Why is an abscess still draining after 3 weeks. What causes prolonged abscess drainage. How to treat a persistently draining abscess. When to seek medical attention for an abscess that won’t heal. What are the risks of untreated abscesses. How to prevent abscesses from recurring.

Understanding Abscesses and Pus Formation

An abscess is a localized collection of pus that forms as a result of an infection. Pus, a thick fluid containing dead tissue, cells, and bacteria, is produced by the body as part of its immune response to fight off infections. While abscesses typically resolve within a few weeks with proper treatment, some may continue draining for an extended period.

How does pus form in an abscess? When bacteria or fungi enter the body through broken skin, inhaled droplets, or poor hygiene, the immune system sends neutrophils (a type of white blood cell) to combat the invaders. During this process, some neutrophils and surrounding tissue die, accumulating as pus.

Common Causes of Abscess Formation

• Bacterial infections (especially Staphylococcus aureus and Streptococcus pyogenes)
• Fungal infections
• Poor hygiene
• Weakened immune system
• Skin injuries or cuts
• Ingrown hairs
• Blocked sweat glands or oil ducts

Why Does an Abscess Continue Draining After 3 Weeks?

When an abscess persists in draining beyond the typical healing period of 1-2 weeks, several factors may be at play. Understanding these reasons can help in determining the appropriate course of action and treatment.

Potential Reasons for Prolonged Abscess Drainage

1. Antibiotic resistance: The bacteria causing the infection may be resistant to the prescribed antibiotics, leading to ineffective treatment.
2. Inadequate initial treatment: If the abscess was not properly drained or treated initially, it may continue to produce pus.
3. Presence of foreign bodies: Objects such as splinters or debris trapped in the wound can prolong the healing process.
4. Compromised immune system: Conditions like diabetes, HIV, or certain medications can weaken the immune system, slowing down the healing process.
5. Recurrent infections: New infections in the same area can cause continued drainage.
6. Deep-seated or large abscesses: Larger or deeper abscesses may take longer to heal completely.
7. Underlying medical conditions: Certain diseases can interfere with proper wound healing.

Is prolonged drainage always a cause for concern? While some drainage is normal during the healing process, persistent drainage after 3 weeks may indicate a need for further medical evaluation. It’s essential to monitor the abscess and consult a healthcare provider if symptoms worsen or fail to improve.

Common Locations for Persistent Abscesses

Abscesses can form in various parts of the body, but some areas are more prone to persistent infections due to their environment or exposure to bacteria. Understanding these common locations can help in identifying and addressing potential issues early on.

High-Risk Areas for Abscess Formation

• Skin surface (especially in areas with hair follicles or high friction)
• Dental region (gums, teeth roots)
• Perianal area
• Armpits
• Groin
• Breast tissue
• Internal organs (liver, lungs, brain)

Why are certain body parts more susceptible to abscess formation? Areas with warm, moist environments or those exposed to frequent friction and bacteria are at higher risk. For instance, the mouth is particularly vulnerable due to its warm, moist conditions ideal for bacterial growth. Similarly, skin folds and hair-bearing areas provide favorable conditions for abscess development.

Recognizing Symptoms of a Persistently Draining Abscess

Identifying the signs of a persistently draining abscess is crucial for timely intervention and appropriate treatment. While some symptoms may be similar to those of a newly formed abscess, others might indicate a more chronic condition.

Key Symptoms to Watch For

• Continuous or intermittent discharge of pus
• Redness and swelling around the affected area
• Warmth in the surrounding skin
• Pain or tenderness
• Foul odor from the drainage
• Fever or chills (in case of systemic infection)
• Fatigue or general malaise
• Slow or non-healing wound

Can the color of pus indicate the severity of the infection? While pus color can vary, ranging from white to yellow, green, or brown, it doesn’t necessarily correlate with the severity of the infection. However, a change in color or consistency of the drainage, especially if accompanied by other worsening symptoms, may warrant medical attention.

Treatment Options for Persistently Draining Abscesses

Addressing a persistently draining abscess requires a tailored approach based on the underlying cause, location, and severity of the infection. Treatment strategies may range from conservative management to more invasive procedures.

Conservative Management Techniques

1. Warm compresses: Applying warm, moist compresses to the affected area can help promote drainage and healing.
2. Proper wound care: Keeping the area clean and dry, and changing dressings regularly is essential for preventing further infection.
3. Antibiotics: Oral or topical antibiotics may be prescribed to combat bacterial infections.
4. Pain management: Over-the-counter pain relievers can help alleviate discomfort associated with the abscess.

Advanced Treatment Options

• Incision and drainage: For larger or deep-seated abscesses, a healthcare provider may need to make an incision to drain the pus thoroughly.
• Packing: After drainage, the wound may be packed with gauze to promote healing from the inside out.
• Culture and sensitivity testing: Analyzing the pus can help identify the specific pathogen and its antibiotic susceptibility.
• Imaging studies: CT scans or ultrasounds may be used to assess the extent of deep abscesses.
• Surgical debridement: In severe cases, removal of dead or infected tissue may be necessary.

