Purulent infection, Acute and Chronic .

Briefs about purulent infection

1. Surgical Infection.Surgical Infection.
Acute Purulent Infection of Acute Purulent Infection of
the Skin and Cellular Spaces.the Skin and Cellular Spaces.
Reader: Kushnir R.Ya.Reader: Kushnir R.Ya.
Lecture:Lecture:

2. Classification of the surgical infectionsClassification of the surgical infections

Acute surgical infections.Acute surgical infections.

Chronic surgical infections.Chronic surgical infections.

3. Acute purulent surgical infectionsAcute purulent surgical infections

Acute purulent aerobic infections.Acute purulent aerobic infections.

Acute anaerobic infections.Acute anaerobic infections.

Acute specific infections.Acute specific infections.

Viral infections.Viral infections.

4. Acute Purulent Aerobic InfectionsAcute Purulent Aerobic Infections

The cause of the most frequently purulent The cause of the most frequently purulent
surgical infections it's:surgical infections it's:

Staphylococcal infections.Staphylococcal infections.

Streptococcal infections.Streptococcal infections.

Gram - negative infections.Gram - negative infections.

Mixed bacterial infections.Mixed bacterial infections.

5. Five classical local signs of Five classical local signs of
inflammation are:inflammation are:

Heat-the inflamed area feels warmer than the Heat-the inflamed area feels warmer than the
surrounding tissues.surrounding tissues.

Redness of the skin over the inflamed area.Redness of the skin over the inflamed area.

Tenderness, due to the pressure of exudate on Tenderness, due to the pressure of exudate on
the surrounding nerves.the surrounding nerves.

Swelling.Swelling.

Loss of function-an inflamed tissue does not Loss of function-an inflamed tissue does not
perform possible its physiological function.perform possible its physiological function.

6. Boil (Furuncles)Boil (Furuncles)

Boil constitute one of the very widespread purulent Boil constitute one of the very widespread purulent
diseases of the hair follicle and sebaceousdiseases of the hair follicle and sebaceous

7. Boil (Furuncles)Boil (Furuncles)

8. Boil (Furuncles)Boil (Furuncles)

9. ComplicationsComplications

boil may lead to cellulilis, particularly in those boil may lead to cellulilis, particularly in those
whose power of immunity is less.whose power of immunity is less.

boils may also lead to infection of the boils may also lead to infection of the
neighbouring hair follicles where numbers of neighbouring hair follicles where numbers of
hair follicles are too many (e.g. axilla) leading to hair follicles are too many (e.g. axilla) leading to
hydradenitis.hydradenitis.

boils usually secondarily infect the regional boils usually secondarily infect the regional
lymph nodes.lymph nodes.

10. HydradenitisHydradenitis

11. TreatmentTreatment

The general health of the patient has to be improved, as boils The general health of the patient has to be improved, as boils
often occur in individuals with debility and ill-health.often occur in individuals with debility and ill-health.

Incision is usually unnecessary as the pustule is very small. Only Incision is usually unnecessary as the pustule is very small. Only
a touch of iodine on the skin pustule will hasten necrosis of the a touch of iodine on the skin pustule will hasten necrosis of the
overlying skin and help the pus to drain out.overlying skin and help the pus to drain out.

If escape of pus does not occur spontaneously or with If escape of pus does not occur spontaneously or with
application of iodine, removal of the affected hair allows ready application of iodine, removal of the affected hair allows ready
escape of pus.escape of pus.

Antibiotic is usually not required.Antibiotic is usually not required.

After escape of pus this placet should be cleaned twice with a After escape of pus this placet should be cleaned twice with a
suitable disinfectant e.g. hexachlorophene.suitable disinfectant e.g. hexachlorophene.

If boils are recurrent, diabetes should be excludedIf boils are recurrent, diabetes should be excluded..

