The class of soft tissue inflammation consists of individual nosological varieties of general etiopathogenesis. Pathological processes can be of a different nature and can be of several types
The clinical picture of soft tissue inflammation, despite the diversity of nosological species and the localization of processes, has a common symptomatology. It is significant for the tactics of physiotherapeutic treatment and is primarily due to the presence of the inflammatory process. This is the formation of a painful infiltrate with swelling of the soft tissues , hyperemia of the skin above it (with a slight depth of the process) and symptoms of local hyperthermia, an increase in overall body temperature. With purulent-necrotic inflammatory pathologies of the soft tissues, a symptom of fluctuation is characteristic, in which a general reaction in the form of an intoxication syndrome with fever of purulent-resorptive origin builds up.
The development of such a syndrome is mainly due to the pathogenicity of a specific infectious agent. Lymphadenitis and lymphangitis, being independent nosological varieties, often complicate the course of all inflammation in the soft tissues. Inflammatory processes on the face are especially difficult and dangerous for health. In this case, purulent foci sometimes spontaneously open.
Main symptoms
The main symptoms of soft tissue inflammation are:
- inflammatory;
- intoxication;
- pain
- lymphostasis
- trophic and metabolic disorders.
Varieties of the pathological process
The group of varieties of this disease includes:
Furunculosis is a purulent-necrotic inflammatory process of an acute nature, affecting the hair follicle and surrounding connective tissue. This pathology can be of a recurring chronic nature and differ in the appearance of multiple boils on the body (at different stages of development).
Phlegmon - purulent diffuse inflammation of the tissue tissue. This pathology differs from an abscess in that the formation is delimited from nearby tissues by a specific pyogenic membrane. It has a tendency to spread through cell spaces. There is inflammation of the soft tissues of the leg.
It is very simple to get in everyday life. Various inflammations occur due to broken knees, abrasions, scratches. Microbes penetrate the soft tissues of the legs by:
- skin combs;
- fungal diseases;
- diabetic ulcers;
- varicose veins;
- injection in unsanitary conditions;
- injuries and injuries;
- introduction of microflora with blood or lymph from the primary inflammatory foci.
For the same reasons, inflammation of the soft tissues of the hand may occur.
Carbuncle is a purulent-necrotic inflammatory process of an acute form, affecting several sebaceous glands and hair follicles and spreading to the skin and subcutaneous tissue.
Bursitis is an inflammatory pathology of synovial bags, which is accompanied by the accumulation of exudate in their cavities. Mastitis - inflammation of the parenchyma and breast interstitium. There is inflammation of the soft tissues of the joints.
An abscess is a limited accumulation of purulent masses in various organs and tissues.
Panaritium - inflammation of the soft tissues of the finger. Almost all varieties of panaritium belong to this category, except for bone, articular and pandactylitis, in which dense tissue formations and finger structures are affected.
Paraproctitis is an inflammation of the peri rectal fiber, which is caused by the presence of an infectious focus in the wall of the rectum.
Lymphadenitis is an inflammatory process that develops in the lymph nodes and occurs in most cases a second time. It is a complication of a variety of purulent-inflammatory pathologies and specific infections.
Hydradenitis is an inflammatory process that occurs in the apocrine sweat glands of a purulent nature.
Causes
Pathogens of soft tissue inflammation are pathogenic bacteria, in most cases, a variety of staphylococci. Pathogens such as E. coli and anaerobic infection are sometimes found. Their penetration into tissues occurs with wound injuries, microtraumas (with combs, injections conducted in violation of antiseptic rules). It is possible to introduce pathogenic microflora by lymphogenous, hematogenous and contact routes from primary infectious foci. Inflammation develops through proliferative and alternative-exudative phases with an outcome in sclerotic changes and reparative regeneration.
Symptoms of the pathological process at different stages
This disease is a process that proceeds in three main stages. The first stage of the pathological phenomenon, as a rule, arises sharply and is asymptomatic.
Initially, inflammation causes alteration - a violation of the circulation in small vessels, which is associated with the transformation or damage to tissue structures. The narrowing of the capillaries during the inflammatory process in the soft tissues, in turn, provokes hypotrophy, that is, weakening and reduction of muscle volume. If at this stage the pathological phenomena associated with inflammation are not eliminated, it tends to go into the second - exudation, which is a pronounced swelling, and then into the third.
In the second stage
In the second stage of inflammatory disorders in the soft tissues, painful sensations arise. Tissues literally bursting from the fluid collected in them, and they are forced to signal this through a pain syndrome.
So, damaged muscle fibers are the source of pain in the body during inflammation, and information about these disorders comes to the nervous system through neuromuscular connections. Therefore, it is extremely important to adequately interpret the pain instead of taking pain medication during the development of such a pathological process in the soft tissues, as this happens in the vast majority of cases. As a result of everything that happens, a breakdown of neuromuscular connections occurs, the muscle ceases to transmit information about its damage to the motor neuron. Under the influence of pain medication, muscle atrophy and tendon contracture develop.
The third stage of inflammation
The third stage of the inflammatory process is called proliferation and is the resorption of soft tissue edema. This can happen spontaneously, which can be facilitated by special exercises - the creation of natural drainage.