How long should you wait before seeking medical attention for a persistently draining abscess? If an abscess continues to drain for more than 2-3 weeks without improvement, or if you experience worsening symptoms such as increased pain, fever, or spreading redness, it’s crucial to consult a healthcare provider promptly.

Preventing Recurrent Abscesses and Promoting Healing

While treating an existing abscess is important, preventing future occurrences and promoting proper healing are equally crucial. Implementing certain lifestyle changes and following good hygiene practices can significantly reduce the risk of recurrent abscesses.

Preventive Measures and Healthy Habits

• Maintain good personal hygiene: Regular bathing and handwashing can help prevent bacterial infections.
• Avoid picking or squeezing: Resist the urge to manipulate the abscess, as this can introduce more bacteria.
• Boost immune system: A balanced diet, regular exercise, and adequate sleep can strengthen your body’s defenses.
• Manage underlying conditions: Properly control diseases like diabetes that may increase infection risk.
• Use clean towels and clothing: Avoid sharing personal items to prevent the spread of bacteria.
• Practice proper wound care: Clean and protect any cuts or scrapes to prevent infection.
• Avoid tight clothing: Loose-fitting clothes can reduce friction and allow better air circulation.

Are there any natural remedies that can help prevent or treat abscesses? While not a substitute for medical treatment, some natural remedies may support healing and prevention. These include tea tree oil (with its antimicrobial properties), turmeric (for its anti-inflammatory effects), and probiotics (to support overall immune function). However, it’s important to consult with a healthcare provider before using any alternative treatments, especially for persistent or severe abscesses.

Complications of Untreated Persistently Draining Abscesses

Failing to address a persistently draining abscess can lead to various complications, some of which may be severe or life-threatening. Understanding these potential risks emphasizes the importance of proper and timely treatment.

Potential Complications

1. Sepsis: A life-threatening condition where the infection spreads to the bloodstream, affecting multiple organ systems.
2. Tissue damage: Prolonged infection can cause permanent damage to surrounding tissues.
3. Fistula formation: Abnormal connections between organs or tissues may develop.
4. Chronic pain: Ongoing discomfort in the affected area can persist even after the infection resolves.
5. Scarring: Improper healing may result in significant scarring.
6. Antibiotic resistance: Overuse or misuse of antibiotics can lead to the development of resistant bacterial strains.
7. Systemic infection: The infection may spread to other parts of the body, causing additional abscesses or infections in vital organs.

Can a persistently draining abscess resolve on its own without treatment? While some minor abscesses may eventually drain and heal without intervention, persistently draining abscesses that last beyond 3 weeks typically require medical attention. Attempting to let such infections resolve on their own can lead to more serious complications and prolong the healing process.

When to Seek Immediate Medical Attention

While many abscesses can be managed with proper care and treatment, certain signs and symptoms indicate a need for immediate medical intervention. Recognizing these red flags can help prevent severe complications and ensure timely treatment.

Warning Signs Requiring Urgent Care

• High fever (above 101°F or 38.3°C)
• Rapidly spreading redness or warmth around the abscess
• Severe pain that is not relieved by over-the-counter pain medications
• Difficulty breathing or swallowing (especially for abscesses in the throat or neck area)
• Dizziness or confusion
• Rapid heartbeat
• Abscess located near sensitive areas (eyes, genitals, or anus)
• Signs of allergic reaction to treatment (rash, itching, swelling)

How quickly should you seek medical attention if you notice these warning signs? If you experience any of these symptoms, it’s crucial to seek medical care immediately, either through your healthcare provider or an emergency department. Prompt treatment can prevent the infection from spreading and potentially becoming life-threatening.

Follow-up Care and Monitoring

Even after initial treatment, it’s important to monitor the healing process of a persistently draining abscess. Regular follow-up appointments with your healthcare provider can ensure proper healing and allow for adjustments to the treatment plan if necessary. During these visits, your provider may:

• Assess the wound healing progress
• Check for signs of recurrent infection
• Adjust medications if needed
• Provide guidance on wound care and prevention strategies
• Address any concerns or questions you may have

Maintaining open communication with your healthcare provider throughout the healing process is essential for achieving the best possible outcome and preventing future occurrences.

Causes, Locations, Symptoms, Treatment, and Prevention

Pus is a thick fluid containing dead tissue, cells, and bacteria. Your body often produces it when it’s fighting off an infection, especially infections caused by bacteria.

Depending on the location and type of infection, pus can be many colors, including white, yellow, green, and brown. While it sometimes has a foul smell, it can also be odorless.

Keep reading to learn more about what causes pus and when you should call your doctor.

Pus-causing infections can happen when bacteria or fungi enter your body through:

• broken skin
• inhaled droplets from a cough or sneeze
• poor hygiene

When the body detects an infection, it sends neutrophils, a type of white blood cell, to destroy the fungi or bacteria. During this process, some of the neutrophils and tissue surrounding the infected area will die. Pus is an accumulation of this dead material.

