| disease | Abscess |
An abscess is a localized collection of pus that forms during an acute infection in tissues, organs, or body cavities due to necrosis and liquefaction of diseased tissue, surrounded by a complete abscess wall. The most common causative bacterium is Staphylococcus aureus. Abscesses can originate from acute suppurative infections or result from pathogenic bacteria spreading from distant primary infection sites via the bloodstream or lymphatic system. They often develop when inflammatory tissue undergoes necrosis and liquefaction under the action of toxins or enzymes produced by bacteria, forming a pus-filled cavity. The pus consists of exudate, necrotic tissue, pus cells, and bacteria. The formation of a fibrin network within the pus confines the lesion to a localized area, while the surrounding tissue exhibits congestion, edema, and leukocyte infiltration. Eventually, granulation tissue proliferates to form the abscess wall. Depending on its location, an abscess may present with varying clinical symptoms. Diagnosis is typically confirmed through medical history, clinical examination, and necessary auxiliary tests. Treatment primarily involves drainage.
bubble_chart Diagnosis
Clinical Manifestations 1. Superficial abscesses are slightly raised above the body surface, presenting with redness, swelling, heat, pain, and a sense of fluctuation. In small abscesses, deep-seated locations, or thick-walled cavities, the sense of fluctuation may not be obvious. 2. Deep abscesses generally lack a sense of fluctuation, but the tissue overlying the abscess often exhibits edema and significant local tenderness, accompanied by systemic toxic symptoms.
Diagnostic Criteria 1. Superficial: Abscesses manifest as localized redness, swelling, heat, pain, and tenderness, followed by the appearance of a sense of fluctuation. 2. Deep: Abscesses present as diffuse local swelling, pain, and tenderness, with no obvious fluctuation. Pus can be aspirated by test puncture, and ultrasound can also assist in diagnosis.bubble_chart Treatment Measures
Principles of Treatment 1. Prompt incision and drainage should be performed. The incision should be made at the site of obvious fluctuation and parallel to the skin lines. The incision should be sufficiently long and positioned at a low level to facilitate drainage. For deep abscesses, puncture localization should be performed first, followed by layer-by-layer incision. 2. Postoperative dressing changes should be timely. 3. Systemic antibacterial and anti-inflammatory medications should be administered. For wounds that fail to heal over time, the underlying cause should be investigated.
Principles of Medication 1. For superficial abscesses, after incision and drainage, intramuscular or intravenous antibiotics "A" + "B" may be selected. 2. For deep abscesses accompanied by systemic toxic symptoms, broad-spectrum, high-efficacy antibiotics of the "C" class and supportive therapy may be chosen.
1. Cure: After incision and drainage, the abscess disappears, the incision basically heals, and systemic symptoms disappear. 2. Improvement: After abscess incision and drainage, the drainage is smooth, the wound granulation is healthy, and systemic and local symptoms disappear.
