Panaritium is the general name for various acute purulent processes in the area of \u200b\u200bthe fingers of the hand. The special significance of panaritiums lies in the fact that they are very common, accounting for about 15-20% or more of all outpatients. This disease sometimes causes significant temporary disability of patients, and if improperly treated, it can lead to permanent dysfunctions of the fingers, disability, and in some cases even death of the patient.

The clinical course of panaritiums, as well as some of their signs, largely depend on the structure of the fingers of the hand and their topographic and anatomical features: the presence of vertical fibrous bridges extending from the skin to deeper anatomical formations, the cellular structure of the subcutaneous tissue of the palmar surface of the fingers; the presence of tendon sheaths with double walls and a kind of mesentery (mesotenone), ulnar and radial synovial bags, sometimes communicating with each other; structural features of the nail and nail bed, etc.

Panaritium reasons... The immediate cause of panaritium is the penetration of various pathogens of purulent inflammation into the tissues of the fingers: streptococci, staphylococci, etc. They usually penetrate through various minor injuries of the skin of the fingers: through abrasions, cracks, injections, cuts, scratches, bites, etc. Most often these minor injuries are observed at work, in agriculture and at home. Sometimes the cause of panaritium is manicure, accidental wounds during operations (especially purulent ones) or during autopsy.

Depending on the localization of the inflammatory process, it is necessary to distinguish the following main forms of panaritium:

1) superficial panaritiums: cutaneous, subcutaneous, nail, periungual or paronychia and subungual;

2) deep panaritiums: tendon, bone, articular. Finally, there are cases when there is a lesion of all tissues of the finger - this is the so-called pandactylitis. If superficial panaritiums arise primarily, then deep panaritiums most often develop secondarily, due to the spread of infection from any primary panaritium, especially often subcutaneous. Thus, deep panaritiums are predominantly (mainly) a complication of superficial panaritiums. Here we will focus on the description of only those forms of panaritium, which may require urgent surgical intervention (incision).

Panaritium signs and symptoms... The symptoms of panaritium are somewhat different depending on their shape.

The most important form of purulent diseases of the fingers is subcutaneous panaritium, since it not only occurs especially often, but with improper treatment is, as said, the source and cause of deep panaritium. With subcutaneous panaritium, an acute purulent process develops in the subcutaneous tissue. Panaritium begins with slight swelling, redness, and pain. This form of panaritium is very characteristic of increasing pulsation and very severe pain in the sore finger, sometimes so significant that it causes severe suffering to the patient and even deprives him of sleep. Common phenomena are also often observed: an increase in temperature, a violation of the general condition, etc.

Tendon panaritium, or tendovaginitis, is the most severe form of panaritium, sometimes even dangerous to the patient's life. At the same time, the purulent process develops in the tendon sheath and is accompanied by the accumulation of purulent fluid there, which, causing compression of the mesotenone, can lead to rapid tendon necrosis. In most cases, the purulent process spreads throughout the tendon sheath, that is, in the area of \u200b\u200bthe II-III-IV fingers - from the base of the nail phalanx to the level of the heads of the metacarpal bones, and in the area of \u200b\u200bthe I and V fingers - from the base of the nail phalanges to the palm into the synovial bags located in the area of \u200b\u200bthe I (thenar) and V (hypotenar) fingers.

The main signs of purulent tendovaginitis are: uniform swelling of the entire affected finger with a predominance of swelling on its dorsum; severe pain when trying to make passive movements in any joint of the finger (especially during extension), which, as a result, are sometimes completely impossible; the finger is usually in a slightly flexed position; when palpating or pressure (which is best done with a bell-shaped probe), pain is determined along the entire tendon sheath.

The skin of a sore finger often has a normal color, but with advanced tendovaginitis, it acquires a bluish tint. Usually, pronounced general phenomena are observed: fever, headache, loss of appetite, general weakness, axillary or elbow lymphadenitis, changes in blood (leukocytosis). In some cases, there is a severe septic condition. Suppurative tendovaginitis, given to its own course, can lead to a number of complications (purulent tenobursitis, phlegmon of the hand and forearm, sepsis), as well as to necrosis of the corresponding tendon with complete loss of finger function. Often, only early surgery can save the tendon and function of the toe.

