Inflammations of the soft tissues of the leg can occur in various forms and be localized in a variety of places. The clinical picture, however, has general manifestations. The course of treatment must be prescribed by a doctor, one of the stages is shock wave therapy.
With a small depth of the process, painful swelling develops with redness and increased skin temperature. If the inflammation goes deeper, the patient experiences attacks of fever, and signs of intoxication appear. This indicates the beginning of the purulent-necrotic stage.
If you suspect inflammation of the soft tissues of the leg, you should immediately consult a doctor, since a rapidly developing inflammatory process may ultimately lead to the need for amputation.
Treatment of phlegmon
Treatment of phlegmon is surgical - opening the abscess, excision of necrotic tissue (see photo below).
In the photo, the phlegmon is opened, the Achilles tendon is visible at the bottom of the wound.
After opening the abscess, the wound is cleaned, inflammation subsides, and wound healing processes begin.
In the photo, the wound has cleared and is beginning to heal.
In the complex treatment of phlegmon, antibiotics, immunocorrectors, physiotherapy, etc. are also used.
The photo below shows phlegmon of the left forearm, which developed from a boil.
In the photo below, the same phlegmon is opened, the wound is cleaned.
The photo below shows the same wound, almost healed.
The wound has healed.
The photo below shows advanced phlegmon of the thigh. The duration of the disease is 2 weeks.
The patient refused hospitalization, so treatment of phlegmon had to be carried out in a clinic. In the photo below - the same phlegmon 7 days after the operation - the wound has cleared and is granulating.
After cleaning the wound, secondary sutures were applied (photo below).
Medical Internet conferences
The goal is to study the problem of the development of post-injection complications in patients suffering from drug addiction: assessing the frequency of their occurrence in the structure of possible post-injection complications, assessing the effectiveness of their treatment.
The most common site of drug administration is the cubital region (58%), which is due to the accessibility for self-injections. Groin area - 13%, thigh - 13%, foot - 3%, lower leg - 3%. Noteworthy is the appearance of post-injection complications in drug addicts in the gluteal region (10%), which was previously extremely rare, because This pathology is usually associated with the administration of drugs for therapeutic or prophylactic purposes.
Among this group of patients, the most common complication is phlegmon (45%). Abscess - 27%, inflammatory infiltrate - 6%, artery thrombosis - 10%, phlebitis - 6%, gangrene - 6%. 75% of this group of patients were observed in the hospital only with a localized lesion, however, some patients developed more complex complications - sepsis (3%), severe sepsis (9%).
Note that the severity of a possible complication or course of the disease is also influenced by concomitant pathology. In addition to the fact that all patients in this group suffer from drug addiction, 49% have Hepatitis C, 11% have Hepatitis B, 6% have Hepatitis A, 6% have HIV infection and only 28% of patients have no concomitant diseases, which is a rather low figure given the age of the patients.
When treating post-injection complications in this group of patients, almost all patients underwent surgical intervention (96%). For 82% of them, only one intervention was sufficient - opening and drainage of abscesses. 7% of patients underwent necrectomy and opening of purulent leaks (more often in patients with gangrene).
Based on the results of treatment, conclusions were drawn regarding the length of hospital stay for patients with a similar pathology. A larger number of patients in the study group were discharged from the hospital within a few days, but some patients needed an extension of their hospital stay due to the severity of their condition. Of course, it is impossible to unify the length of stay in the hospital for patients with post-injection complications and drug addiction, because There are a number of features: age, concomitant diseases, severity of the condition, risk of developing sepsis, etc.
When studying the problem of treating post-injection complications in patients suffering from drug addiction, it was impossible not to turn to data on the mortality of such patients. Among the selected group of patients, mortality was only 6%, although this figure is quite high. It should be noted that mortality in this group of patients was recorded in patients suffering from severe sepsis, and among such patients it was 67%.
Abscess
Unlike phlegmon, an abscess is an accumulation of pus separated from other tissues. In essence, an abscess is a localized phlegmon.
In the photo - in the upper outer quadrant of the left gluteal region - there is a painful swelling with redness of the skin. 10 days ago, injections were given in this place - post-injection abscess of the left gluteal region.
In the photo above, against the background of existing callus, pain, redness of the skin, swelling arose, the epidermis was partially exfoliated with pus - a subcallosal abscess.
Cause of buttock abscess
An abscess is an inflammatory disease in which a cavity filled with pus forms in the tissue. Such an abscess is formed if pathogenic pyogenic microorganisms get under the skin, and the immune system cannot cope with them.
As a rule, an abscess is caused by representatives of coccal microorganisms:
streptococci, staphylococci, as well as intestinal flora, in particular, Pseudomonas aeruginosa and other bacilli.
In many cases, doctors note a combination of several pathogens, which complicates the diagnosis and treatment of an abscess.
The listed microorganisms often live on the skin of even healthy people and do not cause any diseases. But as soon as they penetrate the natural protective barrier (skin), inflammation begins. In the case of a buttock abscess, the following reasons are possible:
- Carrying out an injection into the gluteal muscle without observing the necessary hygiene rules: with a non-sterile needle, without disinfecting the injection site with alcohol.