Many types of infection can cause pus. Infections involving the bacteria Staphylococcus aureus or Streptococcus pyogenes are especially prone to pus. Both of these bacteria release toxins that damage tissue, creating pus.

Pus generally forms in an abscess. This is a cavity or space created by the breakdown of tissue. Abscesses can form on your skin’s surface or inside your body. However, some parts of your body are exposed to more bacteria. This makes them more vulnerable to infection.

These areas include:

• The urinary tract. Most urinary tract infections (UTIs) are caused by Escherichia coli, a type of bacteria that’s found in your colon. You can easily introduce it into your urinary tract by wiping from back to front after a bowel movement. It’s pus that makes your urine cloudy when you have a UTI.
• The mouth. Your mouth is warm and moist, making it the perfect environment for bacterial growth. If you have an untreated cavity or crack in your tooth, for example, you might develop a dental abscess near the root of the tooth or your gums. Bacterial infections in your mouth can also cause pus to collect on your tonsils. This causes tonsillitis.
• The skin. Skin abscesses often form due to a boil, or an infected hair follicle. Severe acne — which is a buildup of dead skin, dried oil, and bacteria — can also result in pus-filled abscesses. Open wounds are also vulnerable to pus-producing infections.
• The eyes. Pus often accompanies eye infections, such as pink eye. Other eye issues, such as a blocked tear duct or embedded dirt or grit, can also produce pus in your eye.

If you have an infection that’s causing pus, you’ll probably also have some other symptoms. If the infection is on the surface of your skin, you might notice warm, red skin around the abscess, in addition to streaks of red surrounding the abscess. The area might also be painful and swollen.

Internal abscesses usually don’t have many visible symptoms, but you might have flu-like symptoms. These can include:

• fever
• chills
• fatigue

These flu-like symptoms can also accompany a more severe skin infection.

Any cuts or incisions made during surgery can develop a type of infection called a surgical site infection (SSI). According to Johns Hopkins Medicine, people undergoing surgery have a 1-3 percent chance of getting one.

While SSIs can affect anyone who’s had surgery, there are certain things that can increase your risk. SSI risk factors include:

• having diabetes
• smoking
• obesity
• surgical procedures that last for more than two hours
• having a condition that weakens your immune system
• undergoing treatment, such as chemotherapy, that weakens your immune system

There are several ways that an SSI can develop. For example, bacteria might be introduced through a contaminated surgical instrument or even droplets in the air. Other times, you might already have bacteria present on your skin before surgery.

Depending on their location, there are three main categories of SSIs:

• Superficial. This refers to SSIs that only occur on your skin’s surface.
• Deep incisional. This type of SSI occurs in the tissue or muscle surrounding the incision site.
• Organ space. These occur within the organ being operated on or in the space surrounding it.

Symptoms of SSIs include:

• redness around the surgical site
• warmth around the surgical site
• pus draining from the wound or through a drainage tube if you have one
• fever

Treating pus depends on how serious the infection causing it is. For small abscesses on your skin’s surface, applying a wet, warm compress can help drain pus. Apply the compress a few times a day for several minutes.

Just make sure you avoid the urge to squeeze the abscess. While it might feel like you’re getting rid of the pus, you’re likely pushing some of it deeper into your skin. It also creates a new open wound. This could develop into another infection.

For abscesses that are deeper, bigger, or harder to reach, you’ll need medical help. A doctor can draw out the pus with a needle or make a small incision to allow the abscess to drain. If the abscess is very large, they may insert a drainage tube or pack it with medicated gauze.

For deeper infections or ones that won’t heal, you may need antibiotics.

While some infections are unavoidable, reduce your risk by doing the following:

• Keep cuts and wounds clean and dry.
• Don’t share razors.
• Don’t pick at pimples or scabs.

If you already have an abscess, here’s how to avoid spreading your infection:

• Don’t share towels or bedding.
• Wash your hands after touching your abscess.
• Avoiding communal swimming pools.
• Avoid shared gym equipment that would come in contact with your abscess.

Pus is a common and normal byproduct of your body’s natural response to infections. Minor infections, especially on the surface of your skin, usually heal on their own without treatment. More serious infections usually need medical treatment, such as a drainage tube or antibiotics. Contact your doctor for any abscess that doesn’t seem to be getting better after a few days.

Abscess Drainage – Paul E. Savoca

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An abscess around the anus develops as a result of an infection in glands within the anal canal. Although this infection usually does not become serious, occasionally it may reach the deeper tissues surrounding the anus. This results in the formation of a painful collection of fluid and pus. An incision and drainage of the infected fluid can relieve this pain. The wound that is made is left open to allow any residual pus to drain. Sometimes a dressing is placed in the wound as well.

Following the drainage of an abscess, there is approximately a 50-50 chance for the further development of a fistula. A fistula is a tunnel beneath the skin that starts at the gland which caused the infection and runs to the area of the abscess and then out onto the anal skin. This causes persistent drainage. A fistula may result in the development of further abscesses in the future. It is therefore imperative that patients follow up with their surgeon following drainage of their abscess.

