Panarea disease is curable. Subungual panaritium: treatment of inflammation

is an acute purulent inflammatory process localized in the tissues of the fingers (less commonly, toes) and occurring on the palmar surface of the fingers. Manifested by pain, swelling, redness, increased body temperature, and symptoms of general intoxication. Diagnosed based on complaints and the results of an objective examination. If a bone or joint form of the disease is suspected, radiography is necessary. In the initial stages, conservative treatment is possible. When an abscess forms, opening, drainage, and severe cases amputation is indicated.

ICD-10

L03.0 Phlegmon of the fingers and toes

General information

Panaritium is an acute suppuration of the fingers (less commonly, the toes). It is one of the most common pathologies in purulent surgery. It develops as a result of the activity of pyogenic microorganisms (most often Staphylococcus aureus) that penetrate the tissue through minor skin lesions. With panaritium, swelling, redness and pain in the finger area are noted. In severe forms, chills and fever are observed. The pain can be sharp, throbbing, and depriving you of sleep. In the early stages, conservative treatment is possible; in the later stages, surgery is necessary.

Causes of panaritium

The direct cause of the pathology is most often Staphylococcus aureus, which penetrates the tissue through wounds, abrasions, injections, cracks, splinters or hangnails, which sometimes go unnoticed or look so insignificant that the patient simply does not pay attention to them. Less commonly, panaritium is caused by gram-negative and gram-positive bacilli, streptococcus, E. coli, Proteus, as well as anaerobic non-clostridial microflora and pathogens of putrefactive infections.

To the number external factors factors that contribute to the development of felon include systematic cooling, humidification, vibration, maceration, pollution or exposure to irritating substances. Internal factors, increasing the likelihood of panaritium occurrence are endocrine diseases, hypovitaminosis, metabolic disorders and decreased immunity.

Panaritium is more often observed in children, as well as young and middle-aged people - from 20 to 50 years. According to statistics, three quarters of patients fall ill after microtrauma received at work. The most common localization is the 1st, 2nd and 3rd fingers of the right hand. The development of felon is promoted by both external (cooling, vibration, exposure chemical substances), and internal (weakened immunity) factors.

Pathanatomy

On the palmar surface of the fingers there are many important anatomical formations: tendons and tendon sheaths, nerves, blood vessels, joint capsules, etc. The subcutaneous tissue in this area has a special structure. Numerous elastic and strong fibers run from the skin to the palmar aponeurosis. In addition, longitudinal bundles are located in the thickness of the fiber connective tissue. As a result, the fiber is divided into small cells, reminiscent of a honeycomb.

This structure, on the one hand, prevents the spread of inflammation “along”, on the other hand, it creates favorable conditions for the penetration of the purulent process deep into the tissues. That is why with panaritium, rapid progression is possible, involving tendons, bones and joints, or even all tissues of the finger.

Classification

Taking into account the location and nature of the affected tissues, they are distinguished the following types felon:

• Skin felon. The most light form. An abscess forms in the thickness of the skin.
• Periungual felon (paronychia). The inflammation is localized in the area of ​​the periungual fold.
• Subungual panaritium. Develops under the nail plate.
• Subcutaneous panaritium. Occurs in subcutaneous tissue palmar surface of the fingers.
• Bone panaritium. Distinctive feature is the involvement of bone in the purulent process.
• Articular felon. Develops in the interphalangeal or metacarpophalangeal joints.
• Osteoarticular panaritium. Usually occurs with the progression of articular panaritium, when inflammation spreads to the articular ends of the phalangeal bones.
• Tendon panaritium. Localized in the tendon area.

Symptoms of felon

Symptoms may vary depending on the form of the disease. However, in any form there is a number of common manifestations. In the initial stages of panaritium, there is redness, slight swelling and mild to moderate painful sensations, possibly a burning sensation. Then the swelling increases, the pain intensifies, becomes intense, bursting, tugging, depriving sleep.

A purulent focus forms in the area of ​​inflammation, which is clearly visible in superficial forms of panaritium. The formation of an abscess may be accompanied by weakness, fatigue, headache and fever. Symptoms of intoxication are more pronounced in deep, severe forms of panaritium (bone, joint, tendon). In addition, each form of panaritium has its own characteristic symptoms.

Cutaneous panaritium usually occurs in the area of ​​the nail phalanx. The skin turns red, then a limited area of ​​the epidermis peels off in the center of the redness. A blister forms, filled with a cloudy, bloody or grayish-yellow liquid that is visible through the skin. At first the pain is mild, then it gradually intensifies and becomes throbbing. This form of panaritium is often accompanied by stem lymphangitis, in which red stripes form on the forearm and hand along the inflamed lymph nodes. With uncomplicated panaritium, the general condition does not suffer; with lymphangitis, fever, weakness, and weakness are possible.

Periungual felon(paronychia), as a rule, develops after an unsuccessful manicure or is a complication of hangnails and cracks in the periungual fold in people who work physically. Initially, local swelling and redness are noted, then the process quickly spreads, covering the entire nail fold. An abscess forms quite quickly, visible through the thin skin of this area. Severe pain occurs in the area of ​​inflammation, disturbing sleep, but the general condition is almost unaffected. Lymphangitis with this form of panaritium is rarely observed.

Maybe spontaneous opening abscess, however incomplete emptying may cause a transition acute form felon into chronic. As the process progresses, pus can break through under the base of the nail, spread into the subcutaneous tissue of the palmar area, onto the bone and even the distal interphalangeal joint.

Subungual panaritium. It is usually a complication of paronychia, however, it can also develop primarily as a result of a splinter, a puncture wound in the area of ​​the free edge of the nail, or during suppuration of a subungual hematoma. Since the developing abscess in this area is “pressed down” by a hard and dense nail plate, subungual panaritium is characterized by extremely intense pain, general malaise and a significant increase in temperature. The nail phalanx is swollen, pus is visible under the nail.

