““SURGICAL INFECTION. ACUTE SURGICAL INFECTION. ACUTE PURULENT INFECTION OF THE PURULENT INFECTION OF THE SKIN AND CELLULAR SPASESSKIN AND CELLULAR SPASES””

PURULENT SURGICAL INFECTION. It is the inflammatory process of different localizations and character. The purulent microorganism are the reasons of surgical infection.

I. Determination. Reasons.

The character, the dose and the virulence of microorganism, the state of patient and the presence of necrotic tissues, the disturbance of blood circulation and immunology state of patient are the important factors of development of purulent surgical infection.

It causes many diseases and post operation purulent disorders. These patients consists 33% in according to all surgical patients.

There are the processes:1) purulent diseases;2) the purulent and destructive processes as the complications of acute surgical diseases;3) suppuration of operation wounds;4) suppuration of the tissues after its trauma

II. CLASSIFICATION OF THE SURGICAL INFECTIONІ acute: а) purulent; б) putrefactive; в) non-specific anaerobic (gangrene); г) specific

anaerobic (tetanus, anthrax, diphtheria of the wounds).

ІІ chronic: а) non-specific; б) specific (tuberculosis, syphilis, actinomucosis).

In according to proceeding:.In dependence of aethiology: s, streptococcus, gonococcus, anaerobic non-

sporemade, clostridium, complex and other infections

In dependence of localization: surgical infection of the skin and subcutaneous tissue, infection of the skull cover (brain and capsules), purulent infection of the chest and it’s organs (lungs, mediastenum), infection of the peritoneum and the organs of the abdominal cavity, infection of the pelvis organs, infection of the bones and joints.

The factors which can stimulate the development of surgical infection are: 1) hemorrhage and dead tissues into wounds;

2) polyinfection with the synergetic action; 3) increased virulence of microorganism.

Exogenic

III. The ways of penetration of microorganism into the wound

Air-dropsContact

The ways of penetration of microorganism into the

woundEndogenic infection

Hematogenic and lymphogenic

Contact

Internal

III. Pathogenesis of the surgical infection

Many factors have significance in pathogenesis of the purulent infection.

The main are:

1. Violation of the nutrition of the skin and mucous covers on the entering

gates of the infection;

2. The virulence, the type and the number of contaminating bacteria

3. Devitalized tissue within the wounds;

4. The presence of foreign bodies;

5. The nature, the location and the duration of the wounds;

6. The local and general immunity response of the individual

7. The type and the thoroughness of treatment

8. The general condition of the patient

IV.Reaction of the organism on the invasionLocal appearance:• pain,• oedema,• breaching the function,• hyperemia,• venous stasis,• high temperature

There are hyperergic, normergic, hypergic and anergic forms of inflammation

General appearance: - symptoms of intoxication (headache, weakness), fever,

tachycardia, hypotonia, encephalopathia;- Changes in the blood (leycocitosis, hastening the SSE,

moving of llycocite formula to the left, hypoproteinemia, increasing of immunoglobulines, growing phagocyte’s activity).

V. THE METHODS OF DIAGNOSTIC V. THE METHODS OF DIAGNOSTIC OF SURGICAL INFECTIONOF SURGICAL INFECTION

Examination of patientLaboratory datesAdditionally instrumentally

investigationsBacteriological method

VI. TREATMENT OF SURGICAL VI. TREATMENT OF SURGICAL INFECTIONINFECTION

Purulent diseases pass two positions of growing: stage of infiltration and stage abscission. Treatment is made due to the stage of diseases.

In the first stageIn the first stage we use the conservative methods: antibioticotherapy,

physiotherapy (soluxe, quarts, dry heat), desintoxycation therapy.

On the second stageOn the second stage with developing of the pus (abscess, phlegmon) or the necrotic changes of tissues we use the surgical methods (opening, draining) of the treatment of purulent process. This is supplements by the antibioticotherapy and antisepticotherapy, desintoxycation therapy, antiinflammatory therapy, protheolytic enzymes, if necessary – immunotherapy.

FURUNCUL

TREATMENT OF THE FURUNCUL

CARBUNCUL

HYDRADENITIS

ABSCESS

TREATMENT OF THE ABSCESS

PHLEGMONE

TREATMENT OF THE PHLEGMONE

ERYSIPELAS

ERYMATOSIS

PHLEGMONOSIS

BULLOSIS-NECROTIC

LYMPHANGITIS AND LYMPHADENITISLYMPHANGITIS AND LYMPHADENITIS

TREATMENT OF THE LYMPHAGITIS AND LYMPHADTNITIS

MASTITIS

TRTEATMENT OF THE MASTITIS

PANARICEUMPANARICEUM

SKIN PANARICEUMSKIN PANARICEUM

SUBCUTANEOUS PANARICEUMSUBCUTANEOUS PANARICEUM

PARONYHIUMPARONYHIUM

SUBNAIL PANARICEUMSUBNAIL PANARICEUM

TENDINEUS PANARICEUM TENDINEUS PANARICEUM (TENDOVAGINITIS)(TENDOVAGINITIS)

BONE PANARICEUMBONE PANARICEUM

JOINT PANARICEUMJOINT PANARICEUM

PANDACTELITISPANDACTELITIS

PHLEGMONS OF HANDPHLEGMONS OF HAND

PHLEGMONS OF HANDPHLEGMONS OF HAND

PHLEGMONS OF HANDPHLEGMONS OF HAND

PHLEGMONS OF HANDPHLEGMONS OF HAND

PHLEGMONS OF HANDPHLEGMONS OF HAND

PHLEGMONS OF HANDPHLEGMONS OF HAND