Abscess after the injection: post-injection treatmentabscess on the buttock

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
melt injections.

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
    after that

Security breach at any injection stage
drug administration can lead to serious consequences, from
which infiltration and abscess are not the most
serious.

Other etiological factors

  • Misdiagnosis

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
tissue.

  • 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
    obesity.
  • If a needle gets into the vessel, it forms
    significant hematoma.
  • If a needle gets into the vessel, it forms
    significant hematoma.
  • Infection by the patient through the hands: combing
    injection sites.
  • Purulent skin infections
  • Bedsores
  • Reduced immunity in persons with immunodeficiency, the elderly
    patients
  • Increased allergostatus
  • Autoimmune diseases

The most common sites of postinjection
abscesses

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
injections.

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
  • Swelling
  • Soreness when you touch the swelling,
    pressure. AT дальнейшем развивается болезненность вне
    skin touch
  • 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
    touch)
  • AT запущенном случае — генерализация процесса с формированием
    internal and external fistula that spread the infection.

Common symptoms

  • General weakness
  • Increased fatigue
  • Degradation of performance
  • Increased body temperature (up to 40C)
  • Sweating
  • 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
sepsis.

Diagnostics

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
infiltrate microflora.

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
tissue 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
discharge wounds.

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.

General treatment

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
    inflammation.
  • 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.

Prevention

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
    syringe
  • 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.
    drug.
  • 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,
    sterile consumables.
  • 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
    injection

Автор: врач-гигиенист, эпидемиолог

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