Bone panaritium — a fairly common form of purulent diseases of the fingers, which is essentially a secondary osteomyelitis of the phalanges of the fingers, resulting from the spread of a purulent process (for example, with subcutaneous panaritium). It should be remembered that any superficial panaritium (especially subcutaneous), lasting more than 10-15 days, usually leads to bone damage. The nail phalanx is most often affected. In an early stage, the signs of bone panaritium resemble those of subcutaneous panaritium (see above), but only they are more pronounced (especially pain). The affected phalanx of the finger increases in size and has a varied appearance depending on which phalanx is affected: the type of a bulb, a mace or a spindle.

When examining the phalanx with a bulbous probe, the soreness of the entire circumference of the phalanx is determined. Often there are general phenomena in the form of an increase in temperature, etc. If you suspect a bone felon, an X-ray should be taken. It should be borne in mind that the first X-ray signs of bone damage are found in most cases only from 12-14 days from the onset of the disease. In the later stages of the development of bone panaritium, a change in the shape of the phalanx occurs, sequesters and fistulas are formed, that is, the usual phenomena of chronic osteomyelitis.

Articular panaritium — purulent inflammation of the interphalangeal and metacarpophalangeal joints of the fingers, which, like bone panaritium, is most often secondary. In the area of \u200b\u200bthe affected joint, severe pain occurs, movements in it become impossible due to rare pain. The joint area swells, redness appears. With a slight jerky pressure along the length of the finger, pain occurs in the area of \u200b\u200bthe affected joint. The entire toe acquires a characteristic fusiform shape in a slightly bent position. When the lateral ligaments of the joint are destroyed, abnormal mobility appears in it, and when the articular cartilage is destroyed, crepitus in the joint. An x-ray can provide valuable data.

Complications of purulent diseases of the fingers: lymphangitis, lymphadenitis, phlegmon of the hand and forearm, the spread of the purulent process to the joints of the hand and fingers, sepsis.

Urgent care with felon often consists in the need to open the accumulation of pus with an appropriate incision in order to prevent the further spread of the purulent process.

Panaritium treatment... The average health worker can only treat superficial felon, in particular subcutaneous. Patients with deep forms of panaritium (tendon, bone and articular) should be immediately referred to a surgeon, and in the presence of general phenomena (temperature, etc.) - to a surgical hospital, after applying a bandage on the sore finger and immobilizing the limb. Therefore, here we will focus only on emergency care for the most common form of panaritium - subcutaneous panaritium.

In the initial stages of panaritium development, that is, in the first 1-2 days, when there is a serous or serous-infiltrative stage, conservative treatment can be used. It consists mainly in the use of local and general antibiotic therapy, immobilization of the hand and forearm, and in some other therapeutic measures. Local antibiotic therapy for panaritium consists in injections of 0.25-1 ml of penicillin-novocaine solution (10,000-50,000 U and more) into the area of \u200b\u200bthe lesion (which, however, is quite painful) or better around it (from 2-4 points) ... Injections are made with a thin needle, daily or every other day.

In addition to local antibiotic therapy, other methods of conservative treatment of panaritiums are also used: the application of an alcoholic wet-drying bandage on the sore finger, which is changed 2-3 times a day; alcohol baths for the finger (45-60 minutes 1-2 times a day), hot hand baths (15-30 minutes several times a day), dressing with Vishnevsky ointment (for the whole arm) and physiotherapy procedures (UHF field) ... With all methods of conservative treatment, immobilization of the upper limb with a splint or plaster splint is absolutely mandatory. With general phenomena, as well as in the presence of lymphangitis or lymphadenitis, the general use of antibiotics or sulfa drugs is necessary.

If the use of conservative treatment for 1 - 2 days does not lead to a subsidence of inflammatory phenomena, but on the contrary, they (in particular, pain) increase or accumulations of pus or necrosis are found, then urgent surgical treatment is necessary, that is, opening a purulent focus, what is produced differently depending on the form of the panaritium. It should be emphasized that timely and radical surgical intervention is the key to success in the treatment of felon. If we consider that most patients with panaritium seek medical help after 2-3 days or more from the onset of the disease, then in the overwhelming majority of cases it is necessary to treat patients with panaritium immediately, that is, on the day the patient calls for help, to resort to emergency surgery.