12. CarbunclesCarbuncles

After penetration of pyogenic bacteria under the After penetration of pyogenic bacteria under the
skin through hair follicles and sebaceous glands skin through hair follicles and sebaceous glands
the process spreads in depth, if the conditions the process spreads in depth, if the conditions
are unfavourable to the body, and affects are unfavourable to the body, and affects
considerable sections of subcutaneous tissue. It considerable sections of subcutaneous tissue. It
is an infective gangrene of the subcutaneous is an infective gangrene of the subcutaneous
tissue due to Staphylococcal (Staphylococcus tissue due to Staphylococcal (Staphylococcus
aureus) infection. Gram-negative bacilli and aureus) infection. Gram-negative bacilli and
Streptococci may be found coincidently.Streptococci may be found coincidently.

13. CarbuncleCarbuncle

14. CarbuncleCarbuncle

15. Antrax CarbuncleAntrax Carbuncle

16. TreatmentTreatment

improvement of the general health of the patient improvement of the general health of the patient
should be brought about.should be brought about.

proper antibiotic should be started immediately from proper antibiotic should be started immediately from
the culture and sensitivity test.the culture and sensitivity test.
OperationOperation may be required:may be required:

when toxaemia and pain persist even after a course of when toxaemia and pain persist even after a course of
antibiotics.antibiotics.

when the carbuncle is more than 2 inches in diameter. when the carbuncle is more than 2 inches in diameter.
It must be remembered that incision is never made It must be remembered that incision is never made
unless there is softening in the centre.unless there is softening in the centre.

17. AbscessAbscess

An abscess is a cavity filled with pus and lined An abscess is a cavity filled with pus and lined
by a pyogenic membrane. This pyogenic by a pyogenic membrane. This pyogenic
membrane consists of dead tissue cells and a membrane consists of dead tissue cells and a
wall of granulation tissue consisting for the most wall of granulation tissue consisting for the most
part of phagocytic histiocytes.part of phagocytic histiocytes.

18. AbscessAbscess

19. AbscessAbscess

20. TreatmentTreatment
The basic principle of treatment of an abscess are:The basic principle of treatment of an abscess are:

to drain the pus;to drain the pus;

to send a sample of pus for culture and to send a sample of pus for culture and
sensitivity test;sensitivity test;

to give proper antibiotic.to give proper antibiotic.

21. ErysipelasErysipelas

It is an acute inflammation of the lymphatics of the It is an acute inflammation of the lymphatics of the
skin or mucous membrane.skin or mucous membrane.
The causative organism is usually Streptococcus The causative organism is usually Streptococcus
haemolyticus.haemolyticus.

22. ErysipelasErysipelas

23. ErysipelasErysipelas

24. ErysipelasErysipelas

25. ErysipelasErysipelas

26. LymphangitisLymphangitis

A spread of infection along the lymphatic A spread of infection along the lymphatic
system is manifested in a disease of the system is manifested in a disease of the
lymphatic vessels and lymph nodes. lymphatic vessels and lymph nodes.
Inflammation of the lymphatic vessels Inflammation of the lymphatic vessels
(lymphangitis) is one of the frequent (lymphangitis) is one of the frequent
complications of infected wounds, especially complications of infected wounds, especially
during the first weeks following injury, and of during the first weeks following injury, and of
local purulent diseases.local purulent diseases.

27. LymphangitisLymphangitis

28. TreatmentTreatment

The treatment of lymphangitis consists primarily The treatment of lymphangitis consists primarily
in elimination of its cause (incision of the in elimination of its cause (incision of the
abscess, pockets of the wound, etc.) and in abscess, pockets of the wound, etc.) and in
giving the affected organ complete rest.giving the affected organ complete rest.

29. ParaproctitisParaproctitis

is the purulent inflammation of around-rectal is the purulent inflammation of around-rectal
cellular tissue.cellular tissue.

30. ParaproctitisParaproctitis

31. TreatmentTreatment

In the stage of infiltration conservative therapy In the stage of infiltration conservative therapy
usually used (antibiotics, sparing thet). At the usually used (antibiotics, sparing thet). At the
phlegmon or abscess there is indicated urgent phlegmon or abscess there is indicated urgent
operation.operation.

32. MastitisMastitis

Mastitis - is inflammation of lactic gland tissue. Mastitis - is inflammation of lactic gland tissue.
There is distinguished lactation mastitis at There is distinguished lactation mastitis at
nursing mothers, mastitis of newborns and in nursing mothers, mastitis of newborns and in
period of pubescence.period of pubescence.

33. MastitisMastitis