An infected hand wound does not go away with swelling. Infections and inflammation of wounds. Signs of purulent wounds

With any accidental injury, microbes enter the wound. They are introduced into the wound at the time of injury (primary infection) by the wounding body or enter the wound from the skin and clothing. It is possible that infection may occur not at the time of injury, but subsequently from surrounding areas of the skin and mucous membranes, bandages, clothing, from infected body cavities and during dressings. Such an infection is called secondary; it can lead to a more severe course, since the body’s reaction to the introduction new infection usually weakened.

The entry of microbes into a wound (microbial contamination of the wound) does not always lead to the development of infection. Depending on the intensity of microbial contamination, impaired viability of wound tissue, the general reactivity of the wounded and a number of other reasons, anaerobic, putrefactive and purulent infection, most often caused by staphylococci and streptococci, can develop in the wound area.

The pathogenic properties of microbial contamination of a wound are revealed 6-8 hours after injury due to the proliferation of microbes and their penetration from the surface into the tissue of the wound walls. A particularly favorable moment for the development of infection is the presence of non-viable tissue in the wound, since dead tissue and hemorrhages are a favorable environment for the development of microbes. In addition to disruption of tissue viability, development infectious complications contribute to circulatory disorders and weakening of the body's resistance after blood loss, shock and due to other reasons.

When an infected wound heals, it is first cleared of necrotic tissue and blood clots (hydration stage), then granulation tissue develops, which covers the bottom and walls of the wound (dehydration stage). Due to scarring of granulation tissue, the edges of the wound come closer and the growing skin epithelium covers granulations. The healing process of an infected wound is accompanied by a significant separation from the wound of purulent exudate containing a large number of microbes, leukocytes and proteolytic and glycolytic enzymes.

Symptoms. Locally in the wound area, redness of its edges, swelling and infiltration, pain in the wound, local increase temperature, dysfunction of the diseased organ and the appearance of purulent discharge from the wound. General symptoms: fever, increased heart rate, intoxication ( headache, decreased appetite, dry tongue), increased white blood cell count and change leukocyte formula in the form of the appearance of young forms (juvenile), an increase in band and segmented leukocytes with a decrease in lymphocytes (shift to the left).

When sutures are applied to the wound after its initial surgical treatment, except common symptoms purulent process, there is pain in the wound area, swelling and swelling, and sometimes redness of the edges of the wound.

First aid and treatment. If the infected wound has not undergone primary surgical treatment or if it was insufficient and there are difficulties in the outflow of discharge from the depths of the wound, the patient, also after the administration of anti-tetanus serum, must be sent to a surgical hospital for surgical treatment. The appearance of developmental symptoms purulent infection in the presence of sutures placed during primary surgical treatment, this is an indication for removing the sutures and opening the wound. Only if there is an infection in the open wound and no symptoms severe course wound infection (high temperature and intoxication), the patient may be under the supervision of a paramedic.

In the hydration stage, when the inflammatory process occurs in the tissues of the wound and it is cleansed from dead, non-viable tissue, it is necessary to influence the microbes and help limit the process and cleanse the wound. To do this, it is necessary to provide rest to the diseased organ by bed rest in case of injury to the torso and lower limbs and splint bandage for wounds upper limbs. The use of antibiotics is also indicated. The wound is loosely tamponed using antiseptic solutions, antibiotics, A. V. Vishnevsky ointment, syntomycin or sulfidine emulsion, hypertonic solutions(5-10% sodium chloride). Dressings are performed as rarely as possible, carefully, without traumatizing the wound tissue, which contributes to the spread of the purulent process. To reduce intoxication and increase immunobiological reactions, improved nutrition and blood transfusions are used, and vitamins are administered.

With the weakening of the infection, the subsidence of the inflammatory reaction, the cleansing of the wound from dead tissue, the development of granulations and the predominance of regeneration processes (dehydration stage), measures are indicated to protect the granulations from injury and secondary infection, as well as improving the conditions for tissue regeneration. During this period, dressings with antiseptic solutions and the use of antibiotics are not needed, but ointment dressings, high-calorie nutrition, vitamin therapy and careful activation of movements are indicated.

Urgent surgical care, A.N. Velikoretsky, 1964

Dark red stripes running from the wound to the heart are characteristic feature blood poisoning.