Subcutaneous panaritium. The most common type of panaritium. Usually develops when small but deep puncture wounds become infected (for example, when pricked by a plant thorn, an awl, fish bone etc.). Initially, slight redness and local pain appear. Over the course of several hours, the pain intensifies and becomes throbbing. The finger swells. The patient's general condition can either remain satisfactory or significantly worsen. For ulcers located under high pressure, there are chills and an increase in temperature to 38 degrees and above. In the absence of treatment, insufficient or late treatment, the purulent process may spread to deep anatomical formations (bones, joints, tendons).

Bone panaritium. It can develop from an infected open fracture or become a consequence of subcutaneous panaritium when infection spreads from soft tissue to the bone. Characteristically, the processes of bone melting (osteomyelitis) predominate over its restoration. Both partial and complete destruction of the phalanx is possible. In the early stages, the symptoms resemble subcutaneous panaritium, however, they are much more pronounced. The patient suffers from extremely intense throbbing pain and cannot sleep.

The affected phalanx increases in volume, which is why the finger takes on a flask-shaped appearance. The skin is smooth, shiny, red with a cyanotic tint. The finger is slightly bent, movement is limited due to pain. Unlike subcutaneous panaritium, with the bone form it is impossible to determine the area of ​​maximum pain, since the pain is diffuse. Chills and fever are noted.

Articular felon. It can develop as a result of direct infection (with penetrating wounds or open intra-articular fractures) or the spread of a purulent process (with tendon, subcutaneous and bone panaritium). Initially, there is slight swelling and pain in the joint when moving.

Then the pain intensifies, movements become impossible. The swelling increases and becomes especially pronounced on the dorsum of the finger. Palpation determines the tension of the joint capsule. Subsequently, a fistula forms on the back of the finger. Primary felons can end in recovery; with secondary felons (caused by the spread of suppuration from adjacent tissues), the outcome is usually amputation or ankylosis.

Tendon panaritium(purulent tenosynovitis), like other types of panaritium, can develop both through direct penetration of the infection and when it spreads from other parts of the finger. The finger is uniformly swollen, slightly bent, intense pain is noted, sharply intensifying when attempting passive movements. When pressure is applied along the tendon, sharp pain is detected. Redness may not be noticeable. There is a significant increase in temperature, weakness, and lack of appetite. Confusion and delirium may occur.

Tendon panaritium is the most severe and dangerous purulent inflammation of the finger. This is due to the fact that pus quickly spreads through the tendon sheaths, moving to muscles, bones, soft fabrics palms and even forearms. If left untreated, the tendon completely melts and the finger loses its function.

Diagnostics

The diagnosis is made based on the patient’s complaints and clinical symptoms of the disease. To determine the shape of the panaritium and clarify the localization of the abscess, palpation is performed with a button probe. To exclude bone and articular panaritium, radiography is performed. It should be taken into account that, unlike bone panaritium, with articular form Disease changes are not immediately detected and may be mild. Therefore, to clarify the diagnosis, comparative radiographs of the healthy finger of the same name on the other hand should be prescribed.

Treatment of felon

Treatment is carried out by purulent surgeons. With superficial forms, the patient can be on an outpatient basis; with deep forms, hospitalization is necessary. In the early stages, patients with superficial panaritium can be prescribed conservative therapy: darsonval, UHF, thermal procedures. In the later stages of superficial panaritium, as well as at all stages of the bone and tendon form of the disease, surgery is indicated. The opening of the panaritium is supplemented with drainage so as to ensure the most effective outflow from the fiber divided into cells.

Surgical tactics for bone or joint felon are determined by the degree of preservation of the affected tissues. In case of partial destruction, resection of the damaged areas is performed. In case of total destruction (possible with bone and osteoarticular panaritium), amputation is indicated. Conducted in parallel drug therapy, aimed at combating inflammation (antibiotics), reducing pain and eliminating the phenomena of general intoxication.

Panaritium is a purulent inflammation of the soft tissues and bones of the finger. Depending on the location of the purulent focus and depth inflammatory process They distinguish cutaneous, subcutaneous, subungual, articular, tendon, bone panaritium, pandactylitis and paronychia.

Cutaneous panaritium is an abscess located under the epidermis of the skin. In the case of nail felon, depending on the location and distribution, three forms are distinguished: paronychia and subungual felon. Paronychia is a purulent inflammation of the cushion surrounding the nail. Subungual panaritium is an accumulation of pus under the nail. Subcutaneous felon is a purulent inflammation of the subcutaneous tissue of the phalanges of the fingers. The favorite localization of the subcutaneous panaritium is the palmar side of the terminal phalanx of the finger. Tendon felon is the most severe and disabling form of purulent inflammation of the fingers, which is accompanied by damage to the tendon sheath and death of the finger tendon. Bone and articular felon occur primarily when there is a deep wound to the bone and joint cavity or when inflammation spreads from surrounding tissues as a complication of subcutaneous felon. In cases where purulent inflammation covers the entire thickness of the finger, they speak of pandactylitis.

Causes of panaritium.

Any panaritium is caused by visible or unnoticed microtrauma: an injection, a scratch, a foreign body (for example, a splinter, glass wool, glass, metal shavings and others), abrasion, wounds during manicure.

The causative agent of the disease penetrates through the resulting skin damage. Panaritium is caused by bacteria, primarily Staphylococcus aureus, as well as streptococci and enterococci. Less commonly, purulent inflammation develops with the participation of Escherichia coli, Pseudomonas aeruginosa, and Proteus.

Predisposing factors for the development of felon are diabetes, impaired blood supply to the hand, vitamin deficiency and immunodeficiency. In such cases, the purulent process develops faster, is more severe and difficult to treat.

The specificity of the symptoms of felon and the nature of the course of the purulent process are due to the peculiar anatomy of the fingers. The fact is that the skin of the palmar surface of the fingers is tightly fixed to the underlying structures and bones by dense connective tissue partitions that form a large number of closed cells with subcutaneous fat. Subcutaneous fat is a favorable environment for the proliferation of microorganisms. Therefore, when the skin is damaged and such a cell with a nutrient medium becomes infected, the purulent process does not spread along the finger, but in depth towards the tendon and bone. This is why bursting and shooting pains in the finger occur early. The skin of the dorsal surface of the fingers, on the contrary, is loosely connected to the underlying structures, so swelling is easier to develop on the dorsum of the fingers, often distracting from the main cause of the disease.

