Suppuration of wound: causes and symptoms
Author: surgeon Yurevich VV
Whatever the surgical intervention to which any patient is exposed, it, one way or another, involves inflicting a wound on him.
Unfortunately, even an ideally performed surgical procedure is often overshadowed by such an annoying phenomenon as suppuration.
What is the suppuration of the wound? A suppuration of the wound is the formation and accumulation of pus in the soft tissues of the wound in the early or late postoperative period. Normally, any wound healing process is accompanied by a different degree of inflammation. As a rule, the natural inflammatory reaction subsides within three to five days, and later the wound heals without any features. However, in some cases, the inflammatory reaction in the wound goes beyond the limits of the physiological norm, which in turn leads to the formation of pus.
Causes of suppuration of the wound
What are the reasons for the festering of the wound?
In most cases, the accumulation of pus in the wound occurs for the following reasons:
1) The presence of infection in the wound. Infection can get into the wound in various ways. Most often this happens in those cases when surgical intervention is performed about any purulent process in the body. For example, it happens with such diseases as purulent appendicitis, purulent inflammation of the uterine appendages, surgery for purulent lung lesions, and so on. Even with ideally performed manipulations during surgery, some of the bacteria from the purulent focus get into the wound, which in some cases leads to suppuration.
Another reason for initiating a wound is much less pleasant - this is a violation of the rules of asepsis and antiseptic in the operation. This kind of suppuration occurs when infection occurs, for example, when the surgeon's hands or surgical field are treated poorly before surgery, using poorly sterilized instruments, suture material, surgical underwear. Also, the infection in the wound can get after the operation, which happens with dressings, when the health worker does not wear a mask, does not use sterile gloves and the like. Or the patient is engaged in self-treatment and incorrectly applies ointments from purulent wounds .
If infection in the wound is prevented in cases of severe purulent processes, it is often impossible, infection with non-sterile material during the intervention is a gross medical error.
2) Purulent inflammation in the wound can occur without infection. This kind of suppuration of wounds occurs in people with increased sensitivity of the body. Despite the fact that modern dressing and suture material, as well as various prostheses, drains and other implants are practically harmless to the human body, in some cases the organism "does not take them" and tries to tear them away in every possible way. Such a process of alienation of alien materials also almost always ends in suppuration.
3) Suppuration of the wound can occur in patients with weakened immunity. So it is reliably proven that patients who underwent various interventions that have any severe chronic diseases of internal organs (liver, heart, lung, kidney, diabetes, HIV infection and others) suffer from suppuration of wounds several times more often than healthy people .
Symptoms and treatment of wound suppuration
Despite the reason that led to the suppuration of the wound, its symptoms are in most cases the same. These include the following:
1) Constant pain in the wound that lasts a long time after the operation, sometimes up to several weeks and, often, is pulsating or shooting (normal pain after surgery rarely exceeds 2-4 days and corresponds to the natural inflammatory process that takes place in any wound).
2) High body temperature, which in most cases rises by the evening and exceeds 38.0-38.5 ° C.
3) Signs of inflammation in the wound, lasting more than 2-4 days. These include redness of the skin around the wound, swelling, increased local temperature in the wound (wound hot to the touch)
4) Explicit signs of purulent process - when pus is released through the sutures of the wound or even after their removal.
These symptoms can never be evaluated separately. Only a comprehensive assessment of them allows accurate and timely diagnosis of this complication.
It should be noted that suppuration of the wound is not so rare and occurs according to different data in 1-15% of all surgical interventions (on average, this figure is 5%). As a rule, the purulent process develops 3 days after the operation and reaches a maximum by the end of the first week. When the patient is in the hospital during the first week after the operation, the doctor most often easily recognizes it and takes appropriate actions. However, in some cases, for example, in deep purulent processes, weak immunity, severe concomitant diseases, festering can develop, as it were, imperceptibly at a later date.
Treatment of wound suppuration is usually reduced to opening the wound, either by removing the sutures in the early postoperative period, or by re-operative intervention in the already healed wound and evacuation of the purulent discharge and subsequent treatment of the wound with antiseptic solutions until it is completely healed. This is called primary surgical treatment of the wound
And in conclusion I would like to say that any purulent process is potentially dangerous for the human body and is fraught with serious addictions up to the infection of blood and death. That is why at the slightest indisposition after any operation and, especially in the presence of symptoms of suppuration, you should immediately consult a surgeon.
A purulent wound is characterized by the presence of pus, tissue necrosis, the development of microbes, edema of tissues, the absorption of toxins. The principles of treatment of purulent wounds are based on the teaching about the processes occurring in the wound during its healing, and the conditions that promote regeneration. Tasks of treatment: removal of pus and necrotic tissues; reduction of edema and exudation; control of microorganisms.
Rana - mechanical damage to tissues with a violation of their integrity. It is proved that for the development of infection in the wound it is necessary to have 105-106 microbial bodies per 1 gram of tissue. This is the so-called "critical" level of bacterial contamination. But the "critical" level may be low. It is now believed that any accidental wound is bacterially contaminated, or infected.
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