A person is surrounded by a huge number of pathogens of various diseases. They are present in the air, in the ground, on the things we use. Of course, healthy skin is a barrier to the penetration of pathogens. But if the skin is damaged, there are wounds, cracks, ulcers, then this is an excellent opportunity for infection. Infectious agents enter the wound at the time it is received or can be brought in by dirty hands, in contact with non-sterile dressing material, or in contact with insects (flies). Pathogens that enter the human body cause infectious inflammation. However, the body healthy person is able to protect itself from infectious agents that have penetrated into it, destroy them and the poisons they secrete. This important protective function in the body is performed by leukocytes (white blood cells) and specific protective substances formed in the blood plasma (antibodies). There is a certain type of white blood cell that “devours” invading pathogens. They are called macrophages (killer cells). Substances produced by the immune system neutralize infectious agents or prevent their further reproduction. Thus, pathogens that enter the body can cause an infection if there are a lot of them and the immune system is not able to resist them, or when the immune system is completely weakened. The period from the moment pathogens enter the human body until the first signs of the disease appear is called the incubation period.

What types of wound infections are there?

Diseases caused by wound infections:

purulent inflammation of the wound,
blood poisoning (sepsis),
tetanus (tetany),
gas gangrene,
erysipelas on the wound,
rabies.

Purulent wound:

The first signs of inflammation appear 12-24 hours after pathogens enter the human body. The wound and the tissue around it turn red as blood flow increases. The wound may feel burning and the body temperature may rise. Damaged tissues swell, so the nerves are pinched and pain occurs. The leukocytes that play a protective role die and, together with the destroyed tissue cells, form pus. Foci of infection are suppressed much faster in tissues that are well supplied with blood. Therefore, purulent infections on the head or neck appear less frequently than on the lower leg or foot. Any wound can become infected, but not every wound will fester. First, the microbes adapt to the wound and after about 6 hours they begin to multiply. The danger of suppuration depends on the nature and location of the wound. Newborn children and the elderly are more susceptible to purulent infection.

Blood poisoning:

A particular danger with a purulent wound is blood poisoning (sepsis). With sepsis, bacteria and the poisons (toxins) they secrete enter the bloodstream and then into all organs. Infectious agents (most often streptococci and staphylococci) spread throughout the body. They act on the lymphatic vessels, which causes their inflammation.

General infection of the body:

Lymph nodes are the last defensive “bastion” that protects the body from infectious agents. Pathogens enter the lymph nodes and enter the circulatory system, causing severe general infection body. With sepsis, the patient's temperature rises, chills, headache appears, nagging pain in the limbs, general weakness, pulse and breathing increase, appetite decreases. If the patient does not consult a doctor in a timely manner, his life may be in danger.

Pay attention to the appearance of the wound:

Wound infections may be obvious or subtle. For example, with tetanus and rabies, the wound does not change externally. With other diseases, changes in the wound are possible - the appearance of swelling or pus.

Pus:

Pus is viscous yellowish or greenish liquid, possessing unpleasant smell. The composition of pus includes dead blood leukocytes, fragments of dead tissue and lymph.

Tetanus:

The vaccination course consists of intramuscular injections toxoid.

Tetanus (lat. tetanus) is an acute infectious disease caused by clostridia found in soil and dust. These bacteria do not cause inflammation of the wound at the site of their entry into the body, therefore they are absent in tetanus early symptoms diseases. The first symptoms appear only after 3-14 days after infection (less often from several hours to 30 days), i.e. at the end of the incubation period. The patient begins to have convulsions, first they contract convulsively masticatory muscles, then the cramps gradually spread to other muscles of the body. Muscle spasm causes any irritant. The bacterial venom attacks the nerves that innervate the respiratory muscles. Common cause death from tetanus is suffocation caused by spasms of the respiratory muscles. The mortality rate reaches 60%. With preventive vaccination, you can avoid of this disease. A vaccine made from tetanus toxins is injected into the gluteal muscles three times at regular intervals. Usually, if there are no contraindications, all children are vaccinated. For this purpose, a complex vaccine against pertussis, diphtheria and tetanus (DTP) is used.

Gas gangrene:

Gas gangrene - the most dangerous wound infection Caused by anaerobes living in soil and dust. Once in the wound, they penetrate into its deep layers. Pathogens of anaerobic gas gangrene are able to live and reproduce only in an oxygen-free environment, so crushed or bruised tissues, to which the flow of oxygenated blood stops as a result of damage to the blood vessels, are most susceptible to infection. During the metabolic process, the causative agents of the disease emit toxic gas, which causes an increase in pressure in the tissues, resulting in compression of the blood vessels in the wound area. Blood circulation in the wound area worsens, oxygen supply to the affected part decreases. These are excellent conditions for the spread of pathogens, so the affected tissues die and decompose after some time without the formation of pus.