The incisions are carried out in accordance with the general rules. It is most convenient to use not ordinary scalpels, but instruments for eye operations. A supply of thin rubber drainage strips should also be kept. Anesthesia is most often local in the form of injections of a 1-2% solution of novocaine with penicillin (8-10 ml) into the thickness of the base of the finger. Injections are given by two injections on the sides of the base of the finger. After both injections are made, it is necessary to apply a thin sterile rubber tourniquet on the base of the finger, which is convenient for incisions on the nail phalanx. In operations on the middle and main phalanx, exsanguination can be achieved by tightening the hand with a sterile rubber tube according to the Kustov method or by applying an elastic bandage or tourniquet on the forearm. Complete anesthesia occurs in 6-8 minutes.

To open the subcutaneous panaritium in the area of \u200b\u200bthe nail phalanx, a horseshoe-shaped or semi-oval (semi-arched) incision is used. The midline incision, which is used by some surgeons, produces a painful scar on the working surface of the finger and, in addition, it does not always bring the desired effect, and therefore it is better not to use a midline incision. The incisions are carried out 2-3 mm back from the free edge of the nail, and first the skin is cut, and then the subcutaneous tissue.

The assistant with the help of small sharp hooks should push the edges of the incision in order to be able to clearly examine the subcutaneous fat and bone. If dead tissue is found, then it is carefully excised with scissors (in children, a wide excision of necrotic tissue should not be performed). Since the entire inflammatory process develops first in the subcutaneous tissue, one should not be afraid to damage any important formations.

Then a strip of thin rubber moistened with sterile petroleum jelly or other oil is inserted into the wound (in order to prevent premature sticking of the edges of the wound). The rubber strip is usually removed after 2-3 days when the wound has cleared and does not need to be drained.

With panaritiums of the middle and main phalanges, anterolateral Klapp incisions are used. These incisions should not be continued along the line of the interphalangeal joints in order not to damage their ligamentous apparatus. The incisions are made through the skin and subcutaneous tissue. First, an incision is made on one antero-lateral surface of the phalanx, and then on the other. Thin rubber strips moistened with petroleum jelly are inserted into the incisions and left as drainage.

After opening the panaritium, the patient should appear the next day for a follow-up examination, and if the pain subsided, then the dressing should not be done. In the future, dressings are made according to the general rules in 2-3 days. After acute inflammation subsides, the patient is prescribed physiotherapeutic procedures (hot hand baths, UHF field, ultraviolet irradiation, paraffin or ozokerite applications), as well as exercise therapy.

Panaritium prevention... Prevention of panaritium consists in the prevention of minor industrial, agricultural and domestic injuries of the hand and fingers, in appropriate hand care and in rational and timely first aid for various injuries of the hands. Prevention of the more severe, deep forms of panaritium is the rational and timely treatment of superficial forms.

Panaritium is an inflammatory process that is localized most often at the nail plate on the fingers. A problem arises due to accidental or systematic injury to soft tissues, as a result of which pathogenic bacteria and viruses enter the wound. They provoke severe edema and the formation of purulent masses. In the absence of proper treatment or due to the transition of pathology to an advanced stage, bacteria can infect not only the soft tissues of the fingers, but also tendons, bones and joints and lead to necrotic processes.

The disease can be recognized by a number of characteristic features, among which are:

• significant sensations appear in the area of \u200b\u200bthe future focus of inflammation, while the pain is characterized by strong pulsation;
• gradually, the skin on the affected area and around it becomes red, swelling and swelling may be noted;
• pus begins to accumulate under the skin, which can sometimes begin to come out;
• the finger becomes virtually motionless, since every movement brings severe pain;
• the patient's temperature rises to +37.5 degrees, weakness and nausea may be observed.

Attention! Sometimes the disease can cause not only subfebrile body temperature, but also increase the indicators to critical +40 degrees. It is important in this condition to immediately consult a doctor, since at first glance, simple suppuration can cause more dangerous complications.

