Fistula on the suture what to do. Important information about ligature fistula: what it is, what it looks like and how to cure it

Fistula after surgery: treatment and consequences

A fistula is a canal that connects deeply located tissues, organs, body cavities with the surface of the body.

Causes

Fistulas can be acquired or congenital. There are many reasons, but there are the most common causes of fistula formation. One of the causes of acquired fistulas is fistulas that occur after operations. The most common postoperative intestinal fistulas. An intestinal fistula is a connection between the intestinal cavity and the surface of the body or internal organ. There are two main categories of causes of postoperative fistulas:

1. B abdominal cavity By the beginning of the operation there is a purulent-inflammatory process.

2. Technical and tactical errors made during the operation. Poor management of the postoperative period.

In the first case, intestinal fistulas are formed after opening and draining (a tube is installed in the area of ​​the abdominal abscess, through which the purulent discharge of the wound comes out) of abscesses (ulcers) of the abdominal cavity due to inoperable disintegrating malignant tumors, gangrenous forms acute appendicitis. After surgical removal of the purulent focus, the inflammation spreads to the surrounding tissues (intestines), as a result of which a defect is formed in the intestinal wall and the intestinal contents leak into the wound. This is how a fistula is formed.

Errors

Errors of a technical nature include the wrong choice of anesthesia, access or small incision, which create difficulties for a high-quality revision of the abdominal cavity (cleaning the abdominal cavity of pus, sources of inflammation). Also technical errors include rough surgical technique, prolonged exposure of drains (rubber tubes) to remove pus) from hard rubber in the abdominal cavity, which leads to the development of bedsores of the intestinal wall.

Treatment

Treatment of external fistulas is difficult task. It includes both surgical and conservative treatment. General principles treatments consist of three factors: 1. local treatment. 2. general treatment. 3. Surgical treatment.

Local treatment:

1. Treatment of a purulent wound (ointment dressings, dressings with antiseptics, etc.)

2. Protection of the skin surface from the digestive effect of the intestinal contents of the fistula (pastes, ointments, powders that prevent contact of intestinal contents with the skin, colostomy bags for collecting intestinal discharge).

General treatment:

1. Treatment of inflammation in the abdominal cavity.

2. Balanced diet (protein diet), parenteral nutrition(nutrient solutions through a vein).

3. Reduction of intoxication phenomena.

4. Increasing the body's defenses (vitamins, polyoxidonium).

Surgical treatment is used for long-term non-healing fistulas, for formed (lip-shaped) fistulas of the thick and small intestine, because such fistulas do not heal.

The essence of the operation is to completely remove the epithelial cover of the fistula. Sometimes they resort to resection of part of a hollow organ.

If the fistula is not treated, the patient develops severe dermatitis of areas of the skin in contact with intestinal discharge. Severe intoxication develops when the purulent process reaches large sizes. Patients progressively lose weight, since intestinal contents containing the products of food digestion, amino acids, carbohydrates, etc. are lost through the fistula.

Fistula on the buttock - causes, symptoms, diagnosis and treatment

A fistula is a kind of pathological channel connecting a hollow organ and the external environment. In the case of chronic paraproctitis, the resulting fistulas connect the rectal cavity and the skin around it. anus. However, the cause of fistulas is gluteal region There may also be specific processes (pulmonary and intestinal tuberculosis, actinomycosis), adirectal tissue cysts, osteomyelitis pelvic bones, Crohn's disease, inflammation of the coccygeal tract.

Fistula on the gum of a child

A fistula is a pathological channel connecting tissues, cavities and organs with outer surface bodies.

A fistula on the gums of a child usually occurs due to inflammation in the area of ​​the apex of the root of a tooth.

Fistula after tooth extraction

Fistula after tooth extraction is an uncommon complication. It is usually accompanied by the presence of an unrecognized purulent process in the gum tissue, jaw or sinuses.

The fistula itself is a canal that connects the site of accumulation of pus with the surface of the gum. It can form in weakened areas of the gum, such as a damaged gum surface at the site of a tooth extraction.

