Phlegmon: classification, symptoms, causes, treatment, prognosis

August 22, 2017 23:00 | Pyoderma

Representing a vast defeat of living subcutaneous tissue without clearly delineated boundaries, phlegmon can affect various parts of the human body.Manifestations of it are quite typical, but the similarities with the abscess make it necessary to carry out a preliminary diagnosis in order to put the most accurate diagnosis.And since it depends on the diagnosis in most cases depends on the choice of treatment, subjective manifestations and survey data provide the most complete information for the attending physician.

Cellulitis that occurs for several reasons, the most common, can be localized in different parts of the body, but at the same time its manifestations are similar and bring serious discomfort for the person.Like any other lesion of the skin, phlegmon is more quickly cured if it is detected at the earliest possible stages.Therefore, even with the initial manifestations of subcutaneous tissue damage, you should consult a dermatologist for a survey.

Features

disease is manifested in the form

of destruction of live tissue, located directly beneath the skin, abscess can arise as the female half of the population, and among men.By age, this lesion can occur at almost any age.However, most often it is diagnosed in middle age, mainly from 35 to 55 years( these are the data of medical statistics).

The peculiarities of this purulent process in men and women have no fundamental differences.

  • In childhood, , a phlegmon can usually appear in a place that has been injured or mechanically exposed.
  • Adults the abscess may be formed not only in the place of mechanical damage, but also against the background of this inflammatory process and after treatment.Abscesses, purulent wounds, boils are the most frequent manifestations that accompany phlegmon, which greatly influence and even provoke its formation.

Localization

The area of ​​phlegmon origin can be different.However, as practice shows, most often this type of purulent lesion of fatty tissue( phlegmon) is subject to the following body parts:

  • chest;
  • thighs;
  • buttocks;
  • back( especially its lower part);
  • is sometimes the face and neck area.

Since the main cause of cellulitis should be considered as the penetration of pathogenic microorganisms in the fat tissue lacerations and cracked skin, these places for any mechanical damage requires special attention.

Phlegmon lacrimal sac( photo)

Classification

Today the generally accepted classification of this process purulent character is its division at the place of localization.And since, depending on the location of the phlegmon, it can have slightly different symptoms, it is necessary to determine the belonging of the developing pathological process to a certain type during the diagnosis.

Locally localization

So, depending on the localization abscess is divided into the following varieties:

  1. Subcutaneous , which progresses directly in the layer of subcutaneous fat.
  2. Subfascial .
  3. The retroperitoneal ( phlegmon of retroperitoneal space), revealed by conducting a general examination of the abdominal cavity with frequent complaints of the patient for pain in the abdomen.
  4. Intermuscular , which is usually accompanied by ongoing or progressive inflammatory processes in the muscle layer.
  5. Obstructed , accompanied or caused by kidney disease - this is how the pathogenic microflora penetrates into this area.
  6. Near-intestinal , located near the rectum and its origin is due to the penetration of pathogens through the walls of the rectum.The most common cause of phlegmon in this case are long-standing constipation and instability of the intestine.

Since the formation of phlegmon may not be directly related to mechanical damage to the skin and the infection is transferred into the subcutaneous tissue by hematogenous pathway with relapses and long-term ongoing diseases, it is sometimes not possible to determine the exact belonging to a certain group of phlegmon.

The phlegmon will be described in detail by the specialist in the video below:

Process steps

Phlegmon can also be classified according to the stage of the process at which the disease occurs.So, physicians are allocated:

  • chronic and acute course of the disease,
  • superficial location of phlegmon or finding it in deep layers of fatty tissue,
  • its limited distribution or extensive.

Causes of

Usually, the cause, according to medical data, of the appearance and further progression of phlegmon is considered mechanical damage to the skin. And through the wounds and cracks on the skin quickly penetrate pathogens that provoke a purulent process in fatty tissue.

The reason for the onset of any purulent process is the activation of pathogenic bacteria in the wound surface.Their penetration can occur not only due to ruptures and traumas of the skin, but also through separation through the circulatory and lymphatic systems.Also to the reasons that can stimulate the formation of phlegmon, include:

  • penetration into the tissues of Staphylococcus aureus;
  • streptococci;
  • is a hemophilic infection that is most often activated in children.It can penetrate through dog bites;
  • anaerobes( bacteroides, peptococci, Clastridia);
  • diphtheria bacillus.

The listed microorganisms and bacteria when entering fatty tissue against the background of a general weakening of the human body are able to begin active reproduction, and cause the onset of a purulent process called phlegmon.