Antibiotics for finger panaritium

Ampicillin

In most cases, patients tolerate treatment with the penicillin group well, while it is these medicines that show the best results in the fight against bacterial panaritium. Adult patients receive 250-500 mg of the active substance during therapy. The number of daily intake is selected individually and can be 2-4 times. The duration of therapy with Ampicillin is one to two weeks.

Erythromycin

A good antimicrobial drug that is used to eliminate most bacterial infections and inflammations. The drug rarely causes serious side effects and overdose if properly prescribed. The amount of the basic substance is 0.25-0.5 g of the drug. In the first days of therapy and in severe cases, panaritium, the patient can take up to five doses of the active component. For better and more lasting results, you should take the tablets one hour before meals or one hour after them. The duration of treatment with Erythromycin with panaritium is seven days, sometimes therapy is continued for two weeks. The daily dose of the active substance should not be exceeded by four grams.

Ilozon

A good antibiotic, which belongs to more modern drugs than Erythromycin and Ampicillin. To obtain a quick result, adult patients need to take 250-500 mg of the active substance up to four times a day. The maximum permissible daily dose of Ilozon is 2 g. Before starting treatment, you should check your kidneys, since taking medication can negatively affect their work.

Attention! Drugs in this group are prescribed only with a confirmed microbial pathogen of panaritium, which may refer to streptococci and other pathogenic bacteria.

Ointments against panaritium on hands

Ichthyol

A safe ointment that does not cause tissue necrosis and can pull out the most dense and deepest purulent neoplasms. Apply the medication up to three times a day in a thick layer. For a quick result, it is necessary to apply a bandage to the affected area. Ichthyol penetrates deep into skin tissue, relieves swelling and inflammation. After the first use, the patient will notice noticeable improvements in his condition. The duration of therapy with Ichthyol is up to 14 days.

Vishnevsky ointment

It differs in a specific smell, but at the same time, in the first few days, it can relieve unpleasant symptoms. For treatment, it is necessary to apply ointment to the affected area in a dense layer and apply a compress. It is best to do this before going to bed. In the morning, the bandage must be removed, the wound must be disinfected with an antiseptic solution and the procedure must be repeated again. It is possible to be treated in a similar way until the felon on the finger completely disappears.

Levomekol

The ointment is easy to use and fast. Apply the drug to a sterile gauze bandage, which must be applied to the sore spot and tied tightly. Change the compress only once a day so as not to cause an overdose. The duration of therapy with Levomekol is set individually, usually it takes no more than two weeks for treatment. The ointment belongs to antibiotics, so you should first familiarize yourself with the contraindications to its use.

Synthomycin ointment

This medication allows you to accelerate the healing of wounds, prevent the development of necrotic processes or eliminate their manifestation. For treatment, it is necessary to take an exclusively sterile bandage or plaster, on which a small amount of medication is applied, a small pea is enough. Before applying, the focus of the panaritium is treated with an antiseptic, after which a bandage is applied to the sore spot and fixed. Change the bandage once a day. The duration of therapy is up to two weeks.

Attention! When using ointments, it is important to change the dressings in a timely manner, since a large number of pathogens of pathology also accumulate under them, which in the end can only worsen the patient's condition.

Lotions against felon

Biosept

A drug is produced in the form of a solution for disinfection and lotions. For treatment it is necessary to take a clean cloth and moisten it with Biosept. After that, the compress is applied to the wound until it dries completely. You can repeat such manipulations up to six times a day. It is necessary to use such lotions only in combination therapy against panaritium. The duration of therapy is until the unpleasant symptoms disappear completely.

Video - Panaritium: causes, diagnosis, complications, prevention

Antisept

It is also a good antiseptic to prevent bacteria and viruses from entering the wound and the affected area. For use, you must take a sterile bandage and moisten it with Antisept. After that, the lotion is applied to the sore spot for 10-15 minutes. Like Biosept, this disinfectant can be used up to six times a day until the manifestations of panaritium are completely eliminated.

Attention! Lotions should be included in combination therapy, since they cannot provide the necessary therapeutic effect to completely eliminate the disease.

The cost of drugs

The table shows all the drugs described for the treatment of finger felon with their cost.

Attention! These prices are indicative only and may not coincide with those indicated in your pharmacy network.