Diagnostics
The occurrence of purulent-inflammatory processes is characterized by a wide variety of clinical manifestations. According to medical research, 40-50% of patients are referred for inpatient treatment.
The effectiveness of the treatment of patients with purulent-inflammatory diseases of the soft tissues depends on the timely diagnosis of such pathologies. A correctly diagnosed diagnosis allows for effective treatment and return them to a normal lifestyle.
Diagnosis at the initial phase can be significantly difficult, since using common methods it is difficult to determine the nature of the disorders in the bone tissue, which often spreads from the soft process.
What is the anamnesis?
During the diagnostic study, the surgeon or traumatologist draws attention to the presence in the patient's history of indications of the development of inflammatory symptoms after injuries, injuries or injections. For example, a superficially localized abscess in soft tissues is easily determined by examination of this area. Deeper pathological processes require ultrasound and diagnostic punctures. After puncture, the resulting biological material is subjected to bacteriological studies to determine the sensitivity of purulent microflora to antibacterial drugs.
In addition, the list of basic diagnostic measures includes such as an X-ray examination of the affected area and PCR diagnostics for tuberculosis. Background pathologies of the patient are also diagnosed, which may require consultation of other specialists: a gastroenterologist, otolaryngologist, endocrinologist.
Pathology treatment
The treatment methods common to all types of soft tissue inflammation are anti-inflammatory (including antibacterial) and detoxification. Mandatory also is a general strengthening treatment prescribed during surgical therapy.
Antibiotics are used for inflammation of the soft tissues, most often penicillins (Amoxicillin, for example), the course of treatment is 10 days, up to four times a day, 250-500 mg. If the patient is allergic to penicillin, macrolides (Erythromycin, Clarithromycin) will be equally effective for 10 days at 250-500 mg, but twice a day.
In addition, antibiotics for external use are used - ointments "Mafenid", "Levomekol", "Levosin". Recovery occurs in 1-2 weeks.
The course of purulent inflammation of the soft tissues and methods of its postoperative treatment or spontaneous opening of the focus of inflammation are inextricably linked with the treatment of wounds and wound infections.
Conservative treatment
Conservative treatment includes physical methods that are performed in the presence of an infiltrate or a small amount of pus, as well as in the absence of the transition of the process to tendons, joints, organ tissues, and serous cavities. It is also advisable in the absence of symptoms of intoxication, since in these cases immediate surgical intervention is required regardless of the degree of the pathological process.
What else is used in the treatment of soft tissue inflammation?
Physiotherapy
At all stages of the inflammatory process in the soft tissues, the fundamental goal of physiotherapy is the rehabilitation of the infectious focus of infection (bactericidal methods), the elimination of the inflammatory process itself. At the stage of infiltration without symptoms of purulent fusion of the tissue or with a small amount of pus (without fluctuation, in the absence of a general reaction), the goal of physiotherapy is to reverse the inflammatory process with resorption of the infiltrate and eliminate edema (anti-inflammatory methods of therapy), relieve pain (analgesic techniques).
In cases of delayed formation of an abscess, physiotherapy is prescribed in order to soften the infiltrate and accelerate the elimination of necrotic masses. Physiotherapy is also used to enhance reparative regeneration processes, increase the level of non-specific resistance (immunostimulating methods) and reduce ischemia (antihypoxic methods of treatment). Helps to quickly relieve soft tissue inflammation.
Methods
These goals are realized by the following physiotherapy methods:
- bactericidal method of therapy - electrophoresis of antibacterial drugs;
- anti-inflammatory techniques - electrophoresis (solution) of calcium chloride, UHF-therapy, low-intensity SMV-therapy, UV-irradiation;
- immunostimulatory techniques: LOC, DUV irradiation, high-frequency magnetotherapy, general VUV irradiation, heliotherapy, electrophoresis of immunomodulators;
- necrolytic methods: high-intensity UHF and microwave therapy, radiation.
- analgesic methods of therapy: SUF - diadynamo- and amplipulse therapy, electrophoresis with local anesthetics, radiation;
- reparative-regenerative techniques: microwave therapy, laser therapy, high-frequency and low-frequency magnetotherapy, ozokerite therapy.
- fibromodulating techniques: phonophoresis with defibrosing drugs, ultrasound therapy, peloid therapy.
- vasodilating agents: electrophoresis with vasodilators, infrared radiation;
- antihypoxic technique - oxygenobarotherapy;
- detoxification - AUFOK.
Effects
The consequences of this pathological process depend on its location, timeliness and adequacy of the treatment. This type of soft tissue inflammation , such as an abscess of the subcutaneous tissue, in most cases ends in absolute recovery. With a brain abscess, the prognosis is very serious, death is observed in 10% of cases. Any other soft tissue inflammation also goes away with the disappearance of all symptoms, if you choose the right treatment methods. Furunculosis and carbuncles, for example, are treated for a long time, especially if the pathology has become chronic. However, these diseases also tend to be cured.
Pathology Prevention
Prevention of the development of diseases of this nature is aimed at preventing the ingestion of pathogenic pyogenic microflora into the body and includes the following measures: adherence to antiseptics during medical procedures (eg, injections), which are accompanied by damage to the skin; timely implementation of the primary treatment of wound surfaces; rehabilitation of chronic foci of infection; increase immunity; hygiene.