Gas bubbles:

The swelling of some parts of the wound and the tightness of the skin can suggest the presence of gas gangrene. Gas bubbles form in the affected tissues; when pressing on the swollen tissues, a characteristic creaking sound is heard. The wound area becomes pale yellow, then red or blue-red, but as the process progresses, the pain goes away completely. The patient’s well-being worsens due to the multiplication of pathogens and the release of toxins into the blood, which are carried throughout the body.

You need to act quickly:

At the slightest symptom gas gangrene, you must go to the hospital immediately. The doctor will make a wide incision and surgical treatment wounds, ensuring air access to the wound. After treating the wound, the patient is prescribed antibiotics, given oxygen, and other treatment methods, for example, hyperbaric oxygen therapy. If gangrene cannot be stopped, the affected limb must be amputated.

Rabies:

Rabies is a viral infection that affects the central nervous system and is transmitted through the bite or scratch of a sick domestic or wild animal. The appearance of the wound does not change with the penetration of pathogens, but incubation period may take up to a year, so if you suspect a bite from a rabid animal, consult a doctor immediately. The doctor will administer a serum that will protect against the disease. People who are in constant contact with animals should be vaccinated against rabies as a preventive measure.

Erysipelas:

Erysipelas - infection, caused by streptococcus, is characterized by an increase in body temperature, inflammation, mainly of the skin. Pathogens enter the lymphatic vessels through fresh or old lesions on the skin. Symptoms of the disease: redness of the wound tissue with clear boundaries, pain when touched, heat, chills To avoid blood poisoning, you should immediately consult a doctor who will prescribe penicillin or another antibiotic. Improper treatment of a disease caused by wound infection can cause great harm to a person and even pose a danger to his life. It is necessary to urgently call an ambulance (ambulance) or take the victim to the hospital. Often only a doctor can provide qualified assistance. However, Rozha is successfully treated with ancient spells and herbs. And often only healers can control this disease. From time immemorial, “grandmothers” cured soldiers from the field of severe wounds. This phenomenon still cannot be explained by traditional medicine.

ON A NOTE:

In case of injury, bite, severe burn and frostbite, you must contact a surgeon to administer anti-tetanus serum or anti-tetanus immunoglobulin. Children are usually vaccinated against tetanus, whooping cough and diphtheria. Representatives of certain professions are vaccinated again.

Doctors call purulent wounds of the skin and adjacent tissues in which there is an accumulation of pus, swelling and tissue death, as a result of which toxins are absorbed by the body in the wound cavity.

The development of suppuration in the affected area is caused by infection or a breakthrough of the abscess.

Doctors call the constant companions of purulent wounds severe swelling in the affected area, hyperemia of adjacent tissues and pronounced pain syndrome. Severe pain, up to sleep deprivation, can be tugging or bursting in nature.

Accumulations of pus and necrotic tissue. Toxins are absorbed, as well as decay products, which causes general intoxication of the body, associated with an increase in temperature, severe headaches, chills, weakness and nausea.

Depending on which process prevails, doctors have identified 3 stages of the suppuration process:

maturation of a focus of pus in the affected area,
cleansing the affected area and regenerative processes in tissues,
healing.

Healing of all purulent wounds is carried out by secondary intention.

opening of purulent leaks (if they are found),
thorough washing and drainage of the affected area,
drug therapy using antibacterial and immunostimulating drugs,
application of special antiseptic dressings,
detoxification,
drug stimulation of the body's triggering natural processes recovery.

Causes

Medical data suggests that absolutely any wound received accidentally already contains bacteria that penetrate the wound at the time it is received. This means that any accidental wound is infected. At the same time, not every wound with bacterial contamination develops a purulent process.

For the process of decay to occur, there must be the simultaneous presence of unfavorable factors:

Sufficient tissue damage cavity.
A sufficient level of concentration of pathogenic microbes in the wound cavity.

Experimental data have shown that to start the process of suppuration in healthy tissues, 1 gram of tissue must contain 100 thousand microbial bodies. In turn, the critical concentration of infection may decrease under unfavorable conditions.