Symptoms of felon.

Depending on the type of felon clinical manifestations will be different.

Intradermal panaritium occurs most easily. It looks like a bubble filled with pus, most often located on the palmar surface of the terminal phalanx. I am concerned about moderate pain and a feeling of fullness in the area of ​​the bladder.

With paronychia that occurs after a manicure, inflammation of the nail fold occurs, which becomes swollen, red and painful. As inflammation continues, the skin of the cushion rises and becomes whitish - pus can be seen through it. Pain with paronychia varies from aching to constant, pulsating in the stage of abscess formation. Pus may spread under the nail plate to form a subungual panaritium, the main symptom of which will be the detachment of part or all of the nail plate with pus.

Subcutaneous panaritium is accompanied by thickening of the affected phalanx of the finger, the skin turns red and shiny. Full movements become impossible due to throbbing pain that intensifies when lowering the arm.

With tendon panaritium, thickening and redness of the entire finger are observed, movements are sharply painful. The finger becomes sausage-shaped and is in a semi-bent state. The pain is severe and pulsating. Swelling may spread to the dorsum of the hand and palmar surface. The purulent process progresses quite quickly, spreading after the swelling to the hand and even forearm. Typical symptoms tendon panaritium are shown in the photo below.

With articular and bone panaritium, the joint and bone of the phalanx of the finger are involved in the purulent process. The symptoms of bone and articular felon are similar to those of subcutaneous felon, but more pronounced. The swelling usually spreads throughout the finger. The pain is strong, intense and cannot be clearly localized, the finger is bent, movements are impossible due to pain and swelling. Spontaneous breakthrough of pus through the skin with the formation of purulent fistulas is possible. In the case of articular panaritium, swelling, redness and pain are initially localized around the affected joint, but if left untreated, they spread to the entire finger. A typical clinical picture is shown in the photo.

Examination for felon.

If you notice these symptoms, you should consult a surgeon at the clinic. In the case of paronychia, cutaneous and subcutaneous panaritium, the diagnosis is made based on clinical picture and additional instrumental examination does not require. Enough to pass general analysis blood and blood glucose to determine the severity of the inflammatory process and diagnose diabetes mellitus, and, if present, the severity of the disease. In case of suspected bone and articular felon, as well as tendon felon (to exclude bone involvement in the inflammatory process), it is necessary to perform an x-ray of the hand. You should know that X-ray picture lags behind the clinical one by 1 - 2 weeks. Therefore, the radiography should be repeated after the specified period of time.

Treatment of panaritium.

At the initial stages of development of the inflammatory process, conservative treatment is possible in the form of antibacterial therapy, baths with hypertonic solution salt and physiotherapeutic procedures. However, patients often skip this stage of inflammation and do not seek medical help.

A purulent process in the finger usually develops on the 3rd day after infection. This is evidenced by constant throbbing pain and an increase in body temperature above 37°C. First a sleepless night caused by pain is an indication for surgical treatment.

For cutaneous felon, the operation consists of excision of the epidermal bubble at the border with healthy skin, treatment with a 3% solution of hydrogen peroxide and brilliant green. This manipulation can be performed at home with sharp nail scissors, after leaving them for 10 minutes in 70% ethyl alcohol for sterilization. The procedure is absolutely painless and does not require anesthesia. However, there is a danger of the existence of a felon in the form of a cufflink, when in the bottom of the bladder there is a fistula opening that goes under the skin. In this case, along with cutaneous felon, there is also subcutaneous felon. Therefore, excision of the exfoliated epidermis without surgical treatment of the subcutaneous panaritium will clearly not be enough for recovery, which will lead to the progression of purulent inflammation.

In case of paronychia, the formed abscess is opened by lifting the skin ridge at the base of the nail. If pus penetrates under the nail, then its exfoliated part is removed.

For subcutaneous panaritium, 2 lateral incisions are made at the border with the palmar surface of the skin, through which through drainage is carried out in the form of a gauze turunda and a rubber outlet. They prevent edges from sticking together postoperative wound, which is necessary for adequate outflow of pus and rinsing purulent cavity during dressings.

Paronychia, cutaneous and subcutaneous panaritium are treated in a clinic. If the diagnosis of tendon, bone and articular panaritium is confirmed, treatment is necessary in a purulent surgical infection department.

At the initial stage, partial treatment of the purulent focus is performed, as with subcutaneous panaritium. Subsequently, individual treatment is carried out.

Antibacterial therapy for felon on an outpatient basis is reduced to taking drugs such as ciprolet 500 mg 2 times a day for 7 days or amoxiclav 625 mg 3 times a day for 7 days.

Prevention of panaritium.

To prevent the development of panaritium, it is very important to properly treat the resulting hand wound in a timely manner. If you receive microtrauma to your hand, you should wash your hands with soap and remove foreign bodies from a wound (splinter, metal shavings, glass, etc.), squeeze a drop of blood from the wound, treat with a 3% hydrogen peroxide solution, lubricate the edges of the wound alcohol solution iodine or brilliant green. Cover with a bactericidal patch or sterile cloth.

When performing a manicure, you should avoid damaging the skin; before performing the procedure, treat the cuticle and adjacent skin with 70% alcohol. Nail clippers should also be immersed in 70% ethyl alcohol for 5-10 minutes. If the skin is damaged, it should be treated with ethyl alcohol and avoid contaminating it with soil, when cutting meat, and so on.

Complications of panaritium.

With advanced panaritium, inflammation may spread to deeper tissues with the development of pandactylitis. The latter is difficult to treat and often leads to amputation of the finger. The transition of purulent inflammation to the tendon and the lack of timely surgical treatment causes tendon necrosis with loss active movements in the finger of the hand. Along the tendon sheath, the purulent process quickly spreads to the hand with the development of phlegmon of the hand, the treatment of which requires extensive surgical interventions.

Articular panaritium often leads to the formation of contractures and stiffness in the affected joint.

Bone felon often leads to the development chronic osteomyelitis finger with a recurrent course, accompanied by partial or complete loss of mobility.

