Повреждения кожного покрова конечностей часто приводят к образованию воспалительного процесса. Различные порезы, раны на руках и ногах легко лечатся в домашних условиях. Но при попадании в поврежденное место инфекции существует риск абсцесса. К гнойным ранам необходимо относиться со всей серьезностью, вовремя обращаться за медицинской помощью, чтобы устранить подобное явление и избежать негативных последствий.
Виды ран на ногах
Травмирование кожи на ноге, происходит из-за влияния разных факторов (механических, тепловых, электрических, химических). Для эффективного лечения поврежденной конечности надо знать, что стало причиной ранообразования. К наиболее распространенным видам открытых ран, с которыми сталкиваются люди, относятся:
- Хирургические — появляются после проведения оперативного вмешательства.
- Случайные — подразделяются в зависимости от степени поврежденности мягких тканей ноги. При порезах острым предметом образуется резаная рана, а когда ранение глубокое и затрагивает внутренние органы — колотая.
- Рваные — обычно появляются после падения, сопровождаются сильной болезненностью и кровотечением. Подобные раны имеют нерациональную форму.
- Ушибленные — образуются в результате ушибов или ударов тупым предметом.
- Рубленые — возникают из-за воздействия рубящих средств (удар топором).
- Размозженные — являются следствием сильного удара, когда повреждается не только кожа, но и ткани, находящиеся под ней.
- Скальпированные или лоскутные — образуются после воздействия острых предметов. При таких ранах требуется проведение операции из-за обширного отслоения кожи.
Причины воспаления раны на ноге
Когда инфекция попадает в раненый участок ноги, это приводит к нагноению.
К факторам, которые провоцируют инфекционную инвазию, относятся:
- Ослабленность иммунной системы человека.
- Несоблюдение элементарных норм личной гигиены.
- Неблагоприятные условия труда (в грязном, пыльном месте).
- Авитаминоз — нехватка в организме важных микроэлементов и витаминов.
- Иррациональное питание.
- Нарушение метаболизма.
- Наличие некоторых тяжелых патологий (гепатит, СПИД, туберкулез, сахарный диабет, болезни сердечно-сосудистой системы).
Симптоматика образования гноя на ранах
Причиной нагноения поврежденного участка ноги обычно становятся стрептококковые и стафилококковые бактерии, которые после попадания в порезанное место образовывают собственную микрофлору.
Вследствие этого процесса происходит омертвение кожных тканей и бактериальное размножение. Если конечность начинает гноиться, нужно обратиться к врачу, а затем начать лечение, следуя всем инструкциям доктора.
Определить образование гноя в раненой ноге можно по следующим симптомам:
- Рядом с поврежденной областью появляется отечность, кожа приобретает красноватый оттенок.
- Повышается температура на раненом участке тела.
- Больного тревожат пульсирующие болевые ощущения, которые возникают внутри раны.
- Из ноги выделяется мутная, гноящаяся жидкость.
- Общая слабость организма, головокружения, тошнота.
Лечение при гнойных ранах нижней конечности обязательно.
Если подолгу игнорировать заболевание, то возникнут осложнения, которые ухудшат состояние здоровья больного человека.
Как правильно обрабатывать рану на ноге?
Для скорейшего заживления раны важно правильно ухаживать за травмированным участком тела. Обработка воспаленной после порезов конечности проводится 2 раза в день в соответствии с ниже приведенными инструкциями:
- Сначала надо продезинфицировать руки и приспособления для предстоящей процедуры.
- Затем аккуратно снять старую повязку (если бинт присох, следует намочить его перекисью водорода).
- С осторожностью приступить к удалению гноя из раненой ноги. Края поврежденного участка необходимо обработать антисептиком.
- Нанести на рану лекарство (если ранение чересчур глубокое, потребуется дренаж или тампон, который вводится в углубление для обработки).
- Следующим шагом будет закрытие поврежденной поверхности бинтом (лейкопластырем, чистой марлевой повязкой).
- В особо тяжелых ситуациях гнойную рану обрабатывают до 4 раз за сутки.
