Warung Bebas

Saturday, 4 August 2012

Treatment and Therapy of Paronychia

Acute paronychia is generally caused by bacteria, the treatment of choice preparations flucloxacilin 4 x 250 mg / day; generally worked well. When formed pus drainage done, without neglecting the five principles of treatment of hand infections are:
1. Administration of antibiotics
2. Rest and elevation of the affected part of the infection
3. Early recognition of pus and the pus is right
4. Remove the pus, if necessary debridement in space abscess
5. Adequate treatment after action

        In the superficial paronychia is generally localized and pussy clearly visible: it can be done with incision drainage or bayonet forms a sharp pointy scalpel which inserted into the sulcus with an oblique angle, should be done parallel to the nail plate. After the drainage then compressed with warm physiological saline solution to stimulate wound drainage; in some cases simply do compresses and topical antibiotic Neosporin. The position of the infected finger was rested in a position of flexion for accelerating wound healing.
       At paronychia deep, often found clinical symptoms of swelling, pus erythematous without clear point; can be given antibiotics as sensitive as cloxacillin or erythromycin. Having given antibiotics and warm compresses will happen to localized pus, and drainage occurs via the spontaneous folding nail indentations, or it can be done as paronychia superficial incision.
       For sub ungual paronychia which not responsive to antibiotics after 2 days, needed surgery to remove 1/3 proximal nail plate; tranversal cut the nail plate with nail scissors under local anesthesia without adrenaline, you can also ethylchloride spray or liquid nitrogen.
Widespread infection in sub ungual distal, 40% of cases occur in the pus under the nail plate. In the area of ​​the hospital performed the penetration of the nail plate, so that the pus can be removed and further handling compress finger with antiseptic solution such as: khlorheksidin 2x a day, and made wet compresses will speed healing.

       Treatment of chronic paronychia requires patience doctors and patients. At this state of chronic bacterial infections must be prevented so that the compressing, while the compress would prolong and worsen the course of the disease state. A common treatment is: reduce exposure to water. When doing work related to the water should wear protective gloves, better wear gloves of cotton and coated with rubber gloves made of vinyl: If the gloves are wet should be replaced.

       The use of drying agents after doing work related to the water with a solution of aluminum chloride or chloroform dalarn 6-20% alcohol; if irritation can be recommended granting corticosteroid lotion or cream.
       Given the chronic paronychia infection causes most of the Candida albicans antifungal use in tincture form used 2x a day that is: the solution klotrimoksasol, haloprigin or miconazole. The use of combination antifungal faster lotrisone topically.

     If there is a sign of inflammation, redness, heat, swelling and pain, is recommended oral erythromycin administration, because it is always found staphylococcus in the wound that is still sensitive to these antibiotics. Other antibiotics is Sulfasetamid 15% solution in 50% methylated spirit or alcohol and the use of paint castelani is still effective.
        Paronychia in patients who also suffer from diabetes is the most important aspects of treatment: in particular the control of blood sugar levels. Toe paronychia often followed unguis incarnatus, surgery can be performed after paronychia controlled, and carried out a radical removal of the nail.
Dose of radiotherapy treatment for chronic cases of 75 rad / week with 43-50 KM (Dermopan Siemens) to a maximum dose of 450 rad (total 6x administration) often helps healing.
        Chronic paronychia which not responsive to any treatment should receive treatment with surgical excision of the crescent shape of the proximal nail fold 5-6 mm. At the widest part extends into the lateral nail fold

       Wound healing by secondary intention occurs, could be 2 months. It may take 2-3 months for the re-establishment of damaged cuticles as in the original state of chronic paronychia. Nail growth dystrophy takes medication for 6 months, the patient should guard against exposure to water during the treatment of paronychia is an infection.

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