Therefore, self-medication for felon is dangerous and can lead to tragic consequences. A positive outcome for this disease is only possible if you seek medical help early. Take care of your health. It is better to overestimate the severity of your symptoms than to seek medical help late.

Surgeon Tevs D.S.

In every special case, especially if there is repeated suppurative processes, you should look for other diseases (diabetes, syphilis, hemorrhagic diathesis, etc.).

General condition of the patient is also of great importance. Particular attention should be paid to the treatment of various anemias, to eliminating vitamin C deficiency and to increasing low level serum protein (onychodystrophy). If the patient has pain, painkillers must be used.

After dissection of felon the importance cannot be underestimated local treatment wounds. Some surgeons apply a compress, a Billroth bandage made of canvas or cellophane, and when changing the bandage, the patient’s hand certain time immersed in disinfectant solutions. Both wet dressing and baths lead to maceration of the skin of the hand.

A maceration reduces the vitality and resistance of skin and tissues, interferes with wound healing and creates the ground for secondary infection. Macerated tissue of the wound edges creates good soil for an outbreak of the inflammatory process. Hertel also spoke about the unfavorable effect of baths in the treatment of felons.

Clapp And Beck baths are used only after the discharge from the wound has stopped, in order to facilitate active gymnastic exercises. We strongly reject the application of wet dressings and the use of baths after opening the inflammatory focus.

I have repeatedly observed the use of baths with manganese solution in outpatient settings, where the duration of this procedure, due to other urgent manipulations, was often too prolonged. As a result, the patient’s hand became swollen and took on a brown color from manganese, as a result of which signs of a possible spread of the process (initial swelling) and changes in skin color could not be detected.

We consider it necessary to emphasize the fact that baths, as a rule, is used for insufficiently opened lesions, for better outflow of pus, but the latter cannot be facilitated either by the use of baths or compresses. They only delay the inevitable reoperation.

We are after opening operations of felon We protect the surrounding skin with ointments, and apply a dry bandage to the wound so that it absorbs pus from the drained wound. While there is discharge from the wound, we change the dressing daily and at the same time irrigate the wound with an antibiotic solution, but never use local infiltration.

After stopping the discharge from the wound and cessation of pain in the limb, the bandage is changed every other day. Applying ointment dressings to a weeping wound is harmful, since the dressing does not absorb pus and the latter accumulates on the surface of the wound.

At treatment of felons In addition to fixing the diseased part of the hand, we must not forget about the movement of its healthy parts. The purpose of the latter: to avoid subsequent immobility of tendons and joints. Gymnastic exercises can be started before the wound heals. After the inflammatory process has stopped, a small bandage is applied that does not interfere with the movement of the fingers and systematic gymnastic exercises begin.

Movements healthy fingers should begin immediately after delimitation of the inflammatory focus. This should never be forgotten, since in practice there are often cases in which it takes much more time to restore the motor function of the fingers than to treat the panaritium itself.

After any infectious process Where hand skin defects remain, granulation tissue should be covered with grafted skin to avoid secondary infection or fibrosis. Otherwise, scarring and contracture occur, which leads to irreversible deformities.

If in progress treatment of felon it becomes clear to the doctor that due to the condition of the tendon or joint, the function of the hand cannot be restored, the patient should be warned about this. In the presence of purulent bone processes, destroying joints, and extensive suppuration of the tendon sheaths, where the necrotic tendon has been removed, as well as in cases of pandactylitis and extensive skin necrosis, depending on the profession of the patient, the question may arise: is it not more appropriate to amputate part of the finger than after long-term treatment get a defective, cosmetically extremely unsatisfactory finger?

Thus, treatment of panaritium before today is still a major challenge. The most appropriate moment, as well as the method of opening the panaritium, are the subject of serious thought. The further task is to promote delimitation of the process and healing of the wound. If complications develop, the spread of the process should be prevented.

Maintaining finger mobility is extremely important and requires attention already in the initial period of wound treatment, after which restoration of hand function is carried out using the method of functional therapy, and if necessary, then with the help surgical interventions. Therefore, the treatment of every deep or complicated panaritium is the task of specialists.

A splinter or finger injury can easily fester to the bone. In medicine, such an inflammatory process is called panaritium. Pathology occurs because pathogenic microorganisms enter the body through damaged integuments. In the absence of proper disinfection, purulent inflammation develops, which can spread to tendons, bones, muscles, joints and even lead to necrotic processes.

What is a panaritium on a finger?

A purulent acute inflammatory process, which is localized on the fingers of the upper extremities, less often on the lower ones, is called panaritium. Inflammation on the back of the hand is not related to this disease. Most often, men and women from 20 to 50 years old suffer from panaritium. This is explained by the fact that at this age people often receive microtraumas to the skin on their hands. Diseases associated with injuries at work develop in 75%, at home - 10%, and in all other cases only 15%.

The palmar surface of the fingers contains many important anatomical structures: joint capsules, vessels, nerves, tendon sheaths and tendons. The subcutaneous tissue in this area also has a special structure - multiple strong and elastic fibers go from the skin to the palmar aponeurosis. In its thickness there are longitudinal bundles of connective tissue.

As a result, the fiber is separated by small bridges, reminiscent of a honeycomb. This structure not only helps prevent the spread of inflammation, but also creates favorable conditions for the purulent process to penetrate deep into the tissues. For this reason, during the development of the disease, bones, tendons, joints and other tissues of the hand can quickly become involved in the pathological process.

Panaritium on the finger develops as a result of the spread of pyogenic microorganisms (usually Staphylococcus aureus) in the tissues. During the development of the disease, redness of the affected area, swelling, and pain are noted. In severe cases, there is an increase in temperature and chills. On early stage conservative treatment is prescribed for the inflammatory process; in the later stages, surgical intervention.

Causes

In addition to staphylococcus, felon can be caused by streptococci, Proteus, Pseudomonas aeruginosa and other pathological microorganisms. The infection penetrates the skin through small cracks and abrasions on the palmar surface of the finger. A person gets wounds during a manicure, puncture of the skin due to fish bones, wood chips, metal shavings and others sharp objects. The infection also penetrates through a burn on the finger, which occurs due to the careless use of fire or hot objects.

