Abscess and its causes: why asepsis is so important

An abscess and the likelihood of its formation directly depends, first of all, on keeping the skin clean, as well as the rules of asepsis when treating wounds or performing injections  procedures.  Patients refer to such inflamed skin lesions as abscesses and often believe that the treatment of abscesses should be delayed until they mature, trying to make do with local remedies. The doctor must remember that the formed abscess is subject to mandatory surgical treatment in order to prevent its possible complication, follow the rules of asepsis when performing all procedures.

Features of soft tissue abscess and its causes

An abscess is a cavity in the subcutaneous fat or muscle that is separated from the surrounding tissues and filled with purulent contents. Unlike other purulent inflammations, with an abscess, the surrounding tissues create a granulation membrane around the place where the purulent process began. An important feature of the abscess – this is the presence of a pyogenic membrane, this inner shell of the abscess produces exudate and does not allow the purulent contents to go beyond the abscess. If the patient has severe chronic diseases (diabetes mellitus, malignant tumors) or other causes that weaken the body, then the pyogenic membrane is intermittent and does not hold purulent contents inside the abscess – it spreads to surrounding tissues  and forms diffuse inflammation.

Breakthrough of an abscess with the release of pus into soft tissues can also occur when the walls of the capsule formed by the granulation membrane become thinner, and when a very large amount of exudate accumulates in it. This process led to the more widely used definition of – abscess.

An abscess develops due to the fact that the integrity of the skin was violated and the infection penetrated through it – most often staphylococcus, but may be streptococcus, Pseudomonas aeruginosa, or other pyogenic microorganisms. This occurs with open wounds, abrasions, scratches, burns, injuries, fractures, frostbite, and other skin injuries.

Abscess also occurs when the infection is transferred through the blood or lymphatic vessels from other sources  - for example, with furunculosis, pyoderma, purulent tonsillitis. Infection can be introduced when injecting with a non-sterile needle. There have been cases of abscesses when high concentrations of drugs (such as 25% magnesium sulfate solution) are injected into the tissues, as well as certain antibiotics and the polio vaccine given to children.

Factors contributing to the activation of infection and the formation of an abscess:

• diseases of the gastrointestinal tract (gastric ulcer, enterocolitis, chronic gastritis);
• metabolic disorders (hypothyroidism, obesity, diabetes mellitus);
• chronic respiratory tract infections (tonsillitis, sinusitis);
• Peripheral circulatory disorders.

Signs that suggest an abscess in a patient

Symptoms that clearly indicate the development of an abscess in the soft tissues can be divided into local & nbsp; and general somatic. Local include:

• redness and swelling of the skin over the site of inflammation;
• soreness to touch and increased pain on pressure;
• Accumulation of liquid contents inside the inflammatory focus.

General somatic signs of abscess are expressed by fever and chills, headache, fatigue and sleep disturbance. If fever and other signs of intoxication of the body appear very clearly, this may indicate the spread of purulent inflammation beyond the abscess.

Treatment of abscess and possible complications of the disease

The most formidable complication of an abscess is sepsis, which develops as a result of tissue breakdown due to the spread of a purulent process. The location of the abscess next to a large vessel or nerve trunk carries the risk of purulent fusion of their walls, and the transition of the inflammatory process from soft tissues to bone can also be a complication.

Regardless of the location of the abscess, treatment should consist of surgical opening of the abscess, emptying it and draining its cavity. After opening, the treatment of abscesses  is carried out according to the principle of therapy of purulent wounds, after cleansing the abscess from purulent masses and remnants of necrotic tissues, dressings with healing ointments are used.  Antibiotic therapy is selected taking into account & nbsp; susceptibility to pathogens. Restorative therapy recommended.

Use of antibiotics  in the local treatment of abscesses is impractical, since the presence of pus reduces their effectiveness. The use of proteolytic enzymes is effective in postoperative treatment. If, despite therapy, intoxication symptoms do not disappear, one should think about the likelihood of developing sepsis and switching to massive antibiotic therapy, infusion measures.