Whitlow on the finger of the hands, feet. Hyponychial, bone, subcutaneous, joint. Classification, treatment, photos

Felon on the fingers is an infectious inflammatory disease of subcutaneous fat. The hearth is located in the tissues of the fingers of the upper limbs, at least - low. Its formation occurs when the microbes through scratches, abrasions.

It is characterized by pain, the swelling, redness. On the stages of development, rather conservative therapy. If there is an abscess, can not do without surgery. Because of this part of the structure of the nuances and location of soft tissue abscess penetrates in depth - to the bones, tendons and joints. If proper treatment is not provided, there may be severe complications.

The disease is divided into 2 groups - purulent and serous. Depending on the location of purulent-necrotic process share the superficial and deep types.

surface	deep
Cutaneous	Bone
Subcutaneous	Tendinous
hyponychial	glenoid
okolonogtevoy	Pandaktillit

How does felon

Whitlow on the finger develops by penetration of infectious microorganisms into the soft tissue.

Formed inflammation, increases the feeling of fullness in the affected area due to swelling, pain appears. In the absence of suitable treatment, the infection is able to break into the next are cells spread on the bone joint.

The deeper into the inflammatory process, the harder the disease occurs. Without competent therapy may result in all of the finger structures in the future, there is gangrene.

Are more likely to relapse abscessed forms. To eliminate inflammation, opened the affected cell. Less commonly diagnosed pathological process on the foot. This is due to the fact that the fingers are exposed to injury more often. The infection spreads equally.

Causes of felon

The primary cause of the pathological process is infection. Gateway happen cutaneous lesions, burns, scratches, insect bites or splinters.

The circumstances preceding the occurrence of the disease:

• frequent hand washing with chemicals or soap substandard;
• regular biting fingers;
• abuse manicure, pedicure;
• the use of derivatives of vitamin A - Isotretinoin, reduced immunity;
• consumption of medications that suppress the protective function for the combined treatment of autoimmune diseases and cancer;
• chronic inflammation on the skin - psoriasis, dermatitis, allergic etiology, lupus;
• vitamin deficiency, diabetes.

Purulent inflammation triggered by different types of bacterial agents, usually bacteria of the genus cocci and mixed flora.

symptoms felon

Clinical manifestations of disease depends on its species.

All forms occur painful swelling and redness is present:

1. Skin appearance. The development of disease-causing process starts on a finger, on the back of the brush. Under the skin, the pop-up bubble accumulated purulent mass. They may contain impurities bleeding. The skin near the bubble is red, almost no pain, only a slight burning sensation is present. An increase, we are talking about exacerbating the condition.
2. paronychia - inflammation of the peri roller at the root. The development is complemented by redness, pain in the nail area, swelling and pain. Through time formed an abscess and purulent exudate. The nail becomes yellowish-green tint, exfoliate. After he grows deformed.
3. Bone type. This is an acute inflammatory disease of the purulent nature, localized in bone tissue. Accompanied by intolerable discomfort, swelling of the fingers, local hyperthermia and redness.
4. Hyponychial appearance. Inflammation develops under the nail plate due microtraumas. It is characterized by severe pain, throbbing inflammatory center located under the nail. The temperature rises locally, the affected area is red, swollen tissue situated near.
5. Joint and bone appearance. The peculiarity of this species are spindly fingers that are difficult to move because of their strong swelling. Pain has no clear position, it is throbbing, unbearable. Perhaps the formation of a fistula through which flows purulent exudate.
6. Tendon shape or purulent abscess. This is one of the most dangerous, which is fraught with the deterioration of motor function of the fingers. Accompanied by a state of high fever, prostration. Finger swells, is in a folded state. When you try to move them, causing severe pain.

According to doctors, often appears whitlow on the finger from first to third in persons 25 to 55 years.

diagnosis felon

Diagnostic measures aimed at the exclusion of other pathologies fingers infectious etiology. Held refinement of the form and depth of the lesion.

1. Inspection. The doctor evaluates the changes in the affected area, detects signs of intoxication, analyzes the axillary lymph nodes. Take the button-probe for on-site inspections, which makes it possible to determine the part where there is the greatest pain and the depth of the ulcer.
2. Medic takes swabs in the presence of exudate or open sores. This allows you to make bacteriological analysis with the establishment of species of the pathogen and its susceptibility to the major antibiotics. Result preparing 5-7 days.
3. Roentgen 2 projections - panoramic, shot. The method is carried out in suspected bone or articular form.
4. Diafonoskopiya. Diagnosis involves candling of tissues involved in the pathological process of a finger. Inflammatory center looks like a dark spot, which makes it possible to determine its approximate magnitude and shape.
5. The overall clinical analysis blood plasma to detect total intensity of the inflammatory process. A study by evaluating ESR level.

Diagnostic plan involves the collection of analyzes to detect inclination and complicating the course of disease conditions. These include detection of glucose in order to avoid diabetes and syphilitic lesions.