Fistula on the leg: causes and treatment

A fistula is an artificial canal formed as a result of an inflammatory-purulent process. In other words, a fistula is a tubular path through which accumulated in the soft or bone tissue pus comes out, emptying the abscess or cellulitis. In the lower extremities, when such a pathology appears, you should sound the alarm and quickly contact a surgeon or traumatologist.

Abdominal drainage for diseases

Drainage is the creation of free, unimpeded outflow of blood, wound secretions and pus from wounds by installing drainage and applying an appropriate bandage. As a result, conditions are created for fastest cleansing wound and its healing.

The appearance of a fistula on the body of a person who has recently undergone surgery is a kind of complication of the process of restoring damaged epithelial tissues, when the regeneration of their cells does not occur or occurs at a slow pace. Many factors influence such a pathological condition of the operated area of ​​the body, but in most cases it is getting into the wound infectious microorganisms, provoking purulent inflammatory process, and also greatly weakened the immune system patient.

A postoperative fistula is a through channel that is hollow inside and connects organs located in the peritoneum with environment. Based on its etiology and symptoms, the pathology is considered extremely dangerous, as it prevents stable wound healing. This increases the likelihood that germs, viruses and fungal infections, capable of causing many secondary diseases varying degrees gravity. After the operation, its formation is associated with the lack of normal dynamics of healing of the strip suture.

The very nature of the formation of a fistula is such that it is formed during the acute phase of inflammation, when purulent masses accumulated in the subcutaneous layer break through the epithelium, in a natural way drain and come out, creating a hole in the abdominal cavity or any other part of the body. Most often in medical practice There are fistulous lesions of the abdominal cavity and lower extremities. This is due to the physiological and anatomical structure human body.

Reasons for education

IN modern surgery It is generally accepted that prolonged non-healing wound surface formed after surgery is a complication that requires medication, and sometimes even surgical treatment. For it to be effective, it is extremely important to establish the factor contributing to the development pathological condition seam The following causes of postoperative fistulas are identified: various localizations and severity:

• improper care of the wound, lack of antiseptic treatment with solutions specially designed for this (Chlorhexidine, Miramistin, Hydrogen Peroxide, Iodocerin), rare replacement dressing material;
• entry of pathogenic microflora directly at the time of the operation, if surgical instruments and threads that have undergone insufficient sterilization are used, or infection occurs during the rehabilitation process;
• low-quality suture threads were used, which led to negative reaction body and their rejection began with extensive inflammation and the formation of purulent masses;
• reduced immune status of the patient, when the cells responsible for suppressing the activity of pathogenic microflora are not able to cope with the task assigned to them functional responsibility and the entry of even non-dangerous strains of microorganisms into the wound leads to purulent damage to the epithelium with the formation of a hollow drainage channel (fistula);
• overweight the body, when a thick layer of adipose tissue excludes normal regeneration of epithelial cells (the cut area of ​​the body simply physically cannot heal, since the fat exerts constant static pressure on the wound);
• old age the patient (patients who are already 80 years of age and older have a very poor tolerance not only to the surgical intervention itself, but also to the period of recovery of the body, because the cells responsible for the formation of fibrous tissue, from which the suture scar is formed, divide at too slow a pace);
• medical negligence and leaving surgical instruments in the abdominal cavity ( similar cases occur periodically in various countries of the world, and their occurrence is associated with insufficient care medical personnel immediately at the time of the operation).

By eliminating these in a timely manner causal factors it is possible to ensure stable recovery of the human body in postoperative period, and also avoid the development of inflammatory processes.

How to treat a fistula after surgery?

The appearance of a postoperative channel through which purulent contents flows out is not death sentence for the patient. The main thing is to start treatment of the pathology in a timely manner so that the fistula does not cause the occurrence of concomitant diseases infectious nature of origin. To do this, the patient is prescribed the following treatment measures.

Antibiotics

Washing the seam

The entire strip wound and the resulting fistula are subjected to daily cleansing with antiseptic solutions. Most often attributed to Hydrogen Peroxide with a concentration of 3%, Chlorhexidine, Miramistin, Iodocerin, manganese water. The procedure is performed 2-3 times a day to cleanse the tissues of purulent secretions and microbes.

Surgical debridement

Quite often, a fistula forms a scar consisting of fibrous tissue that is unable to grow together. This results in a hole that is no longer capable of healing on its own. To eliminate this pathology, the surgeon cuts off the edges of the fistula in order to start a new process of regeneration of exposed tissues.