HOME CARE:

A dressing has been placed over the wound. This should be left in place until you take your first tub bath (sitz bath). This may be in the evening or next morning following your surgery. Your surgeon will tell you the timing. At whichever time you are directed, the outer dressing should be removed. There is usually a dressing in the wound and this should be soaked and then pulled out while sitting in a tub of very warm water. You should then continue to take sitz baths with warm water three times a day for 10-15 minutes.

Your wound may continue to drain a large amount over the next several days as the infection slowly heals. Wear a gauze dressing to the wound to protect your clothing. You may also use a sanitary napkin for further protection of your clothing. You may notice bloody discharge for the next four to seven days.

Patients have much less pain after the surgery than they had prior to the surgery. However, depending on the size of the abscess there may be residual discomfort for a few days. Pain should slowly decrease. After a few days if there is a change in course and pain begins to intensify call the office. You will be given a prescription for pain medication. Follow the directions given by your doctor for taking this medication. After a day or two, if the pain is subsiding try to use just plain Tylenol to ease residual discomfort. To avoid upset stomach, take your pain medication as prescribed with food in your stomach.

Take these drugs exactly as directed. Never take more than the recommended dose, and do not take the drugs more often than directed. If the drugs do not seem to be working, call the office for advice. Do not share these or any other prescription drugs with others because the drug may have a completely different effect on the person for whom it was not prescribed.

Some people experience drowsiness, dizziness, lightheadedness, or a false sense of well-being after taking opioid analgesics. Anyone who takes these drugs should not drive, use machines, or do anything else that might be dangerous until they know how the drug affects them. Nausea and vomiting are common side effects, especially when first beginning to take the medicine. If these symptoms do not go away after the first few doses, check with the physician who prescribed the medicine.

Side effects may include: dizziness, lightheadedness, nausea, sedation, vomiting, if these side effects occur, it may help if you lie down after taking the medication.

• Avoid strenuous activity for 1 week after your procedure.
• Take sitz baths (sit for 15-20 minutes in warm water) three times a day and after each bowel movement for the first few days.
• Don’t worry if you have some bleeding, discharge, or itching during your recovery. This is normal.
• Avoid constipation.
  • Take Benefiber or other psyllium product (Metamucil, Citrucel, Konsyl, etc) one teaspoon twice a day. Take a stool softener such as Colace or Surfak twice a day as well.
  • If you have not had a bowel movement by the morning of the fourth day following surgery, take 2 fleet enemas, 1 hour apart (lubricate the tip of the enema well with Vaseline and insert gently). If no result, drink one bottle of citrate of magnesium, which can be purchased at any pharmacy. Following the first bowel movement, you should have a bowel movement at least every other day. If 2 days pass without a bowel movement, take an ounce of milk of magnesia. Repeat in 6 hours if no result.
  • The use of dry toilet tissue should be avoided. After bowel movements use a wet Kleenex, cotton or Tuck’s pads to clean yourself, or if possible, take a warm bath.
  • If you were given a prescription for an ointment, apply this two or three times a day at the edge of the anal opening.
• Eat a regular diet including plenty of fresh fruit and vegetables. Drink 6-8 glasses of water a day.
• Call the office if your temperature is greater than 101 degrees. Follow-Up Make a follow-up appointment as directed by our staff. The first follow up is usually 2 weeks following surgery.

From the Clinical Staff to All Surgical Patients:

We are here to help you with any pre-operative and post operative questions you might have. We know this is new to you and any surgery can be frightening. We are here to help you through it.

Please keep the following in mind when you call:

1. Please leave a short message as to the nature of your call. Someone will usually get back with you as soon as possible. Remember if you are having a life threatening emergency, CALL 911. If you call after 4 PM you will receive a call back shortly after the office opens at 9 AM.
2. Please call the office where you are seen as that location will have your medical record which will make it much easier to answer any medical questions that you have.
3. Medication refills: Please allow 48 hours for refills. Make sure you leave the following information:
   • YOUR NAME – WITH SPELLING DATE OF BIRTH YOUR BEST CONTACT TELEPHONE NUMBER THE PHARMACY TELEPHONE NUMBER (VERIFY THAT IT IS OPEN) THE NAME OF THE MEDICATION FOR REFILL

Abscess of the pancreas.

What is a pancreatic abscess?

IMPORTANT
The information in this section should not be used for self-diagnosis or self-treatment. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For diagnosis and proper treatment, you should contact your doctor.

A pancreatic abscess is a cavity filled with pus and necrotic masses in the pancreatic tissue. In the vast majority of cases, it develops after acute alcoholic pancreatitis. It is characterized by the appearance of fever, girdle pain, leukocytosis, tumor-like formation in the abdominal cavity about two weeks after an attack of pancreatitis. The diagnosis is established after an ultrasound, MRI or CT scan of the abdominal cavity, analysis of biochemical and general clinical parameters of the blood. The only effective method of treatment is surgical debridement of the abscess followed by antibiotic therapy.