Traditional methods of therapy for the treatment of panaritium

Potassium permanganate solution

Such a procedure significantly disinfects the focus of the disease and allows you to immediately apply ointments when using a combination treatment. With panaritium, potassium permanganate must be used in the form of baths. To do this, it is necessary to dissolve in two liters of boiled water, its temperature should be +37 degrees, a little active substance. The exact dosage for such cases does not exist; one should focus on the color of the solution. It should turn purple. It is very important to ensure that all crystals are completely dissolved, as they can burn the skin. After that, the hand is lowered into the water and held there for about five minutes. You can repeat this procedure up to three times a day until the symptoms of the disease completely disappear.

Garlic bath

To prepare the drug, you need to take a medium head of garlic and turn it into gruel. The resulting mass is poured with boiling water, the water temperature should be 80 degrees. After infusing the product under the lid for 10 minutes, you must lower your hand into it. This bath is carried out until the liquid has cooled completely. As soon as the procedure is over, it is necessary to take out all the gruel and apply it to the affected area. The sore spot is tied with a tight bandage and left until morning. The procedure is repeated once a day until the symptoms disappear completely.

Video - How to treat felon on a finger

Soda baths

This method is perfect for treating pregnant women and children. For 500 ml of boiled water at room temperature, you need to take a tablespoon of soda and salt. After thoroughly stirring the components, it is necessary to lower the sore finger into the solution. The procedure lasts 15 minutes, after which the finger must be wiped off with a paper towel and treated with ointment or antiseptic. You can repeat this procedure up to three times a day during the entire course of treatment.

Attention! With the bacterial type of panaritium, one cannot be limited exclusively to folk remedies, since it is important to completely eliminate the pathogen.

Prevention of panaritium on the fingers

To prevent the disease, it is enough to adhere to the following rules:

Attention! Young children are most often faced with the described pathology. To reduce the risk of panaritium, you should constantly use antibacterial wipes and gels, especially after visiting playgrounds and sandpits.

If the above methods of therapy could not have the proper effect, a decision will be made to surgically remove the panaritium. Also, surgical intervention is carried out in those situations when the patient already shows traces of necrotic processes or the joints and bones are affected.

At the first sign of panaritium, treatment should be started immediately to avoid complications. In case of injury to bone and articular tissues, treatment will be prolonged, and the disease itself can take on a chronic nature and often make itself felt at the slightest decrease in immunity. Before starting the course of therapy, it is advisable to consult a dermatologist to confirm the diagnosis and prescribe adequate therapy.

With bone panaritium, bone tissue is involved in the inflammatory process. Most often, this form of panaritium is a consequence of poor treatment of subcutaneous panaritium (secondary bone panaritium), although primary bone damage is also possible with deep wounds and suppuration of subperiosteal hematomas.

The clinic of primary and secondary bone panaritiums has significant differences. With a primary lesion, the development of bone panaritium, as well as subcutaneous one, is accompanied by intense throbbing pain in the affected phalanx. The finger is in a bent position, movements in the interphalangeal joints are sharply limited, painful. On palpation, the entire phalanx is painful (in contrast to the subcutaneous panaritium). The general condition of the patient suffers to a greater extent than with other types of panaritium. Chills sometimes appear. The body temperature rises to 39-40˚.

The development of secondary bone panaritium takes at least 7-10 days. In the early days, there is a characteristic clinic due to the primary lesion. Then the pain subsides, the fever decreases to subfebrile, but the discharge of pus continues from the wound. When revising a wound with a probe, a usurized bone devoid of periosteum is usually determined.

In the initial stage of bone panaritium on radiographs, spotted osteoporosis and foci of bone resorption are determined. Signs of marginal destruction on the nail phalanx appear on 12-14 days, on the main and middle - 18-20 days after the onset of the disease. At a later date, significant destruction is noted, up to the complete destruction of the phalanx.

Treatment of bone panaritium is only operational. Patients with acute pain, fever will be treated for emergency hospitalization, in the absence of signs of acute inflammation and a significant duration of the disease - planned for several days.

In the early stages, with limited bone destruction, it is possible to perform organ-saving operations (marginal resections, bone curettage). With significant bone destruction, amputation is necessary in most cases.