Способы лечения
Лечение ран на ногах — сложный процесс, который требует много времени. Эффективность оздоровительных мероприятий зависит от тяжести травмы, состояния здоровья пациента. Выводить образовавшийся гной на раненой конечности дома — опасное занятие. Лечение должно быть комплексным, направленным на устранение инфекции из организма больного.
Мази и кремы
Первым делом большинство медиков рекомендуют средства местной терапии для предотвращения воспалительного процесса.
В ходе лечения можно применять следующие целебные мази и кремы:
- Банеоцин — помогает, когда рана на ноге глубокая, а также способствует заживлению при ожогах.
- Левомеколь — превосходное антиинфекционное средство.
- Эплан — эффективен для лечения разнообразных ранений.
- Солкосерил — снимает болезненность с поврежденного участка тела, способствует скорейшему исцелению.
- Мазь Вишневского — используется как действенное антивоспалительное средство, улучшает кровообращение, устраняет инфекцию.
- Гепарин — предупреждает развитие тромбозов, снимает болезненность и другие симптомы гнойной раны.
Противобактериальная терапия
Появившаяся гнойная рана на ноге требует незамедлительного лечения.
Для выздоровления можно использовать различные антисептические растворы, которые отлично борются с бактериями, микробами. К рекомендованным антибактериальным средствам относятся:
- Раствор хлоргексидина или фурацилина — подойдет для обработки открытых ран.
- Порошок «Стрептоцид» — обладает уникальными лечебными свойствами. Поврежденная конечность после применения такого средства будет быстрее заживать.
- Повязку с гипертоническим раствором накладывают на раненую ногу для снятия отеков, болей.
- Йод в качестве антибактериального лекарства использовать не стоит (из-за риска образования ожогов кожного покрова).
- Также важно перорально применять антибиотики, делать уколы, чтобы предотвратить нагноение, вывести инфекцию из организма.
Применение фармакологических растворов
Самыми действенными фармакологическими препаратами, которые используются при лечении ран, являются:
- Диоксидин — устраняет инфекцию, снимает воспаление, выпускается в форме мази или раствора.
- Димексид — уникальное средство, обладает рядом положительных свойств (антигистаминное, анальгетическое, противобактериальное).
- Хлористый натрий — эффективно выводит гной из раны, не оказывает отрицательного воздействия на клетки крови.
Методы народной медицины при лечении ран
Нетрадиционные способы лечения гнойного раневого процесса дают необходимый результат, но только в совокупности с местной терапией и при соблюдении рекомендаций доктора. Самолечение разрешено на начальных стадиях. Ниже приведен список средств, которые помогают лечить поврежденную конечность в домашних условиях:
- Обрабатывать ранение можно целебными растениями. Отличное антивоспалительные действие оказывают настойки и отвары из календулы, сок алоэ, облепиховое масло.
- Мед применяют как альтернативу мазям, кремам.
- Промывать рану можно раствором из эвкалипта.
- Для лечения гнойных ран надо промывать поврежденное место отваром из хрена. Данный продукт обладает противомикробными свойствами. Вместо хрена можно использовать ромашку. Отвар из этого растения предотвращает заражение, не дает инфекции попасть внутрь организма.
- Признанным большинством народных целителей средством является мякоть алоэ. Такое лекарство надо прикладывать к больному месту, чтобы ускорить лечение гнойной раны.
Возможные осложнения
Если патологию вовремя не лечить, возникают осложнения. Последствия неправильного лечения ссадин и гнойных ран бывают следующими:
- Появление хронических болезней лимфатических сосудов (лимфаденит, лимфангит).
- Тромбофлебит — воспаление стенок капилляров, вен и артерий.
- Опасным осложнением является образование гноя на пальцах нижних конечностей.
- Распространение нагноения приводит к абсцессу, периоситу, остеомиелиту.
- В крайне тяжелых случаях у человека развивается сепсис, который нередко становится причиной смерти.
Профилактика
Сколько продлится лечение гнойной раны, зависит от степени запущенности патологии, но лучше будет предотвратить попадание инфекции внутрь организма. Для этой цели важно придерживаться следующих правил:
- Тщательно следить за состоянием кожного покрова.
- При появлении гнойных пузырьков, отеков стоит обращаться за медицинской помощью.
- Не заниматься самолечением без врачебной консультации.
- Не забывать об отдыхе и полноценном сне.
