17. TREATMENT OF ACUTE INFLAMMATION. BASIC PRINCIPLES OF SURGERY

what are the aims of surgery in acute inflammation?

remove purulent material

limit purulent spread

prevent complications

stop body intoxication

remove source of infection

where is the incision based?

on the anatomy, location and size of area involved

how long should the incisions be for abscesses?

2-3cm

how long should the incisions be for phlegmons?

5-6cm

What is Lexer’s aphorism?

incision should be as larger as necessary and as small as possible

what are the goals of drainage? (6)

evacuate pus, exudate and blood from woun

prevent haematoma formation and accumulation of serum

decreases the number of dressings we have to use

maintain a pathway for necrotic tissue to leave

create conditions for antibacterial rinses

decrease the need for antibiotics

what are the types of drains?

rubber

silicone

polychlorinyl tubes

corrugated rubber bands

gauze strips

where do we place the drain?

removal of pus is based on gravity- so we place the drain at the lowest point of the abscess

place sterile gauze dressings soaked in a hypertonic solution on the wound

remove drain after the exudation stops

flush the wound out with antiseptics and antibiotic solutions