Update: October 2018
Postinjection abscess is one of the complications.
intramuscular or intravenous drug injection. AT
classification of abscesses, it is allocated in a separate group, has its own
features of the course and treatment.
Post-injection abscess is characterized by the formation
inflammatory foci of purulent nature in place
Causes of postinjection abscess
The main cause of an abscess at the injection site is non-compliance.
rules of asepsis and antiseptics. Infectious agent can get into
human tissue in three ways:
- through the raw hands of medical personnel;
- through consumables (cotton, syringe, medicine);
- from a patient’s skin that was not treated at the injection site or
Security breach at any injection stage
drug administration can lead to serious consequences, from
which infiltration and abscess are not the most
Other etiological factors
ATведение лекарственного средства, предназначенного для
intravenous or subcutaneous injection into the gluteus muscle
(Riboxin, calcium chloride, etc.). With such an erroneous
drugs simply do not have time to resolve or not at all
dissolve, forming first aseptic infiltrate, and then
infectious due to stagnant fluids in the tissues.
- Violation of the injection technique
This is the use of a short needle (for example, insulin syringes
for intramuscular injection), insufficient needle insertion (on
third or half) when the needle just doesn’t reach the muscular
- Prolonged administration of irritating tissue medications (antibiotics,
magnesium sulfate, etc.).
- A large number of injections in one area, often occurs when
long course of treatment
- A large layer of subcutaneous fat in people with severe
- If a needle gets into the vessel, it forms
- If a needle gets into the vessel, it forms
- Infection by the patient through the hands: combing
- Purulent skin infections
- Reduced immunity in persons with immunodeficiency, the elderly
- Increased allergostatus
- Autoimmune diseases
The most common sites of postinjection
Post-injection abscess of the gluteal region is the most frequent.
complication of injections, since it is in this area that
most intramuscular injections. The peculiarity of this area
consists in a well-developed fatty tissue that serves as the ideal
breeding medium for microorganisms trapped in it.
ATторым местом, где возникают постинъекционные абсцессы, является
hip area. Very often patients who inject themselves with medication.
themselves, choose the front or side of the thigh for injection.
Violation of the rules of asepsis or technique of administration leads to abscesses
soft tissue thigh.
What does an abscess look like, symptoms of inflammation
ATыраженность симптоматики постинъекционного абсцесса зависит от
depth of the inflammatory process: the deeper it is, the less pronounced
visible symptoms, but when pressed a person feels significant
soreness which is incomparable with the appearance of the place
Post-injection abscess in the classic course manifests itself
all the characteristic symptoms of inflammatory purulent process,
flowing inside the body:
Local signs of abscess
- Redness of the skin at the injection site
- Soreness when you touch the swelling,
pressure. AT дальнейшем развивается болезненность вне
- Symptom fluctuation: fingers impose on swelling, with
pressing the skin with the fingers of one hand lifts the cloth and fingers
on the other hand due to accumulation of fluid in the tissues
- Increased temperature of the affected area (skin is hot on
- AT запущенном случае — генерализация процесса с формированием
internal and external fistula that spread the infection.
- General weakness
- Increased fatigue
- Degradation of performance
- Increased body temperature (up to 40C)
- Loss of appetite
An abscess after the injection, even in case of infection
not immediately – purulent fusion precedes infiltrative
stage. Early treatment of infiltration helps prevent
formation of purulent foci. ATыраженность общесоматических
manifestations depends on the severity and prevalence of purulent
process: the stronger they are, the greater the amount of toxic
substances into the bloodstream.
Особенности постинъекционных abscesses и осложнения
Абсцесс после инъекции, как и другие виды abscesses, отличается
from other diseases of purulent-inflammatory nature
pyogenic membrane or infiltrative capsule. From the name itself
it becomes clear that purulent inflammation is limited
this capsule from the surrounding tissue, which protects the latter from
infection. But the progression of the process leads to
accumulation of large amounts of pus and break through the capsule. Wherein
pus penetrates the tissues and intermuscular spaces, forming
extensive phlegmon and fistulous passages.
Complications – most often complicated by the formation of extensive
phlegmon. AT тяжелых случаев возможно возникновение остеомиелита и
As a rule, the diagnosis is established already during the first
medical examination and on the basis of complaints of the patient. For determining
the severity of abscess is a series of studies: general
urine and blood tests, biochemical blood tests, sowing
In the chronic course of the pathology, an ultrasound is assigned to
accurately determine the localization and extent of the inflammatory process. AT
difficult situations involving internal organs in the process,
magnetic resonance imaging or computed tomography
Treatment of abscess after injection
How to treat an abscess after an injection? No options should
Seek medical attention and as soon as possible. Soft fabrics are very fast
melt necrotic masses, increasing the area
spread of infection.
Surgical and local treatment
The most effective treatment is surgical
necrotomy with enzymatic necrolysis, the formation of primary
suture and vacuum aspiration of purulent masses through drains, followed by
flow-washing drainage. Wound healing occurs in 3
times faster than with open reference.
Flow-through drainage is performed using
proteolytic enzymes and sodium hypochlorite. Besides
the direct function of washing out pus from a wound, this method
serves as the prevention of the accession of a secondary infection.
The previously used open wound management technique without
the formation of the primary suture led to secondary infection in
every third patient with the prevalence of Pseudomonas aeruginosa in
Abscess after injections on the buttocks can be treated by puncture
of the hearth, however recently this method loses relevance
due to frequent complications in the form of phlegmon and purulent effusions, as well as
transition to the chronic stage.
Is carried out taking into account the severity of the abscess and etiological
pathogen seeded from the discharge wound. Are applied
broad spectrum antibacterial drugs with parallel
detoxification and anesthetic therapy. Only general treatment
does not always give the desired result and leads to the formation
vast areas of necrotic tissue damage, threatened with sepsis.
Even the ancients said that pus should be released – in this
In case of this rule is the key to successful treatment.
Treatment at the stage of formation of infiltration
- In the event of infiltration should stop the introduction
drugs in this area and begin active treatment of the emerging
- Shown physiotherapy treatment of dynamic currents,
electrophoresis of gamma globulin and proteolytic
ферментов в область inflammation.
- Infiltration is observed in dynamics: if after 3-4 sessions
physiotherapy does not cause a visible decrease in swelling,
pain remains, and ultrasound reveals fluid formation,
proceed to the surgical treatment described above.
Abscess buttocks and another area even if successful and
quick treatment leaves ugly scar skin with deformation
subcutaneous fat layer in the form of fossa. Therefore prevention
post-injection complications plays a crucial role:
- Compliance with the rules of drug administration. It concerns
dose, rate of administration, frequency and compatibility of drugs in one
- Compliance with the technique of injection: the needle should almost
fully immerse yourself in soft tissue and reach muscle.
- Light massage of the injection area for better absorption.
- The exclusion of the introduction of drugs in the same point.
- Compliance with the rules of asepsis and antisepsis: processing hands
staff disinfecting compositions, skin treatment in the area
injection before and after antiseptic injection, the use of disposable,
- Correct definition of topographic points for the introduction of the needle.
The challenge is injecting people with severe
obese, in which the outer-upper quadrant is a
subcutaneous fat zone. AT таком случае выбирают другое место для
Автор: врач-гигиенист, эпидемиолог