If dirt gets into the wound, foreign bodies or clotted blood, the presence of 10 thousand microorganisms per gram of tissue is sufficient for the development of a purulent process.

In the case of ligature ischemia, which is caused by difficulties in tissue nutrition in the area where the ligature is tied, it is critical dangerous level is reduced to only one thousand bodies of pathogenic microbes per gram of tissue.

In 90% of purulent wounds, doctors find pyogenic bacteria. The most frequently detected are Streptococcus, Klebsiella, coli, Proteus, Staphylococcus and Pseudomonas.

Also, the purulent process can be triggered by pneumococci, shigella, salmonella, mycobacteria and other pathogenic flora.

The presence of coagulated blood, necrosis and contamination in the cavity.

Wounds obtained by accident, such as lacerations, bruises, punctures and associated with crushing of soft tissues, often become purulent.

The main cause of suppuration in puncture wounds there is poor outflow of fluid from the wound due to the fact that the wound channel is relatively thin and long, and the hole on the surface of the skin is small.

A high percentage of complications due to the processes of suppuration in lacerated wounds and wounds associated with crushing of soft tissues is caused by severe contamination and/or a significant amount of non-viable tissue.

They fester less often than others cut wounds. This is due to the fact that their edges are slightly damaged, and the wound channel is shallow.

Other factors that increase the risk of suppuration are:

Health status, diabetes mellitus, vascular disorders and a number of somatic diseases.

In case of minor bacterial contamination high immunity reduces the risk of suppuration in the damaged cavity.

In the case of significant bacterial insemination and normal immunity, the purulent process, as a rule, has a more rapid course, but is quite localized and ends with a fairly rapid recovery.

Violations in immune system entail sluggish suppuration and long healing purulent wound, while the risk of complications and spread of infection increases many times over.

Somatic diseases negatively affect the immune system and health in general, as a result of which the likelihood of suppuration increases, and wound healing proceeds more slowly.

The most dangerous disease against which a purulent wound can develop is diabetes mellitus. Even with a small lesion and minor bacterial infection, it can develop severe suppuration, also in patients with diabetes mellitus there is a clear tendency for this process to spread.

Age and weight of the patient. According to statistics, in young people the process of suppuration in wounds develops less often than in old people. Patients with overweight suffer more often from purulent wounds than thin people.
Season. The risk of pus processes in the wound cavity increases in the warm season, and a humid and hot climate has a particularly negative effect. In this regard, doctors try to prescribe planned non-urgent operations during the cold season.
Type of wound and its location. Lesions are least susceptible to suppuration in cervical spine and head areas. Wounds of the back, buttocks, abdomen and chest are susceptible to suppuration somewhat more severely. Injuries to the extremities are most often associated with suppuration; suppuration in the area of the feet is especially severe.

Symptoms

Symptoms of purulent wounds are divided into general and local.

Local symptoms of purulent wounds:

The presence of purulent exudate and a visually visible defect of the skin and tissues.
The main sign of a purulent wound is, in fact, pus.
The amount of pus in the wound may vary; in advanced cases, there may be granulations and areas of necrotic tissue underneath.

Depending on what caused the suppuration, the consistency and shade of the pus varies.

Pseudomonas aeruginosa is characterized by yellowish pus that appears blue-green on the bandage (the pus changes color upon contact with air).
Anaerobic microbes are smelly brown.
Streptococcus - watery yellowish or greenish.
Escherichia coli is liquidish brownish-yellow.
Staphylococcus provokes the development of thick white or yellow pus.

When suppuration forms in the wound, pressing and bursting pain is characteristic. When the outflow of pus is difficult due to the fact that a crust has formed, streaks have formed or the purulent process has spread, increased production of pus and inflammation of the affected area begins. As a result of increased pressure in the wound cavity, a tugging pain appears that is so severe that it can deprive a person of sleep.

Local hyperemia. The skin around the wound becomes hot. At the initial stage, when pus forms, redness of the skin is visible.

In the case when the wound is neglected, the adjacent skin may change from a reddish tint to a purple one or become purple-bluish.

Local increase in temperature.
Swelling of adjacent tissues.

Two types of edema are observed in the affected area. Along the edges of the wound there is usually a warm inflammatory swelling that coincides with the area of hyperemia. Its appearance is caused by impaired blood flow in the affected area.

