a scalpel, the doctor makes an incision in the tissue (not more than 2 cm) in the area of the purulent head or in the place of the greatest inflammation.
Using a Hartmann syringe, the incision is widened to 4-5 cm, and at the same time, the abscess connecting ligaments are torn. They begin to remove pus with an electric suction, after which a cavity is examined with a finger to remove the remnants of tissues and jumpers. The cavity is washed with an antiseptic and drained by introducing a rubber tube into it, which ensures the outflow of purulent exudate.
Postoperative Wound Treatment
Treatment after opening the abscess is carried out using antibiotics. Basically, the doctor prescribes penicillin drugs (Amoxicillin, Cephalexin), which should be taken 4 times a day for 200 or 500 mg. The course of treatment lasts 10 days. If the patient is allergic to penicillin, then macrolides are prescribed (Erythromycin, Clarithromycin).
Antibiotics for external use are ointments Mafedin, Levomekol, Levosin and others, the advantage of which is that their effect extends only to the affected area, and they are not absorbed into the blood.
In addition, the wound after opening the abscess requires treatment. So that its edges do not stick together until a granulation of the cavity from the depth occurs, a tampon with Vishnevsky ointment or liquid paraffin is left in the operated tissues. It should be changed every 2-3 days with dressings. As granulation develops, the swab is removed from the depth. Cauterize excess granulation, while trying not to touch the epithelium growing along the edges of the wound. With slow wound overgrowth, a suture is indicated.
Consider how an autopsy of the Bartholin gland abscess occurs in the pharynx.
The process of opening an abscess Bartholin gland
This gland is considered the largest of those that are located on the eve of the vagina. It inflames quite rarely, and if a purulent capsule has formed, then it must be opened. How is this procedure carried out?
Autopsy of the abscess of the Bartholin gland begins with the fact that the doctor makes accurate cuts, opening the purulent cavity, and releases the accumulated fluid. Then the gland is washed with a solution of hydrogen peroxide (3%). A special tube (drainage) is inserted into the cavity, which is necessary to remove pus residues. Remove it after 5 or 6 days. Treatment is carried out with the help of antibiotics and applications with ointments.
The process of opening an abscess in the pharynx
An autopsy of a paratonsillar abscess is considered the main method for treating purulent diseases in the pharynx. Such an operation is considered simple and rarely causes complications. It is carried out under local anesthesia (a solution of cocaine 5% and dicain 2%). The incision is performed in the region of the greatest protrusion of the pharyngeal wall and its depth should not be more than 1.5 cm, otherwise the nearby bundles of nerves and blood vessels can be damaged. After releasing pus, the doctor with a blunt instrument penetrates the cavity to destroy the septum inside it.
After the paratonsillar abscess was opened, the cavity is filled with a disinfectant solution. After suturing, usually no measures are taken to stop the bleeding. Postoperative treatment involves taking antibiotics.
Conclusion
Thus, opening an abscess is a mandatory procedure, since if not treated, it can lead to various complications. It is strictly forbidden to open it yourself, otherwise it can contribute to the spread of infection to organs and tissues located nearby.