- Introduction of drugs that irritate the skin and soft tissues. It is especially dangerous if the injection is carried out with a short needle and they fall into the subcutaneous area.
- Increases the likelihood of large injections, the presence of already formed hematomas on the buttock, prolonged bed rest, and so on.
- The likelihood of an abscess occurring is much higher in people with weakened immune systems and those with diabetes.
But injections are not the only reason for the onset of such inflammation. Simply microscopic injuries on the skin of the buttock can play a role, especially in the summer, when the skin is sweaty.
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Atheroma
A type of abscess - suppurating atheroma - video of an operation to open an abscess
At the stage of abscess formation, there is still the possibility of conservative treatment (antibiotics, physiotherapy, semi-alcohol dressings), which often results in cure. If a cavity with pus has formed, the only treatment is surgery. Under anesthesia or local anesthesia, the abscess is opened, pus flows out, after which the dead tissue is excised as completely as possible, the wound is washed and drained. After the operation, dressings are required (daily or every other day). The wound healing period is 10 - 20 days (depending on the size, depth and other factors. With extensive phlegmon, skin grafting may be required.
Infiltrate
Infiltrate is the accumulation in the tissues of the body of cellular elements that are unusual for this area, as well as blood and lymph. Its formation is accompanied by an increase in tissue volume, it becomes denser, changes color, and pain is felt at the site.
Treatment and prognosis of this condition depend on the type and cause of its occurrence:
- Inflammatory infiltrate.
- Its development is caused by injury and the spread of infection. Infiltrates can be intramuscular, subcutaneous, and they also form in the chest and abdominal cavity.
- An inflammatory infiltrate is an effusion of blood cells into the tissue. When an infection occurs, it becomes purulent. In addition to suppuration with the formation of phlegmon and abscess, the infiltrate can resolve, sclerosis, or heal with the formation of a scar.
- Tumor infiltrate.
- It develops with the invasive growth of a tumor, when tumor cells grow into healthy tissue, gradually destroying it.
In medicine, there are several more varieties of this condition.
Pulmonary
It is an accumulation of various cells in the lung tissue. In this case, the tissue becomes denser, increases in volume, and the functioning of the respiratory system becomes more difficult. The reason for the formation of lung infiltrate is the penetration of infection and parasites (ascariasis), tumor development, and an allergic process.
To determine pathology, X-ray examination plays a decisive role. Blood tests are also prescribed to determine the nature of the disease and possible pathogens.
Treatment depends on the cause of the pathology. Therapy is prescribed by a pulmonologist.
Postoperative
Infiltration after surgery is a complication resulting from surgery. The cause of the development of pathology is infection and tissue trauma.
Also, the occurrence of infiltrates is facilitated by impaired blood circulation in the area of intervention and reduced resistance to infections in the postoperative period.
The pathology develops gradually. It is detected in the first or second week after surgery. A person’s temperature rises, pain appears in the abdominal area, and stool retention occurs. In the area of intervention, the doctor determines a painful lump.
Infiltrate is dangerous because it stops the healing of the postoperative wound and causes it to fester, so immediately when it is detected, the surgeon prescribes antibiotic therapy.
Post-injection
Pathology develops at the site of subcutaneous or intramuscular injections. Most often, infiltration occurs after injections into the gluteal muscle: pain appears, and a compaction is detected on palpation. The skin turns red, the temperature rises to low-grade levels.
The cause of development is a violation of the rules for administering injections (blunt needles, rapid administration of the drug, frequent injections into the same area, failure to comply with asepsis rules).
To treat infiltration, local agents (iodine mesh), physiotherapy methods (electrophoresis), UHF and antibiotic therapy are used.
Appendiceal infiltrate
This is a complication of acute appendicitis, which manifests itself in the form of tissues of the appendix fused together with organs located nearby (cecum, small intestine, omentum).
The formation forms 2–5 days from the onset of the disease. After the formation of the infiltrate, acute pain in the right iliac region is replaced by dull and aching pain. Inflammation is also detected in the blood (increased ESR, leukocytosis). The temperature rises to low-grade levels. Over time, the seal may fester or resolve. The formation is treated conservatively: the doctor prescribes antibiotics and physiotherapeutic procedures. After 2 months, a planned appendectomy is performed.
How does a buttock abscess develop?
Immediately after the injection, a person does not notice any significant differences, but after a short time, the next time a dense infiltrate appears in this area. It may be red, painful, or swollen. Gradually it becomes softer, which indicates the formation of a purulent cavity. Interestingly, the body protects itself from this inflammation by forming a fairly dense capsule surrounding the abscess.
Further maturation of the abscess entails a deterioration in health. The patient may feel general malaise, fever, and severe pain in the area of the formed abscess. When ripe, a whitish head appears in the middle - an area of thinned tissue through which it most often breaks through.
Treatment of an abscess is always surgical. Surgeon
opens it, removes the accumulated pus, rinses the cavity with antibacterial drugs, and also leaves a drainage through which the pus will be released over the course of several days and the cavity will be rinsed.
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