Some wounds sometimes go unnoticed or look insignificant. The patient does not pay attention to them until the first symptoms of panaritium appear. TO internal reasons the occurrence of the disease includes hypovitaminosis, endocrine pathologies, impaired tissue nutrition, decreased general immunity. Panaritium on the fingers can also develop due to external factors. These include:

• systematic hypothermia;
• violation of the innervation of the finger, hand;
• maceration of the epidermis (swelling and/or loosening);
• skin contamination;
• exposure to irritants;
• disruption of the blood supply to the hand, which is carried out by radiation and ulnar arteries;
• excessive moisture of the skin.

Classification

Taking into account the nature and location of the affected tissues, doctors distinguish the following types of disease:

• Skin felon. The mildest form of pathology is when an abscess forms in the epidermis.
• Subcutaneous panaritium. Purulent contents appear in the subcutaneous tissue located on the dense palmar surface of the fingers.
• Periungual felon (paronychia). The inflammatory process develops in the area of ​​the periungual fold.
• Subungual panaritium. Suppuration occurs under the nail plate.
• Articular panaritium. The pathological process develops in the metacarpophalangeal or interphalangeal joints.
• Bone panaritium. The bones are involved in the purulent-inflammatory process.
• Tendon panaritium. The disease is localized in the tendon area.
• Pandactylitis. The most severe form of the disease, in which a purulent-necrotic process of all tissues of the finger develops.

Symptoms

Depending on the level of damage and location of the injury, the symptoms of panaritium have several varieties:

Complications

It is not advisable to take independent measures to treat purulent inflammation of the finger. To avoid serious consequences felon, you definitely need to consult a doctor. If the purulent-inflammatory process is started, it can lead to complications. Treatment should begin at the first signs of the inflammatory process, otherwise pathologies such as thrombophlebitis, osteomyelitis, lymphadenitis, phlegmon of the hand, and joint contracture may occur. Deep purulent-inflammatory lesions often lead to blood poisoning and sepsis.

A pregnant woman must be extremely careful when performing a manicure, because the infection can pass to the child if infected. It is better to refuse salon services altogether while expecting a baby. When infected, felon can lead to bone phlegmon, which can only be treated with surgery. Disease in advanced stage often causes the development of osteomyelitis chronic form with a relapsing course. As a result of this pathology, you can partially or completely lose the mobility of your finger.

Treatment of felon

Therapeutic methods are adopted, depending on the type of panaritium:

Treatment at home

Treat yourself this pathology necessary, based on the doctor’s recommendations. Surgical and/or drug therapy, and when the wound begins to heal, you can use folk remedies. Vishnevsky ointment is effective for panaritium. To get rid of an abscess, you need to apply a layer of liniment to the affected area of ​​skin and apply a compress on top. The medicine should be used at night and the wound should be disinfected in the morning. The procedure must be repeated until the pus is completely removed.

Good effect gives Dimexide for panaritium. The solution has a healing, antimicrobial, analgesic, anti-inflammatory effect. Dimexide should also be used at night as a compress. If felon occurs on a child’s finger, then baths with salt or soda (2 tsp per 2 glasses of water) and Levomekol ointment, which should be applied under the bandage at night, will be effective.

Drug treatment

Antibiotics for felon are prescribed if the disease is caused by staphylococcal or any other infection. Are used antibacterial drugs from the group of penicillins (Amoxiclav), fluoroquinolones (Levofloxacin) or macrolides (Josamycin). As a rule, intramuscular administration of antibiotics is used, but in case of bone or joint pathology, treatment is carried out using intraosseous infusions.

To remove pus and heal wounds, Oflomelid, Levomekol, Dimexide, Vishnevsky ointment or Ichthyol are used externally. They have antimicrobial, anti-inflammatory, regenerating effects. To remove purulent fluid, these drugs should be applied to a sterile bandage and applied to the site of inflammation up to 3 times a day.

IN postoperative period the wound is treated with antiseptic solutions (Chlorhexidine, Chlorphyllipt). To suppress further inflammation, nonsteroidal anti-inflammatory drugs (Diclofenac, Nimesil) and UHF therapy are prescribed orally. Physical therapy is effective after reducing inflammation. It helps improve local circulation, remove swelling and pain. The average number of procedures is 3-7. Duration – from 5 to 20 minutes.

Traditional methods of treatment

With the permission of the attending physician, you can use folk recipes in the treatment of purulent inflammation on the finger. The most effective:

• Aloe. Cut off both sides of the plant leaf, leaving only the pulp. Apply it to the sore spot and wrap it with a bandage. Do not remove the compress for 5 hours. Repeat the procedure every 4 hours until the condition improves.
• Calendula. Soak the gauze alcohol tincture flowers of the plant, wrap the sore spot, cover with polyethylene. Keep the compress for 3 hours, then replace it with a new one. Carry out the procedure several times a day.
• Potassium permanganate. Warm baths will help at the beginning of the purulent process. Dilute 1 granule of manganese in a glass of hot (tolerable) water. Soak the sore finger in the solution for 15 minutes. Repeat the procedure several times a day until inflammation decreases.

Autopsy of a panaritium

Surgical intervention is the most effective method treatment of panaritium. The operation is prescribed by a doctor after blood tests and other laboratory tests. Mainly used local anesthesia according to Lukashevich-Oberst: a tourniquet is applied to the base of the finger, a puncture is made on the lateral phalanx with a needle to the bone and 2 ml of lidocaine solution (2%) is injected. The same manipulation is carried out on the opposite side of the phalanx. If the palmar bones or joints are involved in the process, the operation is performed under general anesthesia.

Autopsy is carried out differently, depending on the type pathological process:

• Subcutaneous. Longitudinal incisions are made, which are carried out with great care so as not to damage nerve bundle.
• Tendinous. Incisions are made on the anterolateral surface of the finger.
• Subungual. The edge of the nail is excised wedge-shaped or the nail plate is trepanned under the site of accumulation of pus. If complete suppuration and detachment are observed, then it is completely removed.
• Articular. Two side incisions are made with back side brushes, after which the cavity is washed with an antibiotic or antiseptic.
• Bone. The nail phalanx is cut in the form of an arc and washed. If it needs to be removed, a Gigli saw is used.