- Соблюдать общепризнанные правила личной гигиены.
- Правильно питаться — в меню надо включить продукты, богатые витаминами, необходимыми для здоровья кожи.
Основной принцип лечения раны в домашних условиях заключается в предохранении ее от обсеменения бактериями, препятствии инфицирования, и стимуляции естественных репаративных процессов в коже. Этого достаточно для эффективного заживления раны.
Этапы заживления раны
Какой бы ни была рана по своему типу и размеру, в своем заживлении она проходит три обязательных этапа:
- первичное очищение раны — кровотечение из поврежденных сосудов; вскоре после начала кровотечения сосуды сжимаются, что способствует прекращению оттока крови, после снова расширяются, сосудистые стенки в результате становятся более проницаемы, ткани в области раны отекают, что является естественным физиологическим процессом самостоятельного очищения раны от загрязнений и бактерий;
- воспаление — отечность тканей в области раны усиливается, они краснеют, в крови повышается уровень лейкоцитов;
- регенерация поврежденных тканей — на фоне воспалительной реакции (в норме, если рана не обсеменена болезнетворными бактериями, воспаление незначительное), в ране и по ее краям начинается;
- разрастание грануляционной ткани — предшественницы соединительной ткани, из которой в ходе затягивания раны образуется рубец.
Врачи выделяют два вида заживления раны:
- заживление первичным натяжением — происходит в том случае, если рана небольшая, ее края расположены близко друг к другу, в ране отсутствует выраженное воспаление или, тем более, гнойный процесс;
- заживление вторичным натяжением характерно для гнойных ран, а также крупных повреждений.
Открытая рана: лечение в домашних условиях
В том, насколько гладко будет протекать заживление раны, большую роль играет грамотная и своевременная первичная ее обработка. Для нее применяются водные растворы антисептических средств — фурацилина, марганцовокислого калия, хлоргексидина. При продолжающемся капиллярном кровотечении целесообразно применение 3% перекиси водорода, которая, помимо очищающих свойств, обладает кровоостанавливающим действием. Однако, если кровотечение уже прекратилось, от применения перекиси лучше отказаться. Антисептическим раствором (например, хлоргексидином) обильно поливают рану, допустимо легко, едва касаясь, без грубых манипуляций, обмывать рану марлевым тампоном.
Первичная обработка антисептиками позволяет очистить рану как от механических загрязнений — комочков земли, кусочков краски, щепок, пыли, так и смыть с ее поверхности болезнетворные микроорганизмы. Если после промывания в ране остались щепки, осколки стекла — их нужно попытаться удалить при помощи пинцета. Кожа ВОКРУГ раны обрабатывается спиртовым раствором йода (при отсутствии аллергии) или бриллиантового зеленого, после чего на рану накладывается слоем 2-4 мм антибактериальная мазь, например, «Сульфаргин®». Активные компоненты мази оказывают выраженное противомикробное действие за счет содержащихся в препарате ионов серебра, способствуют скорейшему прекращению воспалительного процесса и ускоряет регенерацию и заживление тканей, поверх мази накладывается стерильная повязка.
Лечение рваных ран в домашних условиях проводится только после того, как хирургом будет проведена первичная хирургическая обработка раны, в ходе которой, под местным обезболиванием, иссекаются нежизнеспособные края раны — рваная рана превращается в резаную, после чего ее края сближаются наложением швов. Дальнейшее лечение по согласованию с врачом может проводиться дома. Сшивание необходимо и крупным, зияющим ранам, которые без наложения швов будут заживать долго и с образованием грубых рубцов.
Кроме того, без помощи хирурга не обойтись, если в ходе первичной обработки раны не удалось остановить кровотечение, удалить загрязнения, щепки, осколки стекла или металла. В обязательном порядке необходима помощь врача при укусах животных, а также при ранах, загрязненных землей — в первом случае пациенту с большой долей вероятности понадобится введение вакцины против бешенства, во втором — противостолбнячной сыворотки.
Особенности лечения мокнущей раны
В некоторых случаях с поверхности раны обильно отделяется серозно-фиброзный экссудат. По сути — это физиологическая реакция, направленная на дополнительное очищение раны. При обильном отделяемом необходимо часто менять повязку