Abscess of skin is the local purulent inflammation of integuments which is characterized by formation of a cavity, a limited so-called piogenny membrane. Serve as symptoms of abscess reddening, swelled, sometimes morbidity on which place then the pus congestion is formed. All this can be followed by the general symptoms of intoxication (temperature increase, weakness, headaches). Diagnosis of abscess of skin is performed on the basis of survey of the patient, in certain cases in addition appoint basic researches (the general blood tests and urine). Local treatment is made by the surgeon – the cavity is opened and processed by an anti-septic tank, in some cases the general antibacterial therapy can be appointed.
Abscess (abscess) of skin – as a rule, the acute purulent inflammation striking integuments on any area of a body. Unlike phlegmon, abscess is limited, represents the cavity filled with pus and surrounded with a piogenny membrane. In most cases this cover reliably prevents spread of an infection on surrounding fabrics, however pathogenic microorganisms from the center can sometimes get to blood or a lymph. It results in more serious conditions – limfangita, lymphadenites, metastatic abscesses of internals. On some parts of the body rich with vascular anastomoza, emergence of abscesses is especially dangerous – for example, skin abscesses in the field of a nasolabial triangle can lead to inflammations of a cavernous sine, meningitis, brain abscess.
Skin abscess reasons
In most cases causative agents of abscess of skin are bacteria. They can get into integuments at their damage, through microcracks, are occasionally brought in the hematogenic way from other inflammatory centers in an organism there. The type of the bacteria causing emergence of abscess of skin can be various – golden staphylococcus, sinegnoyny and intestinal sticks. Most often development of such state is caused not by one type of the activator, but their set. In development of abscess of skin decrease of the activity of local protective factors – for example is of great importance, at local overcooling, diabetes, existence of an immunodeficiency, non-compliance with rules of personal hygiene.
After penetration of bacteria in integuments their reproduction with formation of the pathological center begins. All this is distinguished by immune system which begins to react at first nonspecific factors of protection – blood vessels extend, inflow of blood to this site of skin increases, absorption of fabric liquid is slowed down. It becomes the reason of the first displays of abscess of skin – reddenings, hypostasis, painful feelings. After that to the center immunocompetent cages – macrophages and neutrophils which begin to fagotsitirovat activators arrive. As a result pus is formed of mix of fabric liquid, the live and died neutrophils and bacteria – it stimulates skin fibroblasta which form a membrane around the center. The inflammation takes a form of typical abscess of skin.
Skin abscess symptoms
Development of abscess of skin is characterized by a certain staging, duration of each stage quite strongly differs in different cases and depends on many factors – conditions of immunity, type of the activator, localization of an inflammation. The initial stage begins with development of reddening of the site of skin, emergence of a swelling, painful feelings. Temperature of an affected area is much higher, than at surrounding invariable fabrics. The amount of reddening gradually increases, in certain cases reaching 3-4 centimeters – depends on this stage what diameter of abscess of skin will be further. The general symptoms, as a rule, are not observed at this time.
Then production of pus begins – the center of the center begins to turn yellow, is softened, but morbidity and hypostasis remain, sometimes there is a feeling of a raspiraniye in the struck area. This stage of formation of abscess of skin in most cases comes in 3-4 days after the demonstration of the first symptoms. Distribution of an inflammation most often does not happen any more therefore the amount of education remains the same. Pus, in fact, is mix of toxic products of disintegration of fabrics which are partially soaked up in blood and lead to deterioration in the general condition of the person – temperature increase, weakness, appetite violation, sometimes to nausea and vomiting. Expressiveness of these symptoms depends on the skin abscess size – than it more, that the patient feels heavier whereas at small abscesses of changes in the general condition of the person in general can not occur.
At a final stage of the development, in the absence of treatment, skin abscess most often is spontaneously opened, pus follows to the external environment. It reduces morbidity and hypostasis, improves the general condition of the person. However in some cases at this stage development enough heavy complications of abscess of skin is possible. The most frequent of them – spread of an infection in the limfogenny way with development of a limfangit and regionarny lymphadenitis. Opening of a cavity of abscess of skin can sometimes happen not to the external environment, and in surrounding fabrics that leads to the poured purulent inflammations – to a pannikulit, phlegmon. The dissemination of bacteria is not excluded in the hematogenic way – it can lead to the metastatic purulent centers, and in especially hard cases and to sepsis.
Diagnosis of abscess of skin
In most cases diagnosis "skin abscess" does not make any problem, its manifestations are rather familiar to any dermatologist. At survey it is possible to define at what stage there is a development of a disease. At a stage of formation of abscess of skin the center of hypostasis and reddening, painful will be defined at a palpation, dense to the touch. At the subsequent stage of development education will be already had by yellow "nimbus", will become softer to the touch, but morbidity and the increased temperature of the center will remain. Besides, objectively at the patient fever, vomiting can be defined.
At survey it is also necessary to check regionarny lymph nodes – practically always they will be increased, but are painless. Sharp increase in their sizes in combination with morbidity speaks about the beginning of lymphadenitis. The general blood test at skin abscess, as a rule, comprises nonspecific signs of an inflammation in an organism. The neytrofilny shift to the left, increase in speed of subsidence of erythrocytes concerns to them . Set of these manifestations allows to direct the patient to the doctor-surgeon for treatment of abscess of skin.
In certain cases within diagnosis of abscess of skin make also microbiological research of pus – separated on nutrient mediums for identification like the activator. It is necessary to choose the most effective antimicrobic medicine for treatment of this state and its complications. However the similar research demands a lot of time (several days) therefore it at uncomplicated cases of abscess of skin is practically not applied, and antibacterial therapy is made medicines of a broad spectrum of activity.
Treatment and prevention of abscess of skin
Treatment includes both local actions, and the general antibacterial therapy. At the address of the patient with initial manifestations of formation of abscess of skin experts in the field of dermatology and surgery most often recommend to wait (to allow it "to ripen"). After the abscess completely is created, the surgeon opens it, washes out a cavity an anti-septic tank (for example, hlorgeksidiny), establishes a drainage. Antibacterial therapy is necessary at the considerable sizes of abscess of skin or heavy general displays of a disease for prevention of complications. It can include both antibiotics of a broad spectrum of activity, and other antimicrobic medicines (for example, sulfanylamides). The forecast, as a rule, favorable, but at decrease in immunity or diabetes of a complication of abscess of skin can create threat for health and even life. As prevention of development of abscess serves maintenance of work of immune system up to standard, the correct personal hygiene, observance of rules of an asepsis at injections, medical and cosmetology manipulations.