Prevention

home preventative measure– clean hands, but we must not forget that skin overdried by detergents quickly becomes covered with microcracks through which they can easily penetrate pathogenic bacteria. To avoid infection, you should always remember about prevention.

If your finger is inflamed, there is severe pain that does not allow you to sleep, then most likely it is felon. Treatment of felon at home is often more effective than official treatment, but only in the first stages of the disease.

Here are examples of how it was possible to cure felon, taken from the newspaper “Vestnik ZOZH”

Causes and types of panaritium - from a conversation with doctor V. Khoroshev

What is panaritium

Panaritium is acute inflammation finger tissues. Inflammation of the finger occurs due to minor damage to the skin.

The most common occurrence of panaritium is in people performing physical work that leads to microtrauma to the hands, with contamination of the hands with irritating substances. These are drivers, car service workers, builders, carpenters, mechanics, weavers, and cooks. Especially dangerous if a person is sick endocrine diseases, works in conditions of high humidity and cold - these people have impaired blood circulation through the capillaries.

Types of panaritiums:

– cutaneous
– subcutaneous
– periungual
– subungual
– bone
– articular
– tendon
– complete – when all tissues of the finger are affected.

Causes of panaritium:

First of all, the reason is the violation immune system, i.e. failure of general and local (tissue) immunity. Therefore, in some people, inflammation of the finger occurs from the slightest injury, while others do not even know what felon is.

Scheme of disease development

The causative agent of the disease is most often white or aureus Staphylococcus, less often coli and other microorganisms. They are usually found on the skin, but as soon as a wound appears, they rush there, causing inflammation of the finger. initial stage the inflammatory process during panaritium is quickly replaced by purulent-necrotic inflammation, since the accumulation of exudate in confined space leads to impaired blood circulation, and therefore to ischemic tissue necrosis and purulent melting.

Treatment of panaritium at home

If your finger is inflamed and the pain does not allow the patient to sleep, you should immediately run to the surgeon, but if health care not available, use the following:
– ichthyol ointment or Vishnevsky ointment
– hot bath with potassium permanganate
– finger bandages with vodka, alcohol, cologne
– salt a piece of black bread and chew it. Cover the sore finger with this chewed bread and bandage it. (Healthy lifestyle recipes 2003, no. 21, p. 14)

How to treat felon with bread

Before washing the floors, the woman picked off a hangnail and brought the dirt under her nail. By nightfall, the finger became inflamed, swollen, red, and there was severe pain. This went on for several days, and finally she went to the doctor. The surgeon said that we need to remove the nail and clean the bone. But it didn’t come to that, because the patient was advised folk remedy from felon. Take a piece of black bread, add salt and chew until it forms a paste. Place a piece of bandage on the parchment, then the pulp, then cover the top with the other end of the bandage. Apply all this to the sore finger and bandage it. By the morning the swelling had subsided, and there was pus and blood on the bandage - the wound was completely cleansed. (HLS 2002, No. 17, p. 20).

If a finger breaks under a nail, one healer does this: she makes the patient dip his finger 3-4 times in very hot water, then chew black bread and onions, and covers the sore spot with this paste and bandages it with a bandage. The wound clears up overnight. Then he washes the wound with pink manganese water and makes another dressing. And everything heals. (p. 18, 2001, No. 15).

Treating felon at home with garlic

Beginning panaritium can be cured with garlic. You need to attach a clove of garlic to your finger and secure it (HLS 2013, No. 5, p. 33)

Treatment of finger inflammation with chalk

The following folk remedy helps a woman cure felon: lubricates the skin camphor oil and sprinkles it with crushed chalk, ties it with woolen cloth. After three days it gets better. The pain goes away, the pus flows out (HLS 2008, No. 14, p. 30)

How to treat aloe finger felon

The man developed a panaritium on his finger, spent a day in the hospital, had surgery on the third day, and the scar still remains. After some time there was a relapse. The finger became inflamed, festered, and a throbbing pain appeared. Then the man took an aloe leaf, cut it lengthwise and bandaged it with the pulp to the abscess, changed the bandage before going to bed, and the pain did not bother me at night. Aloe was changed every 12 hours. On the third day, the skin on the finger was white and wrinkled, dead. He cut off this skin and smeared the wound with Vishnevsky ointment. After a few days, only a trace in the form of a dot remained. Then this folk remedy helped him several more times. (Healthy lifestyle recipes 2008, No. 18, pp. 31-32).

A woman pricked her finger with a fish fin. After some time, an abscess formed. Neither ointment nor pills helped. My finger hurt so much that I couldn’t sleep at night until I saw an aloe plant on the windowsill. The patient cut off the leaf and applied it to the felon and bandaged it. An hour later the pain subsided and I managed to fall asleep. In the morning there was almost no pain, and the abscess had decreased. I repeated the procedure, and two days later there was no trace left of the wound. (2007, no. 23, p. 32).

Treatment of felon with plantain

The woman's nail on her little finger became inflamed. Three times they opened an abscess on one side of the nail, and the next day it appeared on the other side. The hospital offered to remove the nail, but the woman refused. A friend recommended a folk remedy for panaritium: pick plantain, wash it and tie it to your finger for a day. For the first time in a long time, the patient fell asleep peacefully, and after 3 days the wounds healed. It was possible to cure felon without surgery. (HLS 2011, No. 6, p. 39)

The woman developed an abscess on the second phalanx of her finger and her finger was swollen. At the hospital they cleaned her bone, but not very successfully. Repeated surgery was required. But the patient decided to treat the bone felon at home using the Nosal method - repeatedly wrapping the finger with plantain. The patient picked plantain leaves, washed them well, dried them, tied them to the incision, after steaming the wound in salt water. Now this cut is not visible. (Healthy lifestyle recipes 2010, no. 17, p. 33)

Onion and soap ointment for treating felon at home

One day a woman’s finger hurt, itched terribly, and an abscess appeared on the nail. I contacted a surgeon, he diagnosed felon, applied ointment to the abscess and sent me home. The abscess grew larger, the doctor removed the entire nail and applied the ointment again. Then remove the rest of the nail.