ICD-10

K85 Acute pancreatitis

• Causes
• Pathogenesis
• Abscess symptoms
• Complications
• Diagnostics
• Treatment of pancreatic abscess
• Prognosis and prevention
• Prices for treatment

General

Pancreatic abscess is a severe disease that develops in patients who have had pancreatitis (acute or repeated exacerbation) or pancreatic necrosis with the formation of a delimited purulent cavity in the gland. The disease is dangerous for the patient’s life, and its deceit lies in the obliteration of the clinic against the background of antibiotic therapy. That is why in modern gastroenterology it is customary to prescribe antibiotics for pancreatitis only with concomitant damage to the biliary tract or proven bacterial complications. All cases of fever and abdominal pain within two weeks of pancreatitis should be considered as a probable pancreatic abscess. The only method of treatment leading to recovery is a surgical operation to drain the abscess. Without surgery, mortality in this pathology reaches 100%.

Abscess of the pancreas

Causes

Pancreatic abscess develops against the background of acute pancreatitis, can be formed in any form of pathology, except for edematous; 3-4% of cases of this disease end in the formation of an abscess. It is most often detected against the background of alcoholic pancreatitis. The reasons for the formation of a purulent cavity in the pancreas are not completely clear. It is assumed that the infection can be brought in by blood flow, when pseudocysts are punctured (if asepsis is not observed), during the formation of a cyst fistula with the intestine. The development of an abscess is facilitated by:

• severe pancreatitis with more than three risk factors;
• postoperative pancreatitis;
• early laparotomy;
• early initiation of enteral nutrition;
• irrational antibiotic therapy.

In the vast majority of cases, during aspiration and sowing of the contents of the abscess, Escherichia coli or enterobacteria are released. According to studies in the field of gastroenterology, the addition of a secondary infection is observed in almost 60% of cases of pancreatic necrosis, therefore, in the treatment of this disease, the likelihood of a cavity with purulent contents should be taken into account.

Pathogenesis

When acute pancreatitis occurs, the gland tissue is damaged, due to which the enzymes enter both the gland itself and the surrounding tissues, destroying them. Because of this, pancreatic necrosis may begin, pseudocysts are formed – cavities filled with liquid contents and necrotic tissues. When an infection enters the area of ​​the pathological process, either pancreatic phlegmon develops – total purulent fusion, or an abscess forms. It should be noted that phlegmon is a more severe and prognostically unfavorable condition, clinically practically no different from a single abscess. In addition, with phlegmon, multiple abscesses can form in the tissues.

Abscess symptoms

An abscess of the pancreas is formed for a long time – usually at least 10-15 days. Thus, within two to four weeks from the onset of pancreatitis, the temperature rises to febrile numbers, chills, tachycardia appear, and pain in the upper abdomen increases. The pains are girdle in nature, quite strong. The patient pays attention to weakness, fatigue, lack of appetite, increased sweating. Disturbed by nausea, vomiting, after which bitterness is felt in the mouth for a long time. There are all signs of intoxication. On palpation of the abdomen, attention is drawn to the presence of a tumor-like formation, tension in the muscles of the anterior abdominal wall.

Complications

An abscess of the pancreas is often complicated by the further spread of the infection, the formation of multiple abscesses in the gland itself and surrounding organs. Pus can flow retroperitoneally, break through into hollow organs (intestines, stomach), subdiaphragmatically and into peri-intestinal tissue, pleural and pericardial cavities, in connection with which an intestinal abscess, subphrenic abscess, purulent pleurisy and pericarditis can form. Also, the abscess occasionally can break out through the skin with the formation of a fistula. When enzymes destroy the vessel wall, severe bleeding can occur, sometimes with a fatal outcome.

Diagnostics

The diagnosis of a pancreatic abscess is established by a specialist in the field of general surgery after a thorough examination of the patient. The differential diagnosis is carried out with pancreatic pseudocyst, pancreatic necrosis. The following methods apply:

• Laboratory studies. In the general analysis of blood, high leukocytosis, a shift in the formula of leukocytes to the left, an increase in ESR, and anemia are noted. In the biochemical blood test, attention is drawn to an increase in the level of pancreatic enzymes, hyperglycemia. The level of amylase in urine is increased, although during the formation of an abscess, its amount may gradually decrease.
• Imaging techniques. Ultrasound of the pancreas, CT scan of the abdominal cavity will allow you to determine the location and size of the focus, the number of abscesses. If necessary, simultaneous percutaneous puncture with aspiration, examination and seeding of the contents is possible.

Ultrasound of the pancreas. Against the background of a sharp increase in the size of the gland (circled by a dotted line), a large (up to 3 cm in diameter) abscess is determined in its head (shown by arrows).