Before surgery, antibiotics are used to ensure complete elimination of infectious inflammation. IN otherwise the operation will only lead to an expansion of the diameter of the fistula. The described complex treatment of a non-healing wound ensures gradual healing of the inflamed wound with relief of the drainage channel.

Due to an inflammatory process or surgical intervention a so-called fistula may form - a canal connecting two cavities to each other or an organ to the surface of the body. The inside of the fistula is filled with exudate, so the inflammation progresses over time. This pathology cannot heal on its own; mandatory drug treatment or surgical intervention is required.

What is a fistula

As a result of various pathological processes At the site of inflammation, purulent fluid accumulates - it consists of bacterial cells along with their waste products and dead leukocytes. As the pathology develops, the amount of exudate gradually increases; it does not fit into the cavity, so the body tries to give it a way out. This is how a fistula is formed - a fistula (tube, channel), which connects the affected cavity or organ with the place where the exudate exits (the surface of the skin or another cavity).

A purulent secretion constantly passes through a fistula, the surface of which is covered by an epithelial layer or granulation tissue, multiplying inflammation, so spontaneous healing of such a pathology is problematic, but in some cases possible. In addition, fistulas often have multiple branches, which makes it difficult surgical removal pathology.

Under certain conditions, microorganisms from purulent fluid can “migrate” to surrounding organs and tissues, provoking the appearance of new foci of inflammation. The composition of the separated substance directly depends on the organ with which the channel is connected; The more aggressive the secretion, the more it damages the skin or nearby tissues. When fistulas occur, fluid loss and intoxication of the body occur, which leads to metabolic disorders and water-salt balance.

Fistulas can exist in the body for a long time and, in the absence of proper treatment, affect several organs. If the inflammation of the source organ stops, the canal stops receiving purulent discharge, it closes and heals. When the pathological process resumes, the fistula begins to function again, accumulate and release exudate - a relapse occurs.

What does a fistula look like?

There are internal fistulas, which connect cavities inside the body, and external ones. A fistula on the skin looks like an inflamed wound from which pus oozes; the edges may resemble lips. An external fistula occurs on a person’s skin near cavities - for example, in the throat and nose. In some cases, a person may not be aware of the presence of an inflammatory process in the body until a fistula appears on the surface of the skin. In case of severe damage to internal organs, not only purulent exudate, but also fecal, urinary, and bile fluid can be released from the canal.

What does it come from?

Gram-negative, anaerobic bacteria, streptococcus aureus, staphylococci, some types of fungi, etc. can act as an etiological factor. Fistulas form for the following reasons:

• tuberculosis infection;
• Crohn's disease (severe chronic disease gastrointestinal tract);
• actinomycosis − chronic diseases resulting from fungal infection;
• complications after surgery (for example, a ligature fistula is formed due to suppuration around the sutures on blood vessels);
• chronic ENT diseases;
• the presence of sequestra - dead areas of bone;
• injuries of peri-intestinal tissue;
• dental pathologies (periodontitis, caries);
• paraproctitis - inflammation in the crypts of the anal canal of the intestine;
• neoplasms (benign and malignant) on the rectum;
• suppuration around foreign bodies inside the body (for example, a bullet or its fragments).

Symptoms

The signs of a fistula are in most cases similar, depending on the location of the source of inflammation and the affected organ. In case of pathology, the patient observes in himself following symptoms:

• low-grade body temperature due to the presence of an inflammatory process in the body;
• signs of intoxication - weakness, headaches and muscle pain, sleep disturbance, decreased performance;
• presence of characteristic pain syndrome, If fistulous tract affects nerve endings (for example, rectal fistula is accompanied by painful sensations in the anus, which intensifies during defecation);
• the pain subsides after the bubble breaks through at the end of the canal and releases the secretion onto the skin or into the cavity.

Kinds

There are several classifications of fistulas. Based on their origin, the following types are distinguished:

1. Congenital fistulas are formed due to malformations of the embryo; some of them (for example, umbilical fistula) doctors discover before or during childbirth.
2. Acquired pathological channels arise as a result of inflammatory processes, injuries or operations (for example, a fistula on the leg or arm can occur due to a fracture or bruise).
3. Artificially created fistulas are designed to drain fluids from the body (purulent, urinary, fecal, bile).

According to their location, fistulas are divided into the following types:

1. Urinary – installed on the ureters, bladder or urethra, may form as a result of injury.
2. Biliary fistulas occur due to operations performed on gallbladder. The secretion secreted by such a fistula leaves burns on nearby tissues, so you need to start treatment immediately.
3. Purulent channels can occur anywhere on the body; they often appear on the gums due to poorly healed teeth. IN in rare cases a purulent fistula can heal on its own, but more often a relapse occurs and purulent exudate begins to be released through the canal again.
4. Salivary fistulas are formed as a result of inflammatory processes in the cheek, neck or ear; saliva is released through them.
5. Bronchial - connects the bronchi to pleural cavity.
6. Gastric fistulas are installed artificially for enteral feeding of the patient after gastric resection in case of abnormalities digestive system and gastrointestinal tract.
7. There are fistulas of the upper and lower sections small intestine. The former arise due to injuries or operations, often heal on their own with proper care, the latter are created by surgeons to divert feces with intestinal obstruction or peritonitis (fecal fistula).
8. Channels in the large intestine arise as a result of trauma, surgery, or are installed artificially. They often heal on their own, but require special care - the use of protective ointments to avoid injury.

Diagnostic methods

For staging accurate diagnosis the doctor gets acquainted with the patient’s medical history, palpates the inflammatory focus, assesses the amount and appearance secreted fluid, interviews the patient about complaints regarding dysfunction of internal organs. After this, the doctor refers the patient to further diagnostic measures:

• A blood and urine test and blood culture for the presence of pathogenic bacteria can indicate the presence of inflammation and its nature.
• CT ( CT scan), MRI (magnetic resonance imaging) is often used as a means of diagnosing fistulas.
• One of the most effective methods is radiography with the introduction contrast agent into the fistula cavity to determine the size, length, branching of the fistula.
• The probing method is considered no less effective; it is used only in cases of external fistulas, in which the outer edge extends to the surface of the skin.
• Studies of purulent fluid are used to determine the primary organ that gave rise to the pathological canal.
• During fistula surgery, specialists inject dyes (such as methyl blue) to evaluate the entire structure of the canal and accurately identify the original organ.
• Ultrasound is rarely used to diagnose fistulas, because this method is less informative.

Treatment of fistula

In essence, a fistula is a tube with dead remains of bacteria; often its treatment consists of excision of the canal, cleaning it chemically or mechanically and relieving the inflammation of the organ from which the fistula began. For example, when getting rid of a rectal fistula, the most effective method is surgery. Full recovery patient occurs within 20-30 days, during which time the patient is advised to take medicinal baths and refrain from physical activity to avoid sphincter injuries.

Also used to treat fistulas local remedies(baths, ointments, powders, antiseptic solutions for washing, etc.). In some cases, the doctor prescribes antibiotics to eliminate bacterial infection, painkillers and antipyretics to improve the patient's condition. The following medications are used as drugs used for the treatment of fistulas:

A fistula, or fistula (from Latin - “tube”) is a channel connecting hollow organs to each other or to external environment or connecting a cavity or body surface to a tumor. The fistula looks like a narrow canal, covered with the top layer of skin - the epithelium.

There are fistulas that are the consequences of pathological processes and fistulas that are the consequences of a surgical operation performed to drain the contents of a hollow organ.

It is considered a complication after surgery. Typically, a fistula occurs as a result of suppuration, eventration or infiltrates of surgical scars. Main reason postoperative fistula- contamination of the suture material (ligature or ligature thread) pathogenic microorganisms. A compaction (granuloma) is formed around the fistula, which consists of the ligature thread itself and cells with fibrous tissue, macrophages, collagen fibers, etc. The fistula can be small size and not cause any inconvenience.
Fistulas most often occur as a result of the use of a special silk thread.

Symptoms

The development of a fistula has its own distinct symptoms.

• Seals and mushroom-shaped granulations (tubercles) that are hot to the touch form around the infected area of ​​the sutured wound.
• A limited area becomes inflamed postoperative scar.
• A small (less often large) amount of pus is discharged from the wound.
• The place is redder.
• Swelling and pain appear in the area of ​​the fistula.
• Body temperature rises to 39 degrees.

Consequences of fistula

Sometimes the suppuration reaches a significant size and does not go away for a long time. The result of suppuration of the ligature thread can be an abscess. In such cases, ligature fistulas can secondarily infect postoperative suture or lead to intoxication of the entire body, including disability. Frequent discharge of pus from the opening of the fistula can cause dermatitis.

Postoperative ligature fistula can occur several months after surgery.

Treatment of postoperative ligature fistula

Sometimes the ligature thread festeres and comes out with pus on its own. But you shouldn’t wait for such a moment; it’s better to immediately apply for medical care and prescription of treatment.

This treatment cannot be carried out independently at home. It can and should only be carried out by a specialist.
Treatment of a fistula most often involves surgical removal of the suppurating ligature thread. After this, the patient undergoes a course drug treatment antibiotics or anti-inflammatory drugs. In addition, doctors recommend taking vitamin complexes to strengthen the immune system. For speedy healing The wound is sanitized by washing with a solution of furatsilin or hydrogen peroxide, which perfectly neutralize the surface and wash away the released pus.

In addition to removing suppurating ligatures, excess granulations are also cauterized or scraped out.

There is also a more gentle way to treat postoperative fistula - ultrasound.

If several fistulas have formed, complete excision of the postoperative scar, removal of the infected ligature thread and re-suturing are prescribed.

Prevention of fistula after surgery

Such prevention depends on the surgeon, who must carefully observe all aseptic measures during the operation. The suture material must be sterile, and the wound must be washed before suturing. It is better to use modern absorbable threads - such as Vicryl, Dexon.

How is a fistula that appears after surgery treated? We will introduce you to the most effective methods of treating ligature fistulas, and also tell you why they appear.

Any, even the simplest, surgical intervention on the human body, as a rule, requires quite a lot of time for wounds to heal. Absolutely all operations end with sutures, which should contribute to a faster and better recovery of the patient.

But sometimes, precisely in the place where the open wound was sutured, a strong inflammatory process begins, which is characterized by redness of the skin and the formation of pus. All this indicates that the person has developed a rather serious complication that requires immediate and high-quality treatment.

If you do not start fighting the fistula as quickly as possible, then it is likely that the patient may require another surgical intervention.

What is a fistula after surgery, what does it look like?

• Fistula- this is a hollow channel inside human body, which connects human organs with the external environment. The fistula can also connect internal cavity with benign or malignant formation. As a rule, this tube is lined with epithelium and is a channel through which pus formed inside the body after surgery is released.

• Outwardly, it looks like an ordinary deep wound, around which the skin has become inflamed. A fistula can appear on almost any part of the body, and not necessarily in the place where the incision was made. There are cases when the inflammatory process occurs inside the body for a long time and a person learns that something is wrong with him only when a characteristic hole appears on his body, releasing purulent masses

• But not only pus can be released from the fistula; if the problem has not been dealt with for a long time, and it has affected the internal organs, then feces, urine and bile can be released from the canal that has formed

Fistula in the coccyx area

In addition, doctors distinguish several other types of postoperative fistulas:

1. Full. Has two outputs at once, which contributes to more quick withdrawal inflammatory process and healing
2. Incomplete. It has only one exit, which is usually located inside the abdominal cavity. This contributes to the intensive proliferation of pathogenic microflora and increased inflammatory processes
3. Lip-shaped. In this case, the fistula fuses with the dermatological integument and muscle tissue. It can only be removed surgically
4. Granulating. This type of fistula is characterized by the formation of granulation tissue, hyperemia and quite severe swelling
5. Tubular. A fully formed duct that secretes pus, mucus and feces

Ligature fistula of postoperative scar after childbirth, cesarean section, appendicitis: signs, causes

Ligature fistula

• Ligature- these are special medical threads that doctors use for layer-by-layer stitching of tissues damaged during surgery. Usually, before using them, the open wound is thoroughly cleaned disinfectants and only after this they proceed to suturing

• But sometimes such actions are not enough and they enter the body along with the thread. pathogenic bacteria, provoking severe suppuration and the formation of a ligature postoperative fistula. As a rule, it opens after a few days and the material that was used to stitch the wound comes out along with pus.

