I fec e t c i t on Wound i d n i fec e t c i t on The h i m i port r e t nc n y o f t h t e h in i f n ecti t o i n n is i

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1 Wound infections Infections The importency of the infection is the delaying of the wound healing Mechanically (reduceing the vascular supply) Increases cellular response Bacterial collagenolysis Signs of the infection General signs (3-6 days after injury High fever Depression Decreased apetite 6 days after injury) Signs of the infection Local signs Painful, redish, heat, swelling, functional limitation Factors Infections Quantity and virulency of the germ Patient resistance Aerob bacterium Staphilococcus Streptococcus Enterobacteriumok Pseudomonas Anaerob bacterium Clostridiumok Bacterium 1

2 Infections Bacteriological Presence of bacterium Clinical Presence with local and general signs Infections Infected wounds heal slower than uninfected ones. Mixed infections are relatively common, and tissue bacteria numbers above 1 million organisms delays healing. Parasitic infection Fungal infections This infections of superficial wounds is relativley common. Pythius spp. Infection can be catastrophic complications of relatively triviale wounds Foreign body 2

3 Necrotic tissue Blooding Burns Loss of Blood Supply Other factors High concentration desinfitiation Bone sequester Sutures material Talkum Metal inplants 3

4 Antiseptics Povidone-iodine iodine ( %) Chlorhexidine (0.05%) Hydrogen peroxide (3%) Acetic acid solution ( % 0.5% not recommended) Infections Primer infection Secunder infection Exogen (contact, aerogenic) Endogen (haematogen) Clean Infections Clean-contaminated Contaminated Dirty and infected Clean Clean Nontraumatic surgical wounds Hollow viscus is not entered Incision does not pass through infected or nonviable tissue 4

5 Clean-contaminated Clean-contaminated Surgical wounds in which the lumen of the alimentary, urogenital or respiratory tract may be entered but with minimal invasiveness and contamination. Contaminated Contaminated Traumatic wounds Relatively clen source of wounding Commonly accompanied by inflammation Include surgical wounds that contain spill form another organ and traumatic wounds older than 4 to 6 hours Infected Dirty and infected Old traumatic wounds Pus and/or abscess is present Preoperative entry into viscera may have occurred 5

6 Infections Classification after the bacteriums Pyogenic Putrid Aerogenic Mono- or polyinfection Pyogenic wound infection Staphylococcus Streptococcus, Rhodococcus Corynebacterium Pseudomonas E. coli Pyogenic wound infection 6-8 hrs after wounding Endo- and exotoxins Thrombotisation of vessels Necrosis and neutrophils pus Leucocytosis Signs of pyogenic wound infection Local signs Painful, redish, heat, swelling, functional limitation, lymphadenitis General signs Fever, decresed appetite, depression 6

7 Local signs of pyogenic wound infection in specific clinical forms Sutured wound Swelling, tension of the material and tissue, fluctuation, discharging of pus Painful, redish, functional limitation Opening of the edges and demarcation, second intention Ther.: AB, opening when fluctuating, drainage and bandage Local signs of pyogenic wound infection in specific clinical forms Opened fresh wounds Discharging of pus, swelling Painful, redish, functional limitation Demarcation Ther.: AB, helping in the cleaning up Special clinical forms of pyogenic wound infection Erysipellas Phlegmone Abscess Erysipellas Pyogenic germs specially streptococci in the skin Fastly progrediated and demarcated Horse, cow, pig and dog Pustula, phlegmone and gangrena Thr.: AB, sulfonamides (recidivation) Phlegmone Septic or aseptic inflammation of the connective tissue Subcutan, subfascial, intermuscular, spec: Einschuss-phlegmone in horse Localisated or diffuse 7

8 Signs of phlegmone Subcutan Painful Swelling is sharply described and daughy Functional limitation Fever Signs of phlegmone Phlegmone Subfascial and intermuscular Most painful (skin over the swelling is moveable) Swelling is smooth and tight Strong functional limitation Fever Thr.: AB, rest, hyperaemisation, warm bandage Sanatio Abscess Elephanthiasis Phlegmone Abscess Cavity in the tissue filled with pus Empyema: pus in a natural body cavity Sequester: abscess in the bone Result of haematoma, seroma, phlegmone or foreign body infection Demarcated inflammation and necrotic tissue 8

9 Empyema Empyema Infection of the joints 9

10 Injury of the eye Abscess 10

11 Sequester Haematoma 11

12 The causes of abscess Wrong desinfitiation of the skin Non sterile needle, instruments High concentration of antiseptic fluids Phlegmone Necrotic tisssues Foreign body The signs of abscess Well localised, fluctuateing, painful swelling Centhesis Abscess Abscess becomes to Absorbtion Opened Fistulation Thr.: Open it, curettage, lavage, AB 12

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14 Pus Serum and necrotic tissue part with dead leucocytes and bacteriums Specific for species Putrid wound infection Putrid bacteriums usually with pyogenic germs Clostridium Proteus Pseudomonas Result of pyogenic infection Toxaemis Septicaemia Pyemia Local result Fistulation 14

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16 Anaerob wound infection Anaerob bacteriums usually in deep tissue injury Gasphlegmone Tetanus Gasphlegmone Clostridiums Manifestation of signs (1-4 hrs) Toxins Emphysematous gas production Severe signes Thr.: Surgical approuche, AB, H 2 O 2 Tetanus Clostridium tetani toxins in punctured deep wound or after surgical procedures (castration days) Mainly in horse, cow or in pig Signs: muscle rigidity, ad max opened nostrils, prolaps of the membrana nictitans, trismus, rigid posture and moveing and ear holding, dyspnoe, defance of the abdominal muscles 16

17 Tetanus Thr.: Activ vaccination Passive- tetanus serum AB, diazepam, artificial feeding (infusion), ear plugs, silence and dark 17