X-ray examination of a pancreatic abscess has some features. Since the gland is located behind the stomach, the shadow of the abscess cavity can be superimposed on the gas bubble of the stomach. Therefore, the exposure should be longer, and if an abscess is suspected, a contrast agent is injected into the stomach cavity and a vertical x-ray is taken in a lateral projection – while a rounded shadow with a fluid boundary (abscess) will be behind the stomach. If contrast enters the abscess cavity, we can talk about the presence of a fistula. Also in the pictures you can see signs of intestinal compression, displacement of organs. The left diaphragmatic dome is high, its mobility is limited, there may be effusion into the pleural cavity.

CT scan of the abdominal organs. Diffusely enlarged pancreas. The large arrow points to the body of the pancreas, the small arrows to the abscess located in the tail of the pancreas.

Treatment of pancreatic abscess

The treatment is performed by an abdominal surgeon. An abscess is an absolute indication for debridement and drainage. Practice shows that percutaneous drainage of abscesses leads to a cure only in 40% of cases, moreover, with this tactic, phlegmon, multiple abscesses, and the spread of infection to the tissues surrounding the pancreas can be missed. That is why endoscopic or classical laparotomy excision and drainage of the abscess will be the best option.

During the operation, a careful examination of the surrounding organs, retroperitoneal tissue for secondary abscesses is performed. In parallel, the patient is prescribed antibiotic therapy according to the obtained crops, painkillers, antispasmodics, enzyme inhibitors. Infusion therapy is carried out for the purpose of detoxification.

Laparoscopic drainage of pancreatic abscess with necrectomy.

Prognosis and prevention

Since the causes of the formation of pancreatic abscesses have not been fully elucidated, today there are no measures to prevent the development of this pathology after pancreatitis and pancreatic necrosis. Thus, the prevention of abscess formation is the prevention of pancreatitis – after all, an abscess can form only against its background.

The prognosis for the formation of abscesses is serious: without surgical treatment, mortality is 100%, after surgery, survival reaches 40-60%. The outcome of the disease depends on the timeliness of treatment, rapid diagnosis and surgical treatment. The earlier the diagnosis is made and the operation is performed, the better the long-term results.

You can share your medical history, what helped you in the treatment of pancreatic abscess.

Sources

1. Surgical diseases of the pancreas / Sysolyatin A.A. – 2009
2. Internal diseases / Braunwald E. – 1997
3. Clinical operative purulent surgery: a guide for doctors / Gostishchev V.K. – 2016
4. Abdominal surgery. Practical guide / Grigoryan R.A. 2006
5. This article was prepared based on the site: https://www. krasotaimedicina.ru/

IMPORTANT
Information from this section cannot be used for self-diagnosis and self-treatment. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For diagnosis and proper treatment, you should contact your doctor.

Abscess of postoperative sutures – causes and methods of treatment

Contents

1. Causes of inflammation
2. External symptoms
3. Types of infectious reactions
4. Comorbidities as risk factors
5. Suture healing mechanisms
6. Lump in the seam area
7. Ligature fistula
8. Purulent inflammation of the postoperative suture – treatment
9. Phytotherapy
10. Indications for surgical opening of an abscess
11. What happens if I refuse surgery?
12. Precautions
13. Prevention
14. References

After surgery, the suture may become inflamed. Sometimes this happens after discharge from the hospital. If pus appears, you should seek medical help as soon as possible.

Causes of inflammation

Connective tissue is formed at the site of wound stitching. The epithelial layer protects the damaged area from pathogenic flora – it does not allow it to penetrate inside. If the infection does get into the wound, inflammation may develop, and then an abscess.

Sometimes the cause of the complication is a violation of the rules of asepsis at the stage of suturing. In other cases, the seams diverge due to accidental damage to the epithelial layer, physical overstrain. Remember that trying to remove the stitches yourself is not worth it, even if it seems that the wound has completely healed. The removal of sutures after surgery must be entrusted to an experienced nurse.

Unfortunately, even strict adherence to all prescriptions of the attending physician does not always help: an abscess develops against the background of weakened immunity, advanced age, and the presence of chronic pathologies.

As a rule, the inflammatory process is triggered by staphylococci, Pseudomonas aeruginosa. When the pathogenic flora enters the wound with contaminated medical instruments and consumables, they speak of direct infection. If it penetrates there from another infectious focus, for example, a carious tooth, we are talking about the indirect penetration of dangerous bacteria.

Important : In the first weeks after surgery, you can shower for a maximum of 10 minutes. Water should have a comfortable temperature: too hot or cold slows down the regeneration processes. You can take a bath 30 days after the operation.

External symptoms

A reddened seam may frighten impressionable people, but this sign does not always indicate the onset of an inflammatory process. Puffiness, slight bleeding may indicate accidental damage to the seam when the bandage is inaccurately removed, when clothing is removed. The following signs indicate that inflammation has begun:0006

• swelling of tissues;
• pain in the area of ​​the wound surface;
• redness;
• persistent bleeding;
• the appearance of plaque with an unpleasant odor, purulent discharge;
• fever;
• fever;
• increased blood pressure;
• increased heart rate.

Seek medical attention if several symptoms appear. Put a bandage on the wound before visiting the surgeon – it will serve as protection from additional damage. Before that, rinse the surface with hydrogen peroxide and remove the resulting foam with a napkin. Do not press or rub the wound. Treatment of seams with anti-inflammatory gel, ointment is acceptable.

