Carbuncle is a purulent-necrotic inflammation of a group of sebaceous glands and hair follicles. With further development, the process captures the surrounding fiber. More often, the carbuncle develops on the posterior plane of the neck, in the interscapular and. scapular region, on the lower back, buttocks, less often on the face.

Causes of carbuncle

They occur most often when the skin is contaminated in places of friction with her clothes, due to the ingress of pyogenic viruses (staphylo- and streptococci). Exhaustion, diabetes mellitus, disorders of the gastrointestinal tract, liver and kidneys, vitamin deficiency contribute to the emergence and development of carbuncles.

The main symptoms of carbuncle

Initially, a small inflammatory infiltrate appears with a superficial pustule, rapidly increasing in volume. Tissue tension, sharp pain on palpation, and independent arching pain are noted. The skin in the area of ​​the infiltrate becomes purple, tense, swollen. The thinned epidermis above the focus of necrosis breaks through in several places, several holes appear, from which thick pus is released. Necrotic tissue is visible through the holes.

At a carbuncle the expressed intoxication takes place. The temperature rises to 40 °, nausea, vomiting, headache, loss of appetite. These phenomena are especially sharply expressed with a carbuncle on the face. Of the complications should be called lymphangitis, lymphadenitis, thrombophlebitis, sepsis, purulent meningitis.

Carbuncle treatment

On an outpatient basis, it is permissible to treat carbuncles of small sizes, localized on the trunk and limbs, in the absence of severe intoxication. At the beginning of the disease, in the presence of only an inflammatory infiltrate, before the formation of a purulent-necrotic focus, antibiotic therapy is indicated. Analgesic and cardiac agents, a milk-vegetarian diet are shown. The surface of the infiltrate is treated with 70% ethyl alcohol and an aseptic dressing is applied. Apply ultraviolet irradiation, UHF therapy. With a favorable effect of conservative therapy, the reverse development of the infiltrate occurs after 2-3 days and is accompanied by a decrease in pain, a decrease in body temperature, and the normalization of the blood picture.

The indication for surgery is the formation of a focus of necrosis. The operation for a small carbuncle is performed under local anesthesia with a 0.5 – 0.25% novocaine solution. The carbuncle is cross-cut through the entire thickness of the necrosis to viable tissues with subsequent necrectomy. The operation ends with the introduction of tampons into the wound with a hypertonic solution of sodium chloride or proteolytic enzymes. Until the final rejection of purulent-necrotic masses, dressings with proteolytic enzymes, hypertonic sodium chloride solution are changed every day, staged necrectomy is performed according to indications, then ointment-based products are used. After the operation, antibiotic therapy and physiotherapy are continued.

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