The patient went to visit her sister over the weekend. There, a neighbor gave her a recipe for ointment for panaritium and various boils. Take in equal parts laundry soap, onion, rosin, beeswax, butter, grate everything and cook, stirring until smooth. After cooling, apply the ointment to a bandage and apply to the sore finger. After the first time, the wound was completely cleared. And the third time I applied the ointment for prevention. After the compress, I covered the wound with streptocide. Everything dried up, healing began, but the nail grew crooked for life. (HLS 2011, No. 2, p. 30)

Clay compresses

If the panaritium of the finger does not heal for a long time, clay compresses will help: you need to mix clay with urine until creamy, apply it to a gauze napkin and apply it to the felon on the finger. The same compresses will help if you have a growing bunion near your big toe. (2010, no. 16, p. 10)

Needle injections

Inflammation of the finger near the nail is very unpleasant disease, twitches, does not allow you to sleep. This remedy will help: with the tip of a thin needle from a sterile syringe before going to bed, pressing lightly, prick the entire area of ​​redness with crosses. There will be no inflammation in the morning. (HLS 2006, No. 2, p. 31)

Treatment of felon at home with celandine

The woman began to break out thumb on right leg near the nail. Then a panaritium appeared on the left toe. The pain was so severe that it was impossible to walk.
And since she had diabetes, these abscesses worried her very much. She brewed a strong infusion of celandine (1 tablespoon of herb per 1 glass of boiling water, boil for 10 minutes, leave for 2 hours). She soaked cotton wool in the infusion, applied it to the panaritium on her toe, a film and a bandage on top, and did the same with the second leg. Already in the morning I felt relief. The treatment lasted a week. Every morning and evening the patient changed the bandage and lubricated her fingers with a nourishing cream with chamomile. Soon everything healed, the redness went away. (HLS 2006, No. 13, p. 8, 2003, 323, p. 25)

Celandine juice will help even better. You need to moisten a cotton wool in the juice and wrap it around your finger, with a fingertip on top. Change the cotton wool several times a day. The inflammation of the finger will go away very quickly. (Healthy lifestyle recipes 2004, no. 9, p. 22)

Iodinol treatment

The woman got a splinter on her finger, took the splinter out, but the finger did not heal for a long time. There is redness around the nail. A week later, the woman woke up from severe pain in her finger; it was very swollen, turned white, and filled with pus from the inside. She took iodinol, soaked a bandage in 3 layers, tied it to the abscess, and wrapped a towel on top. In the morning, the bandage was dry, the pus had resolved, but did not come out, and the finger was still swollen. After another three days of such compresses, the swelling went away. (2006, no. 23, p. 2)

Bone panaritium - treatment with a golden mustache

A woman cleaned a perch and pricked it with a fin forefinger under the nail. Soon the pain subsided, but three days later a sore appeared on the finger, resembling a black and blue ball. The surgeon removed the nail, but it did not improve. A few days later, the entire finger swelled up, turned black, and stopped moving. Diagnosis: “felon of the finger bone.”

Neither antibiotics, nor ointments, nor procedures, nor baths prescribed by the doctor helped. It was then that an article about healing power golden mustache plants She made a tincture: she grinded the whole plant in a meat grinder, poured in 500 ml of vodka, and left it for 10 days, instead of the prescribed 21 days, because there was no time to wait.

I started making compresses with this tincture at night, kept my finger warm during the day and lubricated it with this tincture several times a day. I also took 1 tsp of the tincture orally. In the morning on an empty stomach, adding a few drops of aloe juice, I also lubricated my finger with a strong infusion of St. John's wort. Treatment of panaritium lasted 20 days. The finger became as before, the nail grew clean and even. But she suffered for 8 months. (HLS 2006, No. 16, p. 30)

Recipe from panaritium

One day, a friend told a woman a recipe for panaritium, which helped her save her leg. The fingers were about to be amputated, but this folk remedy helped in 2 days. The recipe was dictated by:
Keep the limb in a pale pink solution of potassium permanganate for 30 minutes
Keep calendula tincture in the solution for 30 minutes - 100 ml per 1 liter of water.
30 minutes – in a solution of eucalyptus tincture – 100 ml per 1 liter of water.
In the same eucalyptus solution, moisten a bandage folded in 8 layers, squeeze it out, wrap it around the sore spot, and secure it with a bandage. Do not use film or compress paper here.

This recipe was useful to a woman three years later in a more serious case than panaritium. Her husband’s fingers were crushed by a weight so that all the muscles and skin burst, and dirt and fingerprints immediately got there. He was able to get to the hospital only after 2 hours. The surgeon immediately said that it was 99% amputation, and he bandaged it. The woman immediately remembered the recipe for felon and suggested that her husband be treated with folk remedies, but he refused. The next morning all the bandages were soaked in blood and pus. When they made a new dressing, these bandages were removed without soaking and pain relief, he almost lost consciousness from the pain. Then he agreed to be treated according to his wife’s method.

He held his hand in the first solution without removing the bandages; in 30 minutes they soaked well and came off. That night there was no more pain or twitching. The next day, the bandages came off well - there was no pus, and the wounds were clean with new skin. After the 4th procedure, the hand was no longer bandaged. After some time, the man met his surgeon, he asked why he didn’t go for dressings, and when he saw his hand, he was simply amazed. (Healthy lifestyle recipes 2006, No. 18, p. 9)

Treatment of inert panaritium at home with baked onions

After an injury, a woman’s finger became inflamed, then bone felon began. My whole arm turned red, and an abscess the size of an orange grew under my armpit. She was told a folk remedy - treating felon with an onion. I baked an onion, put it on my finger and wrapped it with a towel on top. The pain quickly subsided, the woman slept for more than a day. But she woke up healthy, the bulb pulled out all the dirt and pus, even from under her armpit. (2004, no. 22, p. 17)

If your finger is inflamed, herbs will help

An ointment made from these herbs will help get rid of any pustular diseases - fistulas, boils, abscesses, ulcers. To prepare this ointment for inflammation and ulcers, you first need to prepare calendula oil. To do this, place 1.5 cups of calendula flowers in a stainless steel pan and pour a glass vegetable oil temperature 80-100 degrees, stir. When it cools down, transfer to a glass jar and leave in the dark for 40 days, strain.