Articular panaritium

In the inflammatory process with articular panaritium, the interphalangeal or metacarpophalangeal joint, soft periarticular tissues are involved. In some cases, the inflammatory process affects the articular ends of the phalanges and then the osteoarticular panaritium develops.

Articular panaritium, as well as bone, is primary and secondary. The primary lesion occurs with penetrating joint wounds. Particularly dangerous in this regard are bruised wounds on the back surface that occur when struck with a fist. Among them, special attention should be paid to the so-called denticular injuries (from Lat. Dens - tooth, ictus - push, blow), arising from a blow with a fist "in the teeth". Secondary articular panaritium is less common and develops as a complication of other forms of panaritium, as well as as a result of technical errors (damage to the articular capsule of the joint) made during surgery for any panaritium.

In the clinical picture of the articular panaritium, the pain reaction is constantly increasing in time and becomes intense. The pain is initially localized in the area of \u200b\u200bthe affected joint, and then spreads to the entire finger and hand. The swelling circularly covers the entire joint. When a significant amount of serous or purulent contents appears in the joint cavity, the finger takes a fusiform shape and is fixed by the patient in a bent state. Axial loading and attempts at passive movements are sharply painful. The patient loses sleep, appetite, weakness, chills appear, body temperature rises to 38–39˚.

On radiographs of the finger, thickening of soft tissues in the circumference of the affected joint is usually determined, the phenomenon of moderate osteoporosis of the parts of the bones involved in the formation of the joint, deformation of the gap occurs in the presence of exudate in the joint cavity and its narrowing when the articular cartilage is destroyed.

With the development of osteoarticular panaritium, the pain usually decreases, the abscess begins to drain outward in a natural or surgical way. A characteristic symptom is the appearance of lateral mobility in the affected joint, in the determination of which bone crepitus may sometimes appear.

Treatment of articular panaritium should be carried out only by a surgeon in a hospital setting. The indications for hospitalization are the same as for bone panaritium. In the early stages of the disease, joint punctures are performed, at later stages - through drainage and lavage of the joint cavity. With osteoarticular panaritium, joint resections are performed, and with significant bone destruction - amputations.

An important task of the general practitioner is the rehabilitation of patients after inpatient treatment. In general, it is carried out in the same way as with tendon panaritium, however, it is impossible to force an increase in the range of motion in this case, since foci of dormant infection may remain in the affected area, which can be activated under the influence of exercise therapy and physiotherapy. In some cases, the administration of antimicrobial drugs after discharge from the hospital is indicated, or local antibiotic therapy (electrophoresis with antibiotics).

Injury to fingers or toes is a very common situation, each person is periodically hit or cut by something. If you do not take proper care of the resulting wound in time, the situation can worsen greatly, and everyone knows this. So, an infection can penetrate, severe inflammation can develop, which will carry a real threat and require surgical treatment, and not just treatment with an antiseptic solution. On the hands of one of the forms of the consequences of untreated trauma to the skin, panaritium appears.

Panaritium - what is it?

Panaritium is an inflammatory process that is localized on the fingers of the upper limbs of a person (in rare cases, on the legs), characterized as acute and always with the presence of purulent discharge. This situation arises due to the fact that, due to damage to the integrity of the skin, microbes penetrate into the wound, which begin to multiply actively. The most frequent place of the formation of this process is the extreme phalanges of the hand in the area near the nail plate on the first three fingers of the hand, where very often there are imperceptible microtraumas.

This problem is observed most often in children and people in the age period from 20 to 50 years. According to statistics, a third of all cases of infection are the result of injuries that were received at work. The complexity of the disease is that due to the structure of the fingers, the inflammation, although it does not spread along, but easily penetrates deep into the tissues, which explains the rapid progression of the disease with the involvement of tendons, bones, joints and other elements.

Causes of panaritium

The main reason for the development of an inflammatory process with the addition of pus is the penetration of bacteria. In the case of panaritium, the source may be staphylococcus, streptococcus, enterococcus, as well as mixed pathogenic microflora. The gates for the penetration of infection are damage to the integrity of the skin of various kinds (scratches, splinters, pricks with needles or bones, abrasions, cracks, burrs). Usually the damage is so minor that it goes unnoticed by humans.