Violation physiological functions. Decreased function of the affected area is associated mainly with swelling and intense pain. The degree of their severity depends on the phase and volume inflammatory process, as well as the location and size of the wound,

General symptoms of purulent wounds

Toxins are released from a purulent wound into the patient’s body, which leads to general intoxication of the body.

Symptoms that are characteristic of suppuration in the wound cavity:

increase body t
weakness, in advanced cases the patient may lose consciousness and fall into a coma
excessive sweating
decreased or complete loss of appetite
chills
headache
specific results clinical tests. The blood test is characterized by the presence of leukocytosis with a shift to the left, as well as an acceleration of ESR. Urine tests usually show elevated protein.

In advanced situations, an increase in the level of creatinine, urea and bilirubin in the blood is observed. There is a high probability of developing anemia, dysproteinemia, hypoproteinemia and leukopenia.

Complications

Pus in a wound can lead to a number of serious complications.

Inflammation may develop lymphatic vessels, which are located proximal to the affected area, up to lymphangitis. Inflammation is visually manifested by the appearance of red stripes, which are directed from the wound to the regional lymph nodes. If lymphadenitis develops, regional lymph nodes increase in size and become painful.

In advanced cases, purulent wounds can provoke the occurrence of thrombophlebitis; this disease causes the appearance of very painful scarlet strands in the direction of the saphenous veins.

If purulent fluids spread through contact, purulent leaks, periostitis, abscesses, purulent arthritis, phlegmon and osteomyelitis may develop.

The most negative consequence When the wound suppurates, sepsis may develop.

In that situation, if the required medical events and for a long time the healing process does not begin, the purulent wound can become chronic.

Western doctors classify wounds as chronic as those that do not show a tendency to heal for a month or more. These traditionally include:

trophic ulcers;
wounds, both surgical and accidental, that do not heal for a long time;
bedsores.

Treatment

Most often, the diagnosis of purulent wounds does not consist in making such a diagnosis - suppuration in the wound is clearly visible even to a non-specialist, but in establishing the nature of the flora that provoked suppuration and the level of infection.

In order to find out the nuances of infection, doctors resort to general clinical and biochemical studies, and a microbiological study of exudate from the wound is also carried out.

Reliably establishing the nature of the infection helps to select the most effective antibacterial drugs.

Tactics for treating wounds in which a purulent process develops include:

Antibacterial therapy. Antibacterial drugs are prescribed in mandatory, maximum selection effective medicines carried out on the basis external characteristics pus (if it is impossible to carry out tests) or data microbiological research contents of a purulent wound.
Detoxification therapy. It is designed to ensure the active removal of toxins from the body. To reduce intoxication, doctors use methods of forced diuresis, infusion therapy, hardware detoxification (hemosorption, plasmapheresis, hemodialysis). The main recommendation for reducing the level of intoxication in the body at home is to drink plenty of fluids.
Immunostimulating therapy. Its goal is to increase the body's resistance and stimulate the production of natural interferon and tissue protective factors.

The treatment is carried out by the surgeon, the doctor determines the tactics of its implementation taking into account the phase of the wound process.

At the stage of formation of a purulent focus, the main task of the surgeon is high-quality, as complete cleansing of the wound as possible, reducing the inflammatory process, combating pathogenic flora and, if there are medical indications, reducing intoxication.

In a combat situation, factors such as malnutrition, untimely medical care, etc. slow down the healing of gunshot wounds.

IN clinical course Primary infected wounds are divided into a latent period, a period of spread and a period of localization of infection. In the first period, the infection does not manifest itself; its duration ranges from several hours to 3-4 days for a purulent infection, up to 5-6 days for an anaerobic one. During the period of spread of purulent infection, signs of inflammation develop around the wound - swelling, redness, swelling, pain; lymphangitis (see), increased lymph nodes; discharge from wounds is greenish-yellow in color. An increase in temperature to 40°, leukocytosis in the blood, acceleration indicate the spread of infection, which can lead to the development of phlegmon, complicated by purulent lymphadenitis, erysipelas, general purulent infection (). Cytological examination wound discharge is important for assessing the course of the process and for prognosis (Fig. 9-20).