The doctor will prescribe treatment after the examination. You may need to redo the seams.

Types of infectious reactions

Superficial infection affects the skin and subcutaneous fat directly in the area of ​​the incision. With deep penetration of the infection, the fascia and muscles are affected. In especially severe cases, bone tissue is involved in the pathological process. To avoid the development of infection, you need to regularly clean the stitches. It is recommended that this be done by a nurse. Treatment is possible not only in the hospital, but also at home. When the wound heals, the nurse will remove the stitches at home: the price of the service depends on where you live.

Superficial infection occurs in the first month after surgery. It is usually caused by staphylococcus aureus. A deep lesion develops within three or more months after discharge from the hospital.

Thickening, redness of the tissues that surround the suture, the appearance of pain are the first signs of infection. Over time, other symptoms appear:

• serous-purulent, serous fluid flowing from the incision;
• tissue swelling in the wound area;
• localized tenderness that gradually increases;
• the appearance of pus from the depth of the wound surface;
• divergence of seams, accompanied by pain, fever.

Comorbidities as risk factors

Even before surgery, doctors take into account the anamnesis of the patient who was admitted to the hospital. The fact is that some concomitant diseases reduce the body’s resistance to pathogenic flora and prevent normal wound healing. These diseases and pathological conditions include:0006

• obesity;
• immunosuppression;
• diabetes;
• dermatosis;
• old, infancy;
• malignant neoplasms;
• pyogenic, infectious foci in any area of ​​the body (dentals affected by caries, infections of the ENT organs, the genitourinary system, etc. ).

If the patient’s natural defense mechanisms do not work well, he must especially carefully monitor the condition of the suture, visit the doctor regularly after discharge from the hospital.

Suture healing mechanisms

1. Formation of connective tissue with fibroblasts: cells that accelerate the repair of damaged tissues.
2. Formation of the epithelial layer on the wound, thanks to which it is possible to avoid the ingress of pathogenic flora inside.
3. Tissue contraction: gradually the area of ​​the wound decreases, it closes.

What determines the rate of wound healing? In young people, this process is faster and easier, they are less likely to have complications. This is due to the work of the immune system, a good supply of body resources. It is noticed that in excessively thin people and patients with obesity, the regeneration process slows down. To recover faster, you need to pay attention to nutrition: the more vitamins and valuable minerals you get from food, the faster the seam will heal. Remember that the body also needs enough protein.

Do not forget to drink plenty of clean water: dehydration disrupts the functioning of the heart and kidneys, slows down regenerative processes. Keep in mind that with weak immunity, the risk of suppuration, the development of an abscess increases dramatically. Among chronic diseases, tumors, endocrine disorders, and pathologies of the vascular system are especially dangerous.

Bump in seam area

The most common complication is the appearance of a bump on the seam, which is accompanied by the release of pus. The reason may be bacterial infections, rejection of threads by the body, illiterate suturing, use of poor quality consumables. If there is a bump, you should not hesitate to visit the doctor: a purulent infection can cause serious harm to health.

Ligature fistula

This complication occurs after abdominal surgery. The incision is sutured with ligatures, which are conventional and absorbable. The healing time of the suture depends on the material chosen. If it is of high quality, the likelihood of complications is minimal. When using an expired thread, the penetration of dangerous bacteria into the incision develops inflammation, a fistula appears after a few days. It is a hard wound, from which pus is constantly flowing. A crust may appear on it, but after a few days the wound opens again, pus begins to flow. The patient complains of fever, headache, general deterioration of health. If you have these symptoms, see your doctor. It will detect the infected thread and delete it. In the absence of medical care, the seal will increase in size. Ointments, gels for local treatment will not lead to the desired result. After removing the ligature, the doctor will tell you how to properly care for the wound. It is imperative that you follow all of his instructions.

With a long course of the inflammatory process, several fistulas appear. In this case, the surgeon removes the scar tissue and re-sutures.

Purulent inflammation of the postoperative suture – treatment

A nurse takes care of stitches in the hospital. She changes dressings, performs treatment, installs drainage if necessary. After discharge, care falls on the shoulders of the patient himself. Processing is carried out daily. It is especially important to carefully process the seams after water procedures. When taking a shower, do not touch the wound surface with a sponge or washcloth. After the hygiene procedure, blot it with a gauze swab, then apply hydrogen peroxide, and after it – brilliant green. Apply a sterile dressing. When the scar is completely healed, the stitches will need to be removed. If you don’t want to go to the clinic for this, invite a nurse to your place: the removal of stitches at home is carried out in compliance with the rules of asepsis. The health worker has all the necessary tools and supplies with him.

Sometimes, even after a few weeks, an ichor is released from the suture, it bleeds. In this case, you need to visit a doctor and undergo treatment under his supervision.

Important : Some patients, when they see an ichor or induration, try to cope with the problem with the help of lotions, compresses. Doctors forbid to wet the seam: high humidity slows down the processes of tissue regeneration.

