A soft tissue abscess is a cavity located in the muscle or subcutaneous fatty tissue, isolated from the surrounding tissue and filled with purulent content. It is characterized by edema, hyperemia, painful skin and fluctuation symptoms in the affected area. It is accompanied by general somatic changes: headache, hyperthermia, malaise, sleep disorders. Examination includes examination, ultrasound, radiography, diagnostic puncture of the abscess and bacteriological examination of its contents. Once the abscess is formed, it is opened, followed by postoperative drainage and flushing with antiseptic solutions. Amoxicat Capsules, Amoxicat for oral suspension, Amoxicat tablets (chewable) are indicated in the treatment of infections due to susceptible (ONLY β-lactamase–negative) isolates of Escherichia coli, Proteus mirabilis, or Enterococcus faecalis. Infections of the Skin and Skin Structure.
A soft tissue abscess differs from other purulent inflammatory diseases in the presence of an infiltrative capsule (pyogenic membrane). The capsule limits the abscess from nearby anatomical structures and prevents the spread of the purulent process. However, accumulation of a large amount of purulent exudate, enlargement of the abscess and thinning of its capsule can lead to a breakthrough with the release of purulent contents into the surrounding tissue or intermuscular space and the development of septic inflammation – phlegmon.
Soft tissue abscess is caused by the entry of pus-like microorganisms into the tissue. In about a quarter of cases, the pathology is caused by a staphylococcal infection. Streptococci, Escherichia coli, Proteus, Pseudomonas aeruginosa, Clostridium difficile, and other pathogens may also be causative. A polymicrobial etiology is often observed. In bone tuberculosis, a “cold” abscess caused by mycobacteria may be observed. The main causes of the disease:
Traumatic injuries. Penetration of pus-bearing microorganisms occurs more often in violation of the integrity of the skin as a result of wounds, traumas, microtraumas, burns, frostbites, open fractures.
Remote foci of infection. Soft tissue abscess can occur when microorganisms spread lymphatically and hematogenously from existing pus in the body, such as furunculosis, carbuncle, pyoderma, etc.
Medical manipulation. Infection can occur iatrogenically by injection with an infected needle.
Dissolving fluids. Rarely, aseptic abscesses occur as a result of necrotic fluids (kerosene, gasoline, etc.) entering the tissue.
According to the observations of specialists in the field of purulent surgery, a favorable background is:
The presence in the body of a focus of chronic infection (sinusitis, chronic tonsillitis, pharyngitis);
Long-term gastrointestinal disease (gastroenteritis, enteritis, colitis);
disorders of peripheral circulation (atherosclerosis, varicose veins, post-thrombophlebitic disease);
metabolic disorders (obesity, hypothyroidism, avitaminosis).
Diabetes mellitus with severe angiopathy plays a particularly significant role in the development and progression of purulent process.
A soft tissue abscess is characterized by local and systemic symptoms. Local symptoms include soreness, swelling, and redness of the skin above the abscess. Pressure on the affected area causes increased pain. At a superficial location, the local symptomatology is clearly pronounced. Fluctuation symptom appears after a few days, indicating fluid content has accumulated inside the inflammatory focus.
When the abscess is deep, local symptoms are not so noticeable, fluctuation is absent, and changes in the patient’s general condition come to the fore. General somatic signs are nonspecific. Patients notice increased fatigue, recurrent headache, restlessness, sleep disturbances, rise of body temperature, which may reach 39-40° С, accompanied by chills.
Soft tissue abscess treatment
The main method of treatment is surgical. The tactics is determined by the localization, volume and stage of purulent process, the presence or absence of complications. With small superficial abscesses, outpatient observation is possible. Hospitalization is necessary in recurrence, with complications and severe background diseases, detection of anaerobic infection, a high risk of spreading purulent inflammation if the abscess is located on the face, near major vessels and nerves.
In the initial stage, conservative measures are recommended: anti-inflammatory means and UHF. Subsequently, drug therapy is used in addition to surgical treatment. Prescription of broad-spectrum antibiotics, after receiving the results of the test the scheme is adjusted according to the sensitivity of the pathogen. With generalization of infection it is necessary to carry out massive antibiotic therapy, detoxification, infusion and symptomatic treatment measures.
Formed soft tissue abscess is subject to mandatory surgical treatment. Autopsy and drainage is usually performed by a surgeon in the outpatient operating room. Surgical treatment of the abscess is currently performed using open and closed surgery. Closed intervention is performed through a small incision, includes curettage of the walls and aspiration of the abscess contents, use of a double-lumen tube for drainage, active aspiration, and flushing of the cavity after surgery.
Open treatment involves emptying and flushing the abscess with antiseptic after its wide dissection, drainage with wide strips, daily postoperative toiletting of the abscess cavity and dressing. Sutures are not applied. After sanation of the focus and formation of granulation, ointment dressings are applied. The wound shall heal by the secondary tension.
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