You can also highlight a number of external factors that create favorable conditions for the development of the problem:

• hypothermia of tissues on constant conditions;
• excessive prolonged hydration;
• exposure to vibration;
• the influence of substances irritating the skin;
• work in the mud.

As for factors of internal origin, a decrease in the level of immune defense, a lack of vitamins, problems with metabolic processes, and diseases of the endocrine system can favorably affect the appearance and development of panaritium.

Symptoms and signs of an abscess on the finger

Symptoms have their own characteristics depending on the specific type of problem, but a number of common manifestations can be distinguished. So, at the very beginning of the process, redness begins around the damaged area, slight swelling and possibly mild painful sensations or a burning sensation. Gradually, the situation is aggravated, which is accompanied by a significant increase in edema and pain. The sensations take on the character of bursting, twitching and very intense, sometimes because of them a person cannot even rest normally at night. Within the framework of inflammation, a focus of pus is formed, which, with skin forms, is clearly visible with the naked eye. The development of felon can be accompanied by a general feeling of weakness, fever and headaches. The deeper the ailment develops, the more pronounced the symptomatic manifestations become.

Types of panaritium on the hands and methods of treatment

The most superficial form of the disease is skin felon. A detached area of \u200b\u200bthe epidermis filled with cloudy pus forms on the surface, and this filling can easily be seen through the skin. Usually, after the exfoliated skin area is excised and the purulent contents come out, the area quickly heals and recovers without complications. But there are deeper and more complex forms of the disease, which we will consider in more detail.

Subcutaneous

One of the most common types of the problem under consideration. It usually occurs when small but deep wounds are infected (for example, a spike or bone in a fish). Inflammation and swelling gradually increase, the pain becomes pronounced and pulsating, and the general condition worsens significantly. Only a surgeon knows how to open a panaritium, since to eliminate the problem, a surgical one is simply necessary under local anesthesia. The wound must be drained in order to wash the cavity with antiseptic solutions during dressings.

Subungual

This type of ailment is most often formed as a result of trauma (bruise) of the nail plate. Due to such damage, a hematoma appears, which can fester. If the accumulation of blood under the nail was eliminated in time, then no problems usually arise - the doctor simply drills the plate and the blood comes out, recovery occurs in a short time. But if the situation has reached the formation of a purulent sac, then the doctor will have to completely remove the nail plate in order to get to the affected area, and it usually takes several months for a new nail to grow (and in most cases, it grows deformed).

Periungual

This type of inflammation is called paronychia and implies localization in the region of the periungual ridge. Most often, the problem begins with an unsuccessful manicure or ignoring skin burrs. The abscess may be partially located under the nail, but it can easily show through the thin skin around it. Spontaneous opening of the abscess is possible, but you should not specifically wait for this, since the problem may not be solved by itself, but only worsen, turning into a chronic form. The fight against the problem is standard - surgical excision of the abscess is necessary.

Bone

Bone panaritium is a more complex problem, which in most cases is a complication of improper or absent therapy of more superficial forms, but it can also be the result of an open fracture. In the first stages, the symptoms are very similar to subcutaneous panaritium, but its severity is many times stronger. The pains are extremely intense and constant. The affected phalanx significantly increases in size, the skin acquires a rich red tint. Finger movements are limited by painful sensations. The destroyed bone requires surgical intervention, and, based on the complexity of the problem, the doctor can remove either one affected phalanx or the entire finger (thanks to effective antibiotics, the worst case is usually avoided).

Tendons or purulent tendovaginitis

Tendovaginitis is the most rare, but also the most difficult form of the problem. The causes of this condition are usually punctured, cut wounds, vinegars, as well as unhealed superficial forms of a purulent-inflammatory process. The danger of this variety lies in the fact that the process immediately spreads to the entire area of \u200b\u200bthe tendon sheath of the finger, and when pus appears, nutrition is completely blocked, which leads to necrotic processes. Tenosynovitis manifests itself with the following symptoms: the finger thickens, all joints are in a bent state, active movements become impossible, and the body temperature rises significantly. The scope of surgical intervention depends entirely on the prevalence and complexity of the particular case.