With the development of an abscess, the doctor selects a treatment that is aimed at stopping suppuration, increasing immunity. If necessary, he removes the stitches, rinses the wound surface with an antiseptic, installs a drain to drain the pus. If the doctor prescribes an antibiotic, an immunomodulator, you should not refuse to take them: complications really appear against the background of weakened immunity, rapid reproduction of a bacterial infection. As an addition to the main therapy, a vitamin complex, solutions, ointments for treatment are prescribed.

Phytotherapy

Healing herbs have analgesic, anti-inflammatory, antibacterial action. They speed up wound healing.

Infusions of medicinal herbs, ointments with their extracts are used for:

• easing intoxication, improving general well-being;
• enhance immunity;
• normalization of the gastrointestinal tract;
• prevention of the negative effects of drugs taken on the body;
• seam processing.

Aloe vera juice, birch buds, highlander grass are used to wash the wound surface. After the procedure, the wound must be wet. To increase immunity, you can drink an infusion of marigold flowers. The rules for preparing infusions are described on the packaging with herbal raw materials, which is sold in a pharmacy.

Important : Phytotherapy methods can only be used as an addition to the main treatment. It is forbidden to replace the prescribed drugs with herbs. Before using infusions and extracts, you should consult your doctor.

Indications for surgical opening of abscess

• no effect of conservative therapy;
• pain, severe swelling, induration, redness of tissues;
• persistent discharge of pus;
• general deterioration of health, lack of appetite, increased body temperature;
• signs of acute inflammation, confirmed by a laboratory blood test.

What happens if I refuse surgery?

• lack of surgical care can cause phlegmon – acute diffuse purulent inflammation of tissues that affects tendons, blood vessels, muscles;
• involvement in the negative process of the nerve trunk, which leads to the development of neuritis;
• the transition of purulent inflammation to nearby bone tissue, which is fraught with the development of osteomyelitis;
• the risk of an abscess not breaking through to the skin surface, but into hollow organs, the abdominal cavity: as a result, pus will spread throughout the body;
• abscess encapsulation in case of untimely seeking medical help, self-treatment: the capsule surrounding the pathological focus increases, the inflammatory process becomes chronic, requires significant surgical intervention, prolonged drug therapy.

Important : Trying to open an abscess on your own is very dangerous! This can cause blood poisoning, the penetration of pus into healthy tissues. As a result, the patient is threatened with a repeated abscess or phlegmon.

Precautions

After discharge from the hospital, follow simple rules for a speedy recovery after surgery:

• give up the contrast shower: sudden temperature changes hinder regenerative processes;
• thoroughly dry the skin in the area of ​​the wound surface after water procedures;
• take a bath only if approved by your doctor;
• If a bump appears on the seam, consult your doctor immediately.

As a rule, patients at home process the stitches themselves, but if the wound surface is in a hard-to-reach place, you need to ask relatives for help or invite a nurse home. She will come at the appointed time and perform the necessary procedures.

Prophylaxis

A timely visit to a doctor will help to achieve prompt relief of the inflammatory process. It is important to drain the wound, take the prescribed antibacterial agent. If you do not consult a doctor when pus appears, sepsis, gangrene may develop.

To prevent postoperative suppuration, the development of an abscess, it is necessary to properly prepare the patient for surgical intervention. It is important to detect existing infections and get rid of them: sanitize the oral cavity, cure diagnosed diseases. After the operation, the patient must strictly observe the rules of hygiene, process the stitches correctly, not lift heavy objects, and eat well. You need to forget about diets until the final recovery. This primarily applies to women who are constantly afraid for the safety of their figure. Health in this case is more expensive. These simple recommendations will help to significantly reduce the likelihood of formidable complications.

Remember that it is easier to avoid a complication than to treat it. If you are afraid that you will not be able to take care of the postoperative wound on your own, make an agreement with the nurse. She will handle it herself.

References

1. Late purulent postoperative complications / Kuznetsov V.D., Bobovnikova N.V., Mikhailov V.F., Antonov V.V.// Surgery. – 1998. – No. 7.
2. Differential diagnosis of ligature and other external fistulas using ultrasound scanning / Zubov A.D., Gubanov D.M., Osipov A.G. // Bulletin of emergency and restorative medicine. – 2011 – Vol. 12, No. 3.
3. Post-hospital postoperative complications in abdominal surgery / Khromova V.N. // News of higher educational institutions. Volga region. Medical Sciences. – 2011.
4. Diagnosis and treatment of purulent ligature complications / Kadyrbaev R.V., Alimzhanov A.K., Timashova E.V., Golovnya M.A.// Bulletin of KazNMU. – 2012.
5. Andreeva P.S., Frenzel A.A. Emergency care in therapy and surgery. – Rostov-on-Don: ed. “Phoenix”, 1999. – 267 p. 2.
6. Barykina N.V. Surgery Rostov-on-Don: ed. Phoenix. 2007.
7. Management of general surgical patients in the postoperative period /A.