Rice. 9 - 20. Wound exudate. Rice. 9. Completed microorganisms by neutrophils and macrophages in the active state of the body’s defense reactions. Rice. 10. Incomplete phagocytosis of microorganisms and death of phagocytes due to insufficient activity of the body’s defense reactions. Rice. 11. Lack of phagocytosis of microorganisms in wound sepsis. Rice. 12. Polyblasts in various phases of activation. Rice. 13. Polyblasts with phenomena of degenerative vacuolization. Rice. 14. Macrophages in various phases of phagocytic activity. Rice. 15. Profibroblasts during the period of active wound. Rice. 16. Unna's plasma cells non-healing wound when reparative processes are disrupted. Rice. 17 and 18. Giant multinucleated cells. Rice. 19. for wound sepsis. Rice. 20. Microflora at. Great amount microorganisms, cellular elements are destroyed. Complete inhibition of phagocytic reactions.

At anaerobic infection(see) the period of spread of infection is characterized by “bursting” pain in the wound, a sharp rise in temperature, increased heart rate, and vomiting. There is no redness of the skin around the wound; it is often pale and shiny with a pronounced pattern of saphenous veins. In gas form the most important feature is tissue, manifested by subcutaneous crepitus, tympanitis with.

In the edematous form, there is no gas, but significant swelling appears around the wound, which quickly spreads (to the entire limb, area of the body).

IN late stages the color of the skin changes - hence the names “bronze”, “saffron”, “blue face”. The course of the infection can be lightning fast, rapidly progressing, or torpid (slow).

With a putrefactive infection (see), the process in the wound develops slowly (over 5-10 days or more), but the death (necrosis) of tissues occurs to the full depth (bones, etc.) without signs of independent delimitation of the putrefactive process. The decomposition of tissues is accompanied by a fetid odor.

The period of localization of purulent infection is characterized by the cessation of entry of infection into the tissues and toxic products into the blood; it may coincide with the moment the formation of the granulation shaft begins. During this period, there is a discharge from the wound of thick, creamy pus with scraps of dead tissue, improvement general condition patient, temperature drops to normal in the morning and subfebrile levels in the evenings final result - secondary healing wounds. Localization of purulent infection often occurs as a result conservative treatment, without surgery.

With anaerobic and putrefactive infections, the period of localization begins only from the moment of final formation of the granulation shaft, which, as a rule, occurs only as a result of the operation performed. Clinical signs improvement from the wound: discharge from ichorous or ichorous becomes purulent.

An outbreak of secondary infection, as well as reinfection, not only prolongs the wound healing time, but also threatens the development of dangerous complications.

Signs of complications are a sudden rise in temperature, lack of purulent discharge from the wound until there is profuse pain and swelling around the wound, enlargement of regional lymph nodes. The impetus for the development of a secondary infection can be a crude attempt to remove sequesters, foreign bodies (tampons), probing a wound, etc. The possibility of reinfection is associated with the presence of limited ulcers, foreign bodies, around which there may be a dormant infection.

Unfortunately, we encounter wounds that are difficult to heal quite often, especially when it comes to burn wounds, trophic ulcers and wounds of the leg with severe venous insufficiency. We will learn how to cope with the difficult task of treating difficult-to-heal wounds in this article.

The main difficulty in treating difficult-to-heal wounds is that the problem has to be dealt with quite long time and most often you have to do it yourself. Since the main treatment of an uninfected wound consists mainly of regular dressings using special wound healing agents.

So, our task is to learn how to treat wounds correctly and effectively. Exactly for effective treatment we need to understand what kind of wound we are dealing with. Of course, firstly, with long-healing wounds, consultation with a surgeon is necessary. The doctor will find out the actual cause of the problem and give individual recommendations for treating the wound. In addition, the treatment process should be periodically monitored by a specialist in order to make changes to the treatment regimen if necessary.

Rules for treating wounds

Regularity. Treatment of the wound should be continuous until complete healing. Therefore, dressings should be done daily. In the very as a last resort, you can do dressings every other day, but only when there is little discharge from the wound and the wound is clean. In all other cases, the wound must be bandaged every day, and in some cases twice a day.

Clean and sterile. Only sterile instruments and dressings are used to treat the wound. Only the bandage and (or) mesh for fixing the dressing may not be sterile, but be sure to be clean. Before bandaging, hands should be washed well with soap and treated with an antiseptic. Ideally, dressings should be done with sterile gloves, especially if you touch the wound.

Accuracy. When dressing, you need to be extremely careful: you cannot tear anything away from the wound. If the bandage is stuck, soak it - do not tear it off, as this will cause pain and further injure the wound.

Knowledge. Wounds can be dry and weeping. You need to be able to distinguish between them, since the treatment of a dry and weeping wound differs. First of all, the choice of form depends on this medicine for wound treatment.