Symptoms

Symptoms of any purulent process can be called the onset of swelling of the tissues, soreness, which increases with the progression of the disease, reddening of the affected part of the tissue and the spread of purulent process to the adjacent healthy tissue in the absence of the necessary therapeutic effect.

The most obvious manifestation of phlegmon is the following:

  • painfulness of the affected area, which increases depending on the stage of the current pathological process;
  • redness of the affected area;
  • rapid spread of phlegmon in an acute process with an increase in the number of affected tissues;
  • tenderness can manifest itself not only when palpation of the affected area, but also when turning the trunk.

The area of ​​tissue damage in the development of phlegmon does not have clearly defined boundaries, however, the surface of the skin here becomes more shiny and shiny.Common manifestations in the initial stages of the disease can be considered the appearance of a headache, worsening of the general condition, a decrease in the duration and quality of a night's sleep, at later stages of the pathological process, shortness of breath, yellowing of the skin can be noted.

Diagnosis and treatment of phlegmon in newborns, children and adults are described below.

Diagnosis of phlegmon

Methods for diagnosing the current putrefactive process in detecting phlegmon may differ, but first of all this will be the subjective feelings of the patient.

Diagnostic measures for the development of phlegmon include:

  • visual inspection of the patient,
  • measurement of his body temperature( with the development of phlegmon development the temperature rises),
  • also carries out an ultrasound examination at the internal location of phlegmon.

Opening and treatment of the phlegmon of the orbit, lower jaw, legs, arms( limbs), shin, mouth cavity - all this we will consider below.

Treatment of

Today, the therapeutic effect in the detection of phlegmon can be performed by therapeutic or medicamental treatment, as well as by surgical intervention.The operation can be used in those cases when there is a formed infiltrate in the affected area: during surgical intervention, the tissues are cleansed and the infiltrate removed.

Therapeutic

For treatment in the initial stages of hospitalization, the patient is not required.

  • In the absence of infiltration in the affected area, the doctor usually prescribes local heat in the form of warmers, warming compresses.
  • A set of UHF procedures can also be recommended.
  • Antibacterial therapy may also be prescribed, which stops the activity of the propagation process of the pathogenic microflora.

Opening of the submandibular phlegmon is shown in this video:

Medical

Drug treatment for the detection of phlegmon should be considered the use of complex therapy with broad-spectrum antibacterials to stop the purulent process in tissues.Also, medicinal products can be used after an operative intervention, with the directionality of the action of drugs - the early healing of the wound surface and the stopping of the process of inflammation.

The drugs most often used in the treatment of phlegmon include preparations of the penicillin group, as well as agents that stimulate the rejection of necrotic tissues: Iruksol, Terrylitin, Trypsin.

Operation

Surgical intervention is the most effective method of treatment in the advanced stage of phlegmon, when the affected tissues have purulent exudate, which during surgery should be removed.

For the operation, the patient is prescribed a complete anesthesia, which allows complete purification from phlegmon of not only affected tissues but also adjacent soft tissues to prevent possible relapse after surgery.

Abscesses and phlegmons of the maxillofacial area

Prevention of the disease

As preventive measures may be the use of drugs that increase immunity, because it is with imbalance in the functioning of immunity, there is an activation of all inflammatory processes in the body and its reducedAbility to resist.

Also for any mechanical damage, it is necessary to carry out the treatment of skin wounds with disinfectant solutions with the utmost care to avoid getting an infection in them.And for any manifestations of discomfort after a mechanical trauma or a long-term inflammatory process in the body undergo a medical examination.

Complications

In the detection of phlegmon, the occurrence of side effects is likely, especially in the case of neglected stages with the formation of a significant amount of infiltrate.Complications of phlegmon include a high probability of deepening the current inflammatory process in neighboring tissues, which increases the risk of general infection of the body.

In determining the possible complications in diagnosing phlegmon, its location should be taken into account.

  • Thus, with the formation of phlegmon in the neck region, neglected stages are fraught with asphyxia due to an increase in the volume of affected tissues.
  • With the formation of phlegmon in the head region, it is possible to penetrate the infection into the brain, which can cause its damage and inflammation.

Forecast

With rapid detection of phlegmon with any location, the patient's survival rate is usually 100%. However, with advanced stages, as well as inadequate treatment, survival is reduced and there may sometimes be an increased risk of death.

The commissural phlegmon is also operable, as described below: