The reading guide arrived at 1 1 in a blink of an eye. In 2020, the relevant departments of our country carried out a series of reforms on rural assistant general practitioners, and at the same time introduced many powerful policies, which can be said to promote the construction of rural doctors to a certain extent and stimulate a large number of candidates to apply for the exam. In order to help candidates apply for the exam smoothly, the following is a summary of superficial soft tissue diseases of rural general assistant doctors compiled by Bian Xiao.

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Summary, clinical characteristics and treatment of furuncle, carbuncle and cellulitis in acute suppurative infection of superficial soft tissue

I. Furuncle

1. Overview

Staphylococcus aureus invades from hair follicle or sweat gland, causing acute suppurative infection of single hair follicle and sebaceous gland. Head, face, neck, armpits, buttocks and other parts that are often rubbed are more common. Improper treatment of boils around the face, especially the upper lip and nose, can cause intracranial infection.

2. Clinical manifestations

A small induration with swelling and pain appears locally, which gradually swells and presents a conical bulge.

Furuncle generally has no obvious systemic symptoms. If you squeeze or puncture the boils in the "danger triangle", it is easy to promote the infection to spread to the skull along the inner canthus vein and ophthalmic vein.

3. Principles of treatment

Furuncle is mainly treated locally, and systemic antibiotics (penicillin, etc. ) is also necessary if there are systemic symptoms, such as fever, headache and general malaise.

Second, carbuncle

1. Overview

Carbuncle: Acute suppurative infection of multiple adjacent hair follicles, sebaceous glands or sweat glands caused by Staphylococcus aureus, or fusion of multiple furuncles. It often occurs behind the neck, with thick skin, and is common in patients with physical weakness or diabetes. Infection often starts from the bottom of a hair follicle, and because the skin is thick, it spreads along the subcutaneous fat layer and invades the nearby hair follicle group.

2. Clinical manifestations

The swollen purple-red infiltration area has unclear boundary, and there are many pus plugs in the center, which are honeycomb-shaped after rupture. Then the center is necrotic, dissolved and collapsed, just like a "crater" with pus and a lot of necrotic tissue inside. Carbuncle often develops around and deep. There are obvious systemic symptoms, and carbuncle of lip is easy to cause intracranial cavernous venous sinusitis, which is more dangerous.

3. Principles of treatment

(1) Take adequate rest, strengthen nutrition, use sedatives, and reasonably choose sensitive antibacterial drugs (penicillin, etc.). ).

(2) Golden Frost and 50% magnesium sulfate can be used in local early stage.

(3) After the above treatment, the smaller carbuncle necrotic tissue in the early stage falls off and the wound can heal gradually. Most carbuncles need incision and drainage because of the large lesion range, poor drainage, many necrotic tissues in the central part, serious systemic symptoms and uncontrollable infection. Incision generally adopts "+"and "++"shape incision. The incision should reach the fascia slightly beyond the scope of inflammation, and try to cut off the necrotic tissue. Filling yarn strip. Generally, dressing changes are made 24 hours after operation, and furacilin gauze is used to reduce inflammation.

Third, cellulitis.

1. Overview

Refers to the extensive, diffuse and purulent infection of loose connective tissue under the skin, fascia or deep, usually in the superficial layer of deep fascia. The common pathogen is hemolytic streptococcus B, and it can also be anaerobic bacteria of Staphylococcus aureus.

2. Clinical manifestations

Severe pain, diffuse redness and swelling, unclear boundary. At first, it was a lump, then the center softened and festered to form an ulcer, and the scar healed in about 2 weeks.

3. Principles of treatment

(1) can be applied locally with 50% magnesium sulfate. It can also be used for ultraviolet or ultrashort wave treatment.

(2) Generally, antibiotics should be used at the same time. Generally, new penicillin or cephalosporin is used first. Adjust the medication according to bacterial culture and drug sensitivity test.

(3) Once abscess is formed, incision and drainage should be performed.

Advanced raider

This paper focuses on the etiology, clinical manifestations and treatment of acute soft tissue infection. All of them are accompanied by local skin redness, swelling, heat, tenderness and elevated body temperature, so we should pay attention to differentiation. The exam questions are mostly type A questions.

Discrimination of error-prone and confusing

Carbuncle: "+"and "++"incisions are generally used for incision. The incision should reach the fascia slightly beyond the scope of inflammation, and try to cut off the necrotic tissue.

The above is the related content of "202 1 summary of knowledge points of superficial soft tissue diseases of rural assistant general practitioners" compiled and sent by Bian Xiao today, hoping to help everyone. At the same time, it is worth noting that the practice requirements of assistant doctors in rural general practice also need attention to avoid doing useless work.