• Most often, this problem is caused by silk threads, so recently doctors have begun to use a material that dissolves on its own after a minimum period of time and does not require the removal of sutures or additional processing

The main reason the development of a postoperative fistula is an infection

The main reasons for the appearance of a fistula after surgery:

• Orgasm perceives the material that was used to stitch the wound as a foreign body and begins to reject it
• The wound itself, as well as the ligature, becomes infected
• Untimely and poor-quality processing of the postoperative suture
• Too much old age patient
• Excess weight
• Reduced immunity

Signs of a fistula:

• A seal appears around the cut in the skin, which begins to hurt noticeably when pressed. In some cases, pronounced tubercles appear that secrete infiltrate

• Redness will be clearly visible near the infected scar. Moreover, it will look brightest as the ligature is applied

• The temperature may rise very sharply. And since the inflammatory process in the body will intensify all the time, it will not go astray to normal levels

• Severe suppuration appears, which, if not treated correctly, turns into a weeping quite large size

• The fistula opening may heal for a while and then become inflamed with renewed vigor.

Consequences that cause fistulas

Postoperative fistula can provoke the development of sepsis

Postoperative fistula itself is not life-threatening. But if the patient lets everything take its course, then the pathogenic bacteria that are inside the fistula opening will begin to infect healthy organs and tissues, and this will provoke the appearance of quite serious diseases.

In addition, the body may refuse to respond correctly to medical therapy, which in turn can also cause quite serious complications.

The most common complications in the treatment of fistula after surgery:

• Abscess. Purulent masses fill the entire internal cavity of the fistula opening
• Phlegmon. In this case, the pus, in addition to tissues, also begins to affect fatty tissue.
• Sepsis. A fistula opening occurs inside the human body. The pus ends up on the patient’s internal organs.
• Fever,provoked by a purulent mass. Temperature indicators can rise to maximum levels. In this case, a person may lose consciousness and have difficulty oriented in space.

Purulent fistula on a surgical suture - treatment

Treatment of purulent fistula

• As you probably already understood, a purulent fistula is not a death sentence even if proper treatment almost always responds quite well to treatment. But still, in most cases, surgery is usually required for a favorable outcome.

• If the doctor decides to delay the intervention, the patient will be prescribed conservative treatment. But it should also be carried out under the strict supervision of a specialist and preferably in a hospital setting. Typically, such treatment is aimed at eliminating pathogenic microflora that provokes inflammation

• If the therapy is chosen correctly, the fistula opening will heal fairly quickly and the patient will be able to return to normal life. To treat an inflamed area of ​​skin, drugs that have antiseptic, antibacterial and bactericidal effects are usually used

• In addition, the patient must be prescribed antibiotics and vitamins that help maintain normal level protective forces body. But I would like to immediately say that conservative treatment does not provide a 100% guarantee that the fistula will not reopen. Therefore, most doctors suggest not to suffer and immediately perform surgery to remove the purulent focus

Only surgical intervention can help completely get rid of the fistula.

• After washing the wound, drainage is usually installed in it. In the postoperative period, the drainage is washed daily and sterile dressings are changed. If after a few days the amount of purulent masses does not begin to decrease, then the patient is additionally prescribed anti-inflammatory drugs, antibiotics and vitamin E

• In addition, bandages and ointments can be used to stimulate the healing process. In this case, for example, troxevasin ointment may be prescribed. As soon as the purulent ceases to be released, the drainage is removed from the wound and then the patient can only make sure that no infection gets into it and periodically change the bandage

Folk remedies for the treatment of fistula

It is permissible to treat postoperative ligature fistulas in a trailer. Some of the methods described below remove inflammation quite well and reduce the amount of pus.

But still, if you decide to get rid of the problem in this way, then before starting treatment, be sure to consult with a specialist. After all, if you have neglected your condition very much, then it is likely that you will only aggravate the course of the disease.