Preparation of ointment. Fresh calendula flowers 2 parts, yarrow – 2 parts, sweet clover – 1 part, dandelion roots – 2 parts, roots horse sorrel– 1 part, tansy inflorescences – 1 part. Wash all these herbs and pass through a meat grinder. Add 1 part of Vishnevsky ointment and 1 part of ichthyol ointment to the herbal gruel. Dilute this entire mixture with calendula oil prepared in advance to obtain a homogeneous elastic mass. Store the resulting ointment against abscesses in the refrigerator.

Panaritium should be treated as follows: Steam your finger in salty hot water, wipe it with cotton wool and alcohol and apply this ointment overnight. In the morning, repeat everything, change the bandages 2 times a day.

This ointment was used by a woman for treatment bitch's udder: I applied a napkin with ointment for the whole night, and changed it in the morning. By the evening, all the nodes had enlarged, the heads of abscesses appeared, and on the 3rd day all the pus began to come out. (Healthy lifestyle recipes 2006, No. 18, p. 31)

Treatment of inflammation of the finger with smoke

This very simple folk remedy helped cure felon and avoid surgery for many people; previously, on the battlefields, even gangrene was treated with this remedy. You need to take a fabric made of natural cotton, flannel, flannel, roll it into a flagellum and set it on fire at one end so that smoke comes out, fumigate the inflamed finger with this smoke for 1-3 minutes. If after some time the pain in the finger resumes, fumigate again. 2-4 procedures are enough, but it is better to treat felon with this remedy in the open air to protect the apartment from the smell. (HLS 2006, No. 25, p. 8,)

Treatment of felon with furatsilin

Crush the furatsilin tablet into powder, pour it onto wet cotton wool, wrap the cotton wool around the sore finger, and put polyethylene and a bandage on top. Leave it like this all night. If it doesn't help the first time, next night repeat the procedure. (HLS 2004, No. 5, p. 26)

If your finger is inflamed, baking soda will help.

The woman was helped to cure felon with a soda solution. 1 tbsp. l. Soda should be brewed with 1 cup of boiling water, stir. When it cools down to warm state put your finger in there. Do this procedure several times. (2004, no. 12, p. 7)

How to treat felon of a finger with solid oil

A woman pricked her finger with a wire. Dirt got in and my finger became inflamed. I didn’t go to the hospital, but applied technical grease. After 2 hours the pain subsided, and by evening the abscess opened. I applied solid oil again, and all the pus was drawn out overnight. In the morning I washed the wound with potassium permanganate and applied a Kalanchoe leaf. Everything has healed. In the village where the author of the letter lives, many residents use this remedy for panaritium and abscesses. (2005, no. 3, p. 8,)

Treatment with potatoes at home

To cure purulent inflammation of the finger, you need to grate a raw potato and apply the pulp to the wound. Secure with bactericidal plaster. Healing occurs very quickly. The recipe has been tested on many people. (Healthy lifestyle recipes 2005, No. 14, p. 29)

Hot water

The woman's finger became inflamed under the nail and an abscess appeared. The doctor said that it was necessary to cut it. But the woman decided to treat panaritium using the traditional method. Made it hot soap solution The hotter it is, the more effective it is. I dipped my finger into the solution, counted to three, but couldn’t stand it until three, only 2 seconds. I drank until my heart began to protest. And in the morning the finger turned out to be healthy. There was no need to cut. (HLS 2005, No. 18, p. 10)

Using hot water you can also prevent the development of felon. As soon as a splinter gets under your nail, you need to pour hot water into a mug, add salt to it, and dip your finger in it. Then cut the nail short, clean and disinfect with alcohol or cologne - the finger will not become inflamed. (2003, No. 4 p. 4)

Ointment for all occasions

Take in equal proportions pine resin, medical tar, butter, aloe leaf pulp, flower honey. Place this mixture on water bath and heat there, stirring until the mixture becomes homogeneous. If it turns out very thick, dilute with vodka.
This ointment helps with any non-healing fistulas, bone tuberculosis, abscesses, helps cure furunculosis, subcutaneous and bone panaritium. You need to smear the sore finger, cover it with plastic and wrap it with a bandage. (HLS 2003, No. 3, p. 25)

Treatment of felon at home with eucalyptus

If you have a purulent inflammation of your finger, then you need to finely chop eucalyptus leaves, cover your finger with them and secure with a bandage. (2003, no. 7, p. 13)

How to cure panaritium on legs with iodine

A 13-year-old girl constantly suffered from felons on thumbs legs The ingrown areas of the nail plate constantly bled, and I had to walk not in shoes, but in rag slippers. She had plastic surgery on her nail beds twice, but it didn’t help. Regular iodine helped. 3 times a day she smeared the affected areas with iodine until dark brown. She did this for only 4 days. Skin in places chemical burn disappeared, but since then the felons have not appeared again. (HLS 2003, No. 3, p. 25)

Cabbage treatment

A woman pricked her finger with a needle while sewing. The finger became inflamed and began to break out. Tied to the sore finger cabbage leaf, changing the bandage 2 times a day. On the 4th day the finger was healthy. (HLS 2002, No. 3, p. 18,)

Nail felon - treatment with soap and protein

The beginning of felon nail can be cured at home with the following ointment: grate laundry soap and add it to the beaten egg white until a paste is obtained. The consistency should be viscous, plastic, but not liquid. Apply this paste to the inflamed finger, on the sore spot, including some healthy skin. It is advisable to let the paste dry and set in the air, then bandage it. Walk like this for a day or two. After removing the bandage, you will see that the sore has broken through and pus has come out of it. If necessary, apply the bandage with soap ointment again (Healthy Lifestyle Recipes 2002, No. 12, p. 17)