Symptomatology requires differential diagnosis with similar diseases:

• onychomycosis;
• erysipelas;
• boils, carbuncles.

Sometimes the doctor you want to exclude chancroid-felon. This is a rare form of primary syphilis, when an "open gate" fingers microdamages upper extremities appear to Treponema pallidum. The disease is common among medical personnel in contact with the virus carrier materials for laboratory tests.

Prevention felon

Identifies a number of preventative measures to help avoid felon.

These include:

• regular observance of hand hygiene;
• correct selection's Skin funds does not dry the skin;
• Sliding and not cut cuticles and before performing the manicure salon, an interest about methods of processing devices;
• wean children nail biting is not to bite off burrs;
• treatment of wounds and abrasions antiseptics - Kutaseptom, Biosept, Antiseptolom;
• use of emollient and moisturizing creams;
• use rubber gloves when cleaning or interaction with the ground.

If your hand has scratches or other damage, you can not work with the meat and the ground. Timely detection of the disease can be quickly solved without consequences. It is desirable at the first detection of redness, pain on the finger handle to doctors.

Therapies panaritium

Whitlow on the finger amenable to treatment only in the first stages, when treatment can take place at home. Apply antiseptics, ointments, antibiotics, non-traditional methods.

What medications are shown.

1. Furatsilin. Available in a mortar and tablets of 0.2 g and 20 mg. Active ingredient acts as nitrofurazone. The drug has a bactericidal effect, destroying bacteria of the cocci. Used for hot baths, floating in them a sore thumb for at least 30 minutes. The course of treatment is 1-2 weeks, depending on the result.
2. Dimexide. Produced as liquids for external use, gel 25% and 50%. The active substance is dimethyl sulfoxide. Medication has antimicrobial, anti-inflammatory and antispasmodic action. His diluted in a ratio of 1: 4 with water is applied appliqué 1-2 times per day. the application rate is 7-10 days.
3. Levomekol. This ointment is packed into tubes. In 1 g contains 7.5 mg of chloramphenicol and 40 mg methyluracil. Smeared thinly on sweaty finger 2-3 times a day for 2 weeks. Ointment eliminates bacteria, accelerates healing.
4. Tetracycline ointment. Drug substance is packed into tubes, the main element is tetracycline hydrochloride 3.226 g It gives high healing results in the development stages. You can combine it with zinc paste of 1: 1, smeared 2-3 times a day in the course of 10 days.
5. Lincomycin. The active component is lincomycin, 15 g of therapeutic substance 300 mg is present. An antibiotic used to eliminate the disease in the form of ointment 2-3 times a day. Use 5-7 days, at the doctor's discretion.

The total duration of treatment course is no more than 2 weeks. If these medications do not bring any results, the patient noted hyperthermia, there was abscess - operation is necessary.

antibiotic therapy

Antibacterials prescribed always, without taking into account the selected therapy techniques - operative or conservative manner. This is explained by the fact that, due to an infectious inflammation appears at high risk of complications. Preferably the broad spectrum antibiotics prescribed exposure.

What are the antibacterial agents are used:

1. 1st generation - Cephalexin orally, intravenously Cefazolin or intramuscularly 3 times with 4 g per day course of 1-2 weeks. The active substance acts both means cephalexin and cefazolin. The first antibiotic is produced in the form of capsules 250 mg of active substance. Cefazolin is presented in a powder for solution at 2000mg / vial and 1,000 mg / vial.
2. 2nd generation - Cefuroxime orally with 5 ml of the suspension every 8 hours Tsefamandol - in the form of injections into the vein or muscle - 2 times a day for 1 year Cefuroxime is produced in the form of solution for injection, the active ingredient - cefuroxime in an amount of 0.75 or 1.5 g in a vial. Cefamandole is a powder for solution for injection. Active element - cefamandole 500 mg, 1 or 2 g vial.
3. 3 generations - Ceftriaxone - into a vein or muscle every 24 hours for 1-2 g The drug presented as a powder for the manufacture of a solution, the active substance - ceftriaxone 0.5 g or 1 g in a vial.

If the patient is in good time to see a doctor appointed by penicillin - ampicillin, gentamicin or Penicillin. receiving rate is from 5 to 7 days, sometimes up to 10 extended. Individuals with gastrointestinal pathologies additionally prescribed pribiotiki.

They protect the gastric mucosa against the adverse effect of antibiotics. For topical use on procaine penicillin solution 1 in the form of injections once a day. Duration of the course of these means of treatment the doctor sets individually.

Physiotherapy

Physiotherapeutic methods have a sedative effect, stimulate blood rheology, improve immune properties. Against the background of the course, eliminated whitlow on the finger, tissues recover faster.

Widely prescribed such techniques:

• quartz - 5-7 procedures;
• UHF - 5-10 sessions;
• phonophoresis prednisolone, hydrocortisone - the number of sessions is determined individually.