What to prepare for dressing a wound

To treat a wound at home, you need to prepare in advance:

A clean oilcloth on which everything necessary for dressing will be laid out
Hand sanitizer
Hand soap
Clean hand towel
An alcohol-containing antiseptic for treating the skin around the wound (an alcohol solution of iodine, brilliant green, calendula tincture or salicylic alcohol are quite suitable)
An aqueous antiseptic solution (furacillin solution, 3% hydrogen peroxide solution, miramistin)
Processed alcohol antiseptic tweezers and scissors (they must be processed before and after each dressing)
Medicine for treating a wound
Sterile dressing(bandage, gauze pads)
Non-sterile, clean dressing material for fixation bandage.

Rules for dressing and treating wounds

Before starting the dressing, you must thoroughly wash your hands with soap and dry them with a clean towel. After this, lay out everything that is needed for dressing. Next step: remove the previously applied external bandage.

Then we wash our hands again or treat them with a disinfectant solution, or put on sterile gloves.

It's time to remove the tissue directly covering the wound from the wound. If the tissue sticks, wet it aqueous solution antiseptic (in this case it is better to use a 3% hydrogen peroxide solution) and wait until the napkin gets wet. We remind you that you cannot tear off the napkin.

After removing the napkin, treat the skin around the wound alcohol solution antiseptic and examine the wound without touching it.

Inspection task assess the condition of the wound: is it dry or weeping (wet).

A wound with a wet, pink, easily injured surface and a significant amount of discharge is considered a weeping wound. If the surface of the wound is dry, with crusts and cracks, this wound is dry.

Also, with each dressing change, it is necessary to evaluate how the healing process is progressing. The following criteria will help assess the healing process: wound size (a wound that heals, albeit slowly, but decreases in size), whether the wound is dry or weeping (the transition from a weeping wound to a dry one indicates successful treatment wounds), wound depth (with successful treatment, the wound becomes more and more superficial).

Caution - danger!

If upon examination you see that the amount of discharge from the wound has increased, or it has acquired a different smell (no matter whether it is unpleasant or even pleasant, for example, sweetish) and color (primarily yellow, greenish, gray).
If the wound does not decrease in size, but, on the contrary, increases, especially if it deepens.
If the pain in the wound increases every day or has sharply intensified.
If there is a tugging and (or) throbbing pain in the wound area.
If treatment of the wound does not produce any positive results.
If there is swelling and redness of the skin around the wound.
If the body temperature has increased, chills have appeared, and there are no other reasons for this condition.
In all of the above cases, you should urgently show the wound to a surgeon!

After examination, the wound is washed with an aqueous antiseptic solution using sterile wipes. They are moistened with an antiseptic solution and the wound is carefully treated. Then the wound is dried with a dry sterile cloth.

The next step is to apply a wound healing agent. Very important point: ointments are used to treat dry wounds, and jelly or gels for weeping wounds. The difference is explained by the fact that a dry wound requires protection in the form of a film, under which it will soften. Ointment is not suitable for a weeping wound, as it will create an environment that will prevent the release of fluid and the entry of oxygen, which will slow down the healing of the wound. Therefore on weeping wound apply products that protect the wound from drying out and possible infection, and will not allow the wound to suffer from lack of oxygen. When the wound is completely dry, you should change the form of the drug so as not to dry it out.

Today, Solcoseryl® is rightfully considered one of the most effective modern wound healing agents. This drug is a deproteinized hemodialysate of the blood of dairy calves, which contains substances responsible for trophism, oxygen supply and restoration of damaged tissues. Solcoseryl® is available in the form of a gel and ointment, so choosing the form of the drug suitable for treating a specific wound (wet or dry) is quite easy. Solcoseryl® gel is used at the initial stage of wound treatment (weeping wound) until it dries out and granulations form - the drug is applied in a thin layer to the surface of the wound 2-3 times a day. After the disappearance of exudate and the appearance of granulations, it is necessary to switch to the use of Solcoseryl® ointment. The ointment is applied to the wound 1-2 times a day, creates a protective film, accelerates the final stages of wound healing, creates conditions for epithelization and the formation of an elastic scar.

The process of treating difficult-to-heal wounds can be quite lengthy, so be patient and remember that by following all the above recommendations, you will solve the problem - the wound will heal, and the experience of treating the wound will remain with you forever. Take care of your health!