Skin abscess – a limited purulent-inflammatory disease of soft tissue is quite common complication of surgical hospital. It is a localized infection in the skin, which begins as redness with time area becomes a solid, eventually softens and abscess pus formed inside. Pus – a mixture of protein, white blood cells and other cells, whose main task is to isolate the infection. Cutaneous abscesses occur with equal frequency in both men and women. Typically, a male characteristic location of abscesses in the neck and head, on the legs and perirectal area. For a female characteristic axillary, vulvovaginal and perirectal location.
The causes and mechanisms of skin abscess.
Like any purulent disease, cutaneous abscess occurs due to violation of the integrity of the body’s protective barriers and penetration of pathogens (bacteria or viruses). Bacteria that cause melting of the skin tissue and the formation of capsules filled with purulent masses are a part of us, but under certain conditions and increase their numbers, they can be activated. A large number of such organisms exist on our mucous membranes: oral cavity, nasal cavity mucosa of eyes, genital, and this part is in the intestine, both thick and thin. Identify abscess pathogen is quite difficult, and from this sometimes depends on the effectiveness of treatment. A variety of bacteria that cause purulent inflammation is very large, we will consider only those which are most often encountered in surgical practice.
- In the majority of the cause of skin abscess is Staphylococcus aureus(Staphylococcus aureus). Recent research shows that Staphylococcus aureus is detected in 27.6% of cases, the detection of cutaneous abscess, and are almost always planted in pure culture, without concomitant flora. 47.4% are abscesses identified in the upper half of the body (abscesses of the face, neck, chest and underarm area), which was the main cause of Staphylococcus aureus. Some of the subgroups are not Staphylococcus are sensitive to many antibiotics, it is difficult to treat.
- Proteus mirabilis – one of the many microorganisms that inhabit the large intestine and excreted with feces microscopy. This microorganism is often the cause of abscesses nizhey half of the body, although it is not a permanent inhabitant of the skin.
- Quite often the cause of skin abscesses acts E. coli, the microorganism is a part of us and part of the intestinal flora, but under certain conditions, and lowered immunity can cause serious and sometimes fatal disease.
- Some drugs can cause sterile abscesses, cellulitis that resemble skin.
- Some diseases can be complicated by the occurrence of abscesses ( pharyngitis ,ingrown nail , abscess , Crohn’s disease , osteomyelitis , orhoepidimit , amoebiasis ,donovanosis , pediculosis pubis …)
Symptoms of skin abscess.
How manifests skin abscess. As mentioned above, skin abscesses can appear anywhere on the body. Most often this is due to violation of the integrity of the protective barrier of human skin – the epithelium, with injuries or cuts. Due to violations of the barrier conditionally pathogenic flora, which lives on human skin, begins to penetrate into the sterile conditions of the organism and, under favorable conditions begin to actively proliferate. The body attempts to send all their strength, to suppress the inflammatory response and limits the portion of the shaft of the healthy tissue of inflammatory cells, and when this barrier is not enough, there is a capsule, and in which is formed an abscess.
Obstruction of the sebaceous and sweat glands may also lead to an abscess. Such abscesses are located mainly in areas with large concentrations of sebaceous and sweat glands – this is the face, neck, armpits and the area around the rectum. Since puberty in adolescents these glands are the peak of its activity, in the same period the largest number of the formation of abscesses. In the area of the rectum is very often the ingrown hairs, plus the accession of infection results in a perirectal abscess. Women abscesses in the genital area are caused by obstruction of the Bartholin glands.
Patients with abscesses usually complain to the local pain and swelling in the affected area of the skin, often noting that the disease started about 3-4 days ago. After some time, usually for 5 – 6 days in the lesion appears symptom fluctuations – oscillatory movement of fluid within the abscess cavity. In most patients, symptoms of intoxication may be absent, but sometimes there may be a moderate tachycardia, which is usually associated with the patient’s anxiety and pain, as well as a direct toxic effect of the infection, the underlying inflammation.
From outward symptoms may appear thick swelling of the skin around the abscess, cellulitis, due to inflammatory reaction and stagnation. Fever may occur later formation of an abscess, and not exceed subfebrile tsifar. However, with further increase in temperature, it is safe to say about the generalization of infection, which is a very important factor, which certainly need to inform your doctor.
Identify abscess is quite simple, as it has a number of very striking features and a surgeon who has been treating this disease, it will not be difficult to diagnose. However, there are quite advanced cases in which there is a secondary infection and the accession process of generalization that can be difficult to find a primary focus of infection. Surgeon produce a primary inspection, you may need to take a smear-imprint with an abscess to identify the causative agent. General blood and urine analysis required to determine the overall resistance of the organism and diagnostic comorbidity. The doctor will need to check with the patient, if he had any injuries, cuts or burns earlier. For the differential diagnosis will need to inform your doctor if you have diseases such as diabetes, cardiovascular diseases, tumors or tumor of connective tissue disease. It should list all the medications that you recently were treated or are being treated at the moment, particular attention should be paid to a number of corticosteroid drugs. Abscesses in the armpit are very similar lymphoproliferative disease, so diagnosis of abscess in the area should be conducted in collaboration with physicians hematologist.
Treatment of Skin Abscess
Abscesses Home treatment can only be carried out at the initial forms and formations of small size. Ideally, treatment should begin as soon as there was inflammation, to avoid further complications. The main means of abscess home treatment is warm compresses.Heat increases blood circulation in the area of inflammation and allows the body to better fight infection by increasing the concentration of white blood cells in the infection. They should not be treated with heat in the home during the formation of purulent process, you must immediately consult a doctor .
The main method of treatment of cutaneous abscess without complications in the form of signs of intoxication – excision and drainage of the cavity followed by surgical debridement. With properly conducted surgery treatment with antibiotics is required. In case of doubt with regard to the differential diagnosis between cellulitis and abscess may conduct diagnostic puncture the affected area. Any number of aspirated pus is proof formed an abscess that needs to be drained by open way. If the pus is not received during diagnostic manipulations, it is likely to have the cellulite process, which have not yet formed cavity. In such circumstances, cellulite treatment begins with a common purpose, warm lotions and antibiotics that can fight with some flora that caused this pathology.Since cellulite process can take place with the formation of cavities, the patient should be observed at the surgeon, despite the use of antibiotics.
What is the prognosis?
Most small abscesses form, such as a boil, pass on their own. Forecast of the abscesses, which are treated stationary, also is favorable. Complications are quite rare, and abscesses are more common with suppressed immune systems. Complications in this case includes the spread or worsening of inflammation to adjacent areas of skin tissue or soft tissue, which can lead to the formation of lymphangitis, lymphadenitis , arthritis ,osteomyelitis , and endocarditis; and very rarely, the spread of infection through the bloodstream to the development of sepsis . Recurrence of infection is another possible complication that can occur after a certain period of time.
Prevention of abscesses.
There are measures that can be taken to prevent the formation of abscesses:
Regular hygiene and using antibacterial soap may help prevent the proliferation of pathogenic bacteria on the skin. This can reduce the chances of developing the inflammatory process. In some cases, your doctor may recommend a special antibacterial gels and ointments with power effect, if you do not have enough germicidal soap. Proper and balanced diet, avoiding harmful habits will help to maintain your body and strengthen the immune system, which will be able to cope with any disease.