What to do and how to treat felon at home?

The first question that should arise in a person with panaritium in any of its forms is which doctor to contact, since without proper treatment, the ailment threatens with great difficulties and even the removal of a finger. Only surgeons are engaged in the treatment of such issues, and even hospitalization is possible. The superficial form can be eliminated by conservative methods, but only at the very early stages; in other cases, it will not work without surgical excision. Alternative methods in the treatment of such an ailment can be used, but only in two cases: at the earliest stages of the development of the problem and with the permission of the doctor as an addition to the main therapy.

How to cure felon with folk remedies

Traditional medicine offers several recipes that can help a patient with such an unpleasant problem as felon on the thumb and any other area:

• onion compress. To prepare it, grind a quarter of an onion on a grater and spread it in a centimeter layer on a cloth napkin. The resulting compress must be applied to the injured finger and fixed for several hours. After removing the product, it is important to take a bath with soda and salt, and reapply fresh onions. Such an event is held twice a day;
• alcohol tincture of propolis also used as a compress ingredient. A gauze cloth soaked in this liquid is applied to the finger until it dries completely. The product can be left on for a whole day, after which it is important to take a break for one day;
• cabbage leaf soften, slightly beating off the handle of a knife, and then simply fix it on the finger for three hours. This procedure is carried out twice a day every day.

Baths will help against an abscess on the finger near the nail

Trays are useful for speeding up the opening of a shallow panaritium, and they can be prepared according to different recipes. However, one must approach the issue very carefully, since too high a water temperature can play a cruel joke, and only accelerate the spread of the purulent process.

The first simple recipe is a salt and soda bath. In half a liter of water, dissolve a tablespoon of both components and dip the affected finger into the mixture. The procedure is recommended to be carried out three times a day for 15 minutes. A garlic bath is prepared in the following way: pour a chopped head of garlic with hot water in the volume of one glass and insist for a quarter of an hour. After that, you can dip the sore finger in the liquid for 15-30 minutes.

How to remove pus from under the finger with Dimexide solution

Dimexide is a solution that consists of a substance called dimethyl sulfoxide, due to which it has a local anesthetic, disinfecting and anti-inflammatory effect. The peculiarity of the drug is that it easily penetrates the skin and can act directly on the focus of the panaritium. For the treatment of purulent accumulation, not a pure solution is used, but diluted with water in a ratio of 1 to 4, otherwise there is a risk of chemical burns. It is necessary to fold the gauze in 8 layers and moisten it in the resulting liquid, then apply it in the form of a compress to the affected area, covering it with polyethylene on top and wrapping it well. It is recommended to leave such a compress for 40 minutes.

Medications

In addition to surgical intervention, drug treatment is also used, both local and systemic.

Antibiotic names

Only the attending physician can make a decision to start antibiotic therapy, and such a method is mandatory in the postoperative period to prevent relapse in an unhealed wound. Depending on the situation, both injections of antibiotics and their oral administration can be prescribed. Given the possible causative agents of the ailment in question, doctors may recommend the following drugs:

• Amoxiclav (semi-synthetic penicillin with a broad spectrum of action);
• Levofloxacin (broad-spectrum antibiotic);
• Ciprofloxacin (an antimicrobial drug for systemic use that can inhibit bacterial growth);
• Ceftriaxone (a third-generation antibiotic also with a broad spectrum of action);
• Lincomycin (is effective against staphylococcal and streptococcal infections);
• Josamycin (belongs to the group of macrolides, is used when other types of antibiotics are ineffective).

Effective ointments

For local application to the lesion, various ointments can be used (in the early stages, they can completely prevent the active development of the problem):

• Ichthyol ointment... The composition should be applied to the affected area twice a day in a thick layer and bandaged well on top;
• Vishnevsky ointment (applied to the site of suppuration as a compress at night);

The content of the article

Etiology and pathogenesis of panaritium

Signs of acute purulent diseases of the fingers and hand

Cutaneous panaritium

Treatment of cutaneous panaritium

Paronychia

Paronychia clinic

Subungual felon

Subcutaneous panaritium

Tendon panaritium

Bone panaritium

Articular panaritium

Pandactylitis