Chapter 2 purulent diseases of soft tissues and extremities

PURULENT DISEASES OF SKIN AND SUBCUTANEOUS TISSUE

Purulent diseases of the skin and subcutaneous tissue are the most common pathologies encountered in the practical work of a surgeon in a hospital. Those of them that have a complicated course require inpatient treatment, but the most of patients are treated as outpatients. With some complications, these diseases can threaten not only health, but also the life of the patient; therefore, they require timely and effective surgical treatment. According to statistics, the first place among these diseases in terms of frequency is occupied by furuncles and furunculosis.

A furuncle (furunculus) is acute purulent inflammation of the hair follicle and surrounding soft tissue (Fig. 2.1). Furuncles develop most often in places with a large number of sebaceous glands. As a rule, those parts of the body are affected that are in direct contact with clothes. Boils are located most often on the neck, back, back of the hand, buttocks, inner thighs, on the face in the nasolabial folds, and on the upper lip at the base of the nose.

Fig. 2.1. The scheme of a furuncle

Predisposing factors for development of furuncles are common systemic diseases in which the body defenses are weakened (diabetes mellitus, exhaustion, vitamin deficiency, alcoholism), as well as work in dusty rooms and non-compliance with rules of personal hygiene.

The disease begins with the penetration of pyogenic infection into the hair follicle or excretory duct of the sebaceous gland. The causative agent of the disease is Staphylococcus aureus or Staphylococcus albus. Acute purulent inflammation develops rapidly, capturing the hair follicle, the excretory duct of the sebaceous gland and the surrounding soft tissues.