Also resorted to a transcranial electrical stimulation. The procedure helps to numb the affected finger to normalize hemodynamics, speed up the recovery process of tissues. 6-7 sessions are usually required.

trays

Herbal baths have soothing, regenerative effect. They can be done 2-3 times a day, a course of 1-2 weeks.

1. Eucalyptus. Buy at the pharmacy tincture, dilute 2 hours. l. to 1 liter. warm water. You can prepare a broth of dried herbs eucalyptus. Mark 2 hours. l., steamed 0.5 liters. water boil for 15 minutes. Cool, dip into the broth a sore thumb and hold for 15 minutes.
2. Celandine. Put in a saucepan 1 tbsp. l. herbs, add 0.5 liters. warm water. Boil to a simmer, reduce the heat and simmer for another 15 minutes. In the bath with a decoction of celandine finger hold for 20 minutes.
3. bathbased magrantsovki. Take 1 tsp to 1 liter. water, stirred until dissolution of the crystals. It is necessary to achieve a light pink shade, otherwise there is a risk of getting burned. Keeping a finger in the solution for 10 minutes. After that, apply a compress with levomikol.

It is desirable to pre-test means components for allergy. It is necessary to apply a decoction or tincture on the brush, wait 30 minutes. If skin changes did not happen - there is no intolerance.

The polyclinic

Whitlow on the finger of the skin and subcutaneous species treated in outpatient conditions:

1. When cutaneous form, the bubble is removed, the wound was treated with a peroxide and brilliant green. Anesthesia is not required.
2. In the case of the subcutaneous type, make 2 cuts on both edges of the affected area, drain the pus.
3. When paronychia, abscess autopsy is performed, by lifting skin roller.
4. Patients with bone, tendon and joint type to seek treatment in the department of purulent surgery. There is conducted a comprehensive therapy, depending on the severity of the condition. Therapeutic regimen selected individually.

On average, the treatment in the clinic takes 1 week.

surgical methods

When conservative therapy was carried out incorrectly, or no avail, the operation is put. Drainage of fluid held under local anesthesia. If the skin around the boil turns white or yellow, local anesthesia is not done, because this symptom indicates damage to the nerve roots.

1. Operational with external manipulation inflammation is done by undercutting exfoliated portion with its further excision and removal of exudate. Anesthesia is not required, the procedure is not accompanied by pain. At the end of the process applied antiseptic application for 5 days. During this time there will be epithelialization of the wound.
2. With deep lesions of infection, it is cut in 10 mm toward the palm at the edge of the nail. Relegated skin covering the nail bed, the purification is conducted by a pathological exudate.
3. If the nail is based exfoliate due to accumulation of pus, it was excised. Finger applied antiseptic dressing. Rubber gasket changing and left still for 1 day.

To restore the finger after the operation and to prevent the accession of a secondary infection, shows a course of antibiotics and antiseptics 5-7 days.

Traditional methods

Unconventional methods of treatment used to enhance the effect of other procedures. Best results are show on the stage of development, help to avoid surgery.

1. Compress with onions baked. Mark vegetable peel and oven bake in oven until golden brown. Ready onion cut in half, attach to fingers and fix bintikom, hold for 4 hours. Abscess matures faster exudate comes out.
2. Lotion of aloe leaves. Sheet of peel, the pulp is put on the site of inflammation, keep 5-6 hours. Agent has anti-inflammatory and anti-edematous action.

If pyoinflammatory species were found, treat them with home remedies dangerous.

Rehabilitation after surgery felon

Main symptoms as pain, swelling and redness, held almost immediately after surgery. Wound healing 1 week. The rehabilitation period should be every day to perform ligation using drugs prescribed by a physician - bactericidal or healing ointments, the collagen sponge.

The finger should be at rest. Finiteness desirable not to strain. Also shown is a course of antibiotics for 5-7 days. You can not throw a drink antibacterial medications ahead of time, move the sore finger, attempt to remove the crust.

complications

In the absence of adequate treatment, there may be negative effects on the felon. They arise when there is a spread of the infection in the tissue located near or in the form of complications after undergoing the disease.

1. Launched felon transition fraught with inflammation in the tissue located next to the development pandaktilita. Pathology heavily treated, often allowed the removal of the finger.
2. Purulent inflammation spreads to the joint, it is its extinction, disturbed motor function.
3. Phlegmon brush. Formed due to the transition of infectious agents on hand.
4. In the absence of tendon view therapy causes contractures and stiffness of the affected joint.
5. Joint and bone felon dangerous development of osteomyelitis in chronic phase with frequent relapses. Characterized by partial or complete loss of mobility.
6. Any form can cause severe intoxication, myositis.

Eliminate complications arising harder than the felon on the finger. Self-medication is dangerous fatal consequences. It can only be cured with full compliance medical recommendations.

Author: Ruslana Korshunova F.

Registration of the article: Mila Friedan

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