Transcript Document

Suppurative-inflamatory disease at new-born of early age
(phlegmon, mastitis, omphalitis, psevdofurunkulez, limfadenit,
perirectitis). Classification. Diagnostics. Tactic. Treatments.
Complications. Consequences. Rehabilitation. Sharp and chronic
haematologic osteomyelitis for children.
Osteomyelitis for babies. Classification. Diagnostics. Tactic.
Treatment. Complications.
Consequences. Rehabilitation.
FEATURES of SKIN, hypodermic-adipose of
CELLULOSE, VESSELS.
1. An organism consists of 80% of liquid. ( due to
diffuzion the rapid distribution of infection).
2.
Conjuctive- tissue barriers are absent in a
hypodermic-adipose cellulose (rapid distribution
of infection).
3.The surfase balls of skin consist of 2-3 layers.
For adults 6-7. (high trauma. Penetration of
infection).
4.
Eventual type of structure of vessels.
(kolaterali absent).
5.
Perpendicular location of vessels in relation
to a skin.
6.
Connection of superficial vessels with main
vessels. (generalization of process).
PHLEGMON of NEWBORNS
It is supurrative – inflamatory diseases of soft fabrics (skin, hypodermic-adipose celluloses)
which is characterized by rapid distribution of process, sharp flow, predominance of
necrotizing changes above inflammatory.
Localization:
•
thorax
•
neck
•
lumbar area
•
lateral surfaces of elbow bends
•
knee-joints
Exciter:
•
staphylococcus
•
streptococcus
Source of infecting of baby skin
•
childbirth ways of mother
•
linen
•
nasopharynx and hands of medical men
•
hands and nasopharynx of mother
Entrance gate:
•
skin
•
Haematologic way through umbilical vessels
Forms of flow:
1. Simple – without sharply expressed septic phenomena
2. Toksiko-septic – with the phenomena of sepsis.
Types of complications:
1. Unconnected with distribution of process depthfirst (pneumonia, otitis,
dyspepsia, peritonitis, meningitis)
2. Related to distribution of process depthfirst (osteomielit, festering
pleurisy, pericarditis, festering miozit, paranephritis et cetera)
Diferential diagnosis:
• Beshikha
• Sharp haematologic osteomylitis
• hypodermic-adipose necrosis
Treatment:
Local:
• pricking all round 0,25% by solution of novocaine with antibiotics near
a hearth (day's dose)
• notches
• bandaging with a 25% solution of magnesia
General:
•
disintoxication therapy (v/v introduction of salt
and albuminous preparations)
•
antibacterial therapy
•
stimulant therapy
•
desensitizing therapy (Dimedrolum, chorus
calcium, Pipolphenum, Suprastinum and other)
Treatment
OMPHALITIS
It is inflammation of umbilical wound with distribution on a skin
and other soft fabrics, that surround a belly-button.
Clinic:
1. Simple form: a) getting wet belly-button;
b) Fungus of belly-button
2. Phlegmonous with a calciphylaxis or without
3. Necrotizing with a calciphykaxis or without.
Dif. diagnostic:
•innate swish and incomplete swish of
belly-button
•phlegmon of new-borns
•diphtheria of belly-button
•calcine of belly-button
Treatment:
Simple form:
* local treatment (a treatment of fossula - cauterization (5%,10%
iodine; nitric acid silver,
25% manganese) fungus is bandaged at foundation and choped off.
Stump is processed by antiseptics.
.
Phlegmonous form:
1.
Prick all round by antibiotic with Novocain
2.
UVCH, quartz
3.
At presence of abscess the dissection is needed
4.
At calciness - a curettement by the spoon of Fol'kmana,
and then is the treatment of wound, bandages.
5. Notches at an anecessity .
Necrotizing form:
1.
Notches
2.
Pricking all round
3.
Bandaging in 2 hours
Мастіт новонароджених
THE THEORIES OF HAEMATOLOGIC OSTEOMYELITIS
1.
2.
3.
4.
Vascular- thrombembolic (bobrova-leksera) 1882
Allergic theory (derizhanova V.S., 1940)
Nervous- reflex (Elanskiy n.I., 1954)
Aseptic necrosis (Stenula v.I., 1989)
LOCALIZATION OF OSTEOMYELITIS PROCESS
1.
Thigh-bone – 30,8%
2.
Tibia – 21,9%
3.
Humeral – 10.3%
4.
Bones of pelvis – 8,2%
5.
Bones of feet – 8.9%
6.
Bones of spine – 2,0%
CLINIC OF HAEMATOLOGIC OSTEOMYELITIS
Junior group
(before 3 years)
Senior group
(before15 years)
Main symptoms
Forms
Local form
•
languor
•
loss of appetite
•
a temperature is normal or 37,8 degrees
•
tachycardia
•
tachypnoe
•
dryness of mucous membranes
•
enteroplegia
•
capriciousness
•
complaints about pain
•
forced position of body and extremity
•
temperature of body – 38 degrees
•
dryness of mucous membranes
The stage of hypodermic phlegmon
absents
•
clinic of v/bone phlegmon
•
+ presence of the local slight swelling
•
sometimes hyperemia
X-ray images acute osteomelitis
X-ray images acute osteomelitis
Immobilization