What is an abscess? This is a cavity filled with pus, which is located in the muscles or subcutaneous fatty tissue. This pathological condition is caused by pathogenic viruses or bacteria. As a result of the accumulation of a large amount of pus, the affected area begins to increase, and there is a risk of an abscess rupture with the release of pus into the adjacent he althy tissue. This leads to the development of extensive inflammation, called phlegmon.
In addition, a neglected abscess provokes neuritis, which contributes to the occurrence of osteomyelitis. Is this pathology treated in a conservative way, how does an abscess open? Let's take a closer look at this.
Causes of an abscess
A purulent disease occurs as a result of a pathogenic infection entering a weakened or damaged organ, which begins to multiply rapidly. The body at this time actively fights inflammation and limitsinflamed place. As a result, a purulent capsule appears.
Infection penetrates into 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.
Abscess may occur due to the fact that infected contents were injected under the skin along with the drug or an infusion of medicines that are intended only for intramuscular injections occurred. This leads to the development of aseptic necrosis of the fiber and purulent inflammation of the soft tissues.
Sometimes an abscess can occur as a result of previous diseases: pharyngitis, tonsillitis, pneumonia, osteomyelitis, ingrown nails.
Possible outcomes of abscess development
What can happen after this purulent cavity has appeared? The outcome of such an ailment is as follows:
- outward or inward breakthrough (into the abdominal or articular cavity);
- breakthrough into 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 scar. But if the pus is not completely out, then the inflammation often recurs or can become chronic. Therefore, the abscess must be opened to remove the accumulated pus.
Technique
The opening of the abscess should be carried out as soon as possible if it is more than four days old and the head of the capsule has already matured. Such a 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 a tissue incision (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 expanded to 4-5 cm and at the same time the abscess binding bridges are ruptured. They begin to remove the pus with electric suction, after which the cavity is examined with a finger to remove the remnants of tissues and bridges. The cavity is washed with an antiseptic and drainage is carried out by inserting a rubber tube into it, which ensures the outflow of purulent exudate.
Treatment of a postoperative wound
Treatment after the opening of the abscess is carried out with the help of antibiotics. Basically, the doctor prescribes penicillin preparations ("Amoxicillin", "Cefalexin"), which should be taken 4 times a day, 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 action extends only to the affected area, and they are not absorbed into the blood.
In addition, the wound after openingabscess needs treatment. So that its edges do not stick together until the granulation of the cavity from the depth occurs, a swab with Vishnevsky ointment or vaseline oil is left in the operated tissues. It should be changed every 2-3 days during dressings. As the granulation develops, the tampon is removed from the depth. Cauterize excess granulation, while trying not to touch the epithelium growing along the edges of the wound. When the wound heals slowly, suturing is indicated.
Let's consider how the opening of the abscess of the Bartholin's gland and in the pharynx.
The process of opening a bartholin gland abscess
This gland is considered the largest of those located in the vestibule of the vagina. It becomes inflamed quite rarely, and if a purulent capsule has formed, then it must be opened. How is this procedure carried out?
Opening a Bartholin gland abscess begins with the fact that the doctor makes neat incisions, 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 the remnants of pus. Remove it after 5 or 6 days. Treatment is with antibiotics and ointment applications.
The process of opening an abscess in the pharynx
Opening a paratonsillar abscess is considered the main method of treating diseases of a purulent nature in the pharynx. Such an operation is considered simple and rarely causes complications. It is carried out under local anesthesia (solution of cocaine 5% and dikain 2%). The incision is made in the area of the greatest protrusion of the pharyngeal wall and its depth should not be more than 1.5 cm, otherwise the bundles of nerves and vessels located nearby can be damaged. Having released the pus, the doctor penetrates the cavity with a blunt instrument to destroy the partitions inside it.
After the paratonsillar abscess has been opened, the cavity is filled with a disinfectant solution. After it is sutured, usually no measures are taken to stop the bleeding. Postoperative treatment involves taking antibiotics.
Conclusion
Thus, the opening of an abscess is a mandatory procedure, because if left untreated, it can lead to various complications. It is strictly forbidden to open it on your own, otherwise it may contribute to the spread of infection to organs and tissues located nearby.