So:

• Take olive oil and strong vodka and equal parts and mix until smooth. Wipe the inflamed area of ​​skin with the resulting mixture 3-4 times a day. To enhance the therapeutic effect, you can immediately apply cabbage leaves previously scalded with boiling water. This way you will not only kill pathogenic microflora, but also contribute to a faster discharge of pus

• To prepare the next miracle remedy, you will need mumiyo and aloe juice. The mummy should be soaked in boiled water, and when it turns it dark brown, add aloe juice to it. You will need to moisten a sterile bandage in this solution and apply it to the sore spot.

St. John's wort decoction for the treatment of fistulas

• If you need to draw out pus as quickly as possible, then use the familiar herb St. John's wort for this. In this case, you can use both the decoction and the leaves. First, tear off the St. John's wort leaves, fill them with water, and then simmer over low heat for 10-15 minutes. When the broth has cooled a little, soak a bandage in it and place the leaves on it in one layer. Fix this bandage on the fistula and leave it there for 4 hours. After this time, the bandage must be removed, the sore spot treated with hydrogen peroxide, and then a fresh one applied.

• A decoction of celandine will help you fight fistula from the inside. If you prepare a decoction from this plant and take it regularly for a month, the substances that it contains will kill the infection located in the fistula opening and help relieve inflammation. But since this decoction thickens the blood very much, it will be better if the dosage is determined by a doctor

• You can try to get rid of a fistula with regular black bread. Take the pulp and lightly sprinkle it with water. When upper layer softens a little, apply the bread to the sore spot and secure with a sterile bandage. Conduct this procedure need once a day. Before each znamenny bread, be sure to treat the wound with hydrogen peroxide. If you do everything correctly, then approximately on the third day you will see that the fistula is completely cleared of pus and begins to heal

Ointment for the treatment of postoperative fistula

Ointment with calendula for healing fistulas

Home-made ointments have also proven themselves quite well. They eliminate the cause of infection quite well and promote more rapid recovery dermatological covers. But even in this case, it is extremely important to be very careful when applying the ointment, as well as pre-treatment wounds.

You need to protect yourself from re-infection of the fistula opening. After all, if you apply unsterile dressings and use a product of questionable quality, you are unlikely to improve your condition.

The most popular ointments:

• At home, you can also use an ointment that will have anti-inflammatory and healing properties. To prepare it you will need pine resin, natural honey, butter, aloe pulp and medical tar. All ingredients are mixed in equal parts and brought to homogeneity in a water bath. The resulting product should be applied to previously disinfected areas of the skin.

• Another effective remedy is ointment made from fresh calendula flowers. They need to be tightly folded into a half-liter jar and filled with melted pork fat or butter. Leave the product in a dark place to brew for 10-12 hours. Then shift it clay pot and simmer for 48 hours in the oven at 70 degrees. After the ointment has cooled, transfer it to a container with an airtight lid and store in a cool, dark place. You can simply lubricate the fistula opening with the resulting product or make medicinal dressings from it.

As mentioned a little above, the best way to get rid of a postoperative fistula is to completely excise it. Although this procedure is quite painful and has a fairly large recovery period, it is she who will protect you from the development of complications such as sepsis and phlegmon.

Stages of the operation:

1. At first antiseptics the fistula opening and all the skin around it are treated
2. Anesthetic substances are then injected into the wound area
3. At the next stage, the wound is carefully dissected and all pus and remnants of the ligature are removed from it.
4. After this, everything is washed well, drainage is installed and closed with a secondary suture.
5. In this case, the vessels are not sutured, as this can lead to the formation of another fistula

After surgery, the affected area of ​​skin will require special care. The wound will definitely need to be treated with disinfecting solutions (for example, furatsilin) ​​and ensure that it is clean and dry at all times. If, even after surgery, excessive granulation is noticeable at the site of the fistula, it must be cauterized immediately.

Video: Ligature fistula of the perineum

A prospective study found that more 62,000 surgical wounds are infected. The degree of infection of wounds varies markedly depending on the degree of contamination surgical field. Risk of wound infection in sterile surgical conditions(there is no infection in the operating room, there are no violations in aseptic procedures, they do not open internal organ) less than 2%, whereas in non-sterile conditions it is 40% or more.

Before surgery, the skin surface is treated with hexachlorophene to prevention of infection of surgical wounds, but at the same time, shaving hair at the surgical site increases the risk of infection. Treatment of the surgical field 5 minutes before surgery was as effective as 10 minutes before surgery. Risk wound infection increased with prolonged hospital stay, as well as with prolonged surgery.

In addition, concomitant appendectomy increases the risk of wound infection in patients after performing “clean” operations. It was found that the likelihood of wound infections can be reduced by reducing the length of hospital stay before surgery, treating the surgical field with hexachlorophene, reducing the area of ​​hair shaving, good surgical technique, reducing operative time as much as possible, installing drains outside the surgical wound, and educating surgeons regarding the incidence of wound infection. Compliance with these rules led to sharp decline the frequency of wound infections - from 2.5 to 0.6% over 8 years.

Although wound infection in most gynecological operations below 5%, which reflects the “purity” of most of them, the risk of wound infection in patients with malignant neoplasms genitals above.

Symptoms of wound infection often present postoperatively, usually after 4 days, and include fever, erythema, tenderness, induration, and purulent discharge from the wound. The cause of wound infections detected on days 1-3 is usually streptococcal and clostridial infections. Treatment of wound infections is usually mechanical: opening the infected wound area above the fascia, cleaning the edges of the wound, if necessary.

Maintaining surgical wound includes sanitation and changing the gauze bandage 2 or 3 times a day, which promotes the growth of granulation tissue at the site of the defect after secondary surgery with gradual scarring. The use of a special vaccine for large wounds speeds up healing and reduces the number of dressings. Cleanliness and granulation of the wound often helps reduce the time required for complete secondary healing.

Delayed method healing primary wound can be used to reduce the likelihood of injury. Briefly about this method: before the surgical procedure begins, the surgical wound is left open above the fascia. Vertical interrupted suture through the skin and subcutaneous tissue Apply 3 cm from the edge, without connecting the edges of the wound. Immediately after surgery, the wound is monitored until the wound begins to granulate well.

The seam can then be joined nearby skin edges sewn or fastened. When using the method of delayed healing of the primary wound, it was shown that in patients at high risk general indicator wound infections decrease from 23 to 2.1%.

Stump infection vagina after hysterectomy it is characterized by erythema, induration and tenderness of the stump. Sometimes there is purulent discharge from upper section vagina. Parametritis is often limited and does not require treatment. Fever, leukocytosis and pain in the pelvic cavity can be associated with severe inflammation of the loose tissue of the vaginal stump, which often extends to the parametrium. In such cases, antibiotic therapy is indicated wide range actions against gram-negative, gram-positive and anaerobic microorganisms.

If in a cult vagina there is extensive suppuration or fluctuating masses are noticed in it, it should be carefully examined, opened with a blunt instrument and left open for drainage.

We are pleased to present you the first one on the Russian-language Internet social network supporters of a healthy lifestyle and a full-fledged platform for the exchange of experience and knowledge in everything related to the words “health” and “medicine”.

Our task is to create an atmosphere of positivity, kindness and health on the site, which will lift your spirits, improve your health and prevent you, because information and thoughts are transformed into material events! ;-)

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Project “To your health!” is positioned as a portal about health, not medicine. In our opinion, medicine is the science of how to recover from a particular disease, and health is the result of a lifestyle in which you do not get sick. The healthier you are, the less likely you are to get sick. Our body is designed in such a way that when in the right way In life we ​​shouldn’t get sick at all. So let's improve our health instead of studying diseases. There are quite a lot of websites about medicine, but in our opinion, they are intended more for medical professionals than for ordinary people. We strive to talk to you about health. We don’t want to write a lot about diseases and methods of treating them - enough has already been written about this. Instead, we'll focus on how to avoid getting sick.

We are interested in a healthy lifestyle, and we want to live happily ever after. We believe that you are also not indifferent to the topic. healthy longevity. Therefore, if you want to be surrounded healthy people and those who strive for this, this site will help you solve this problem. Our plans include creating an active community of people leading a healthy lifestyle, and in this regard, we are pleased to offer you the following opportunities:

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Register yourself and invite your colleagues, friends and loved ones to the site for constant contact with them and exchange experiences. Stay in touch, discussing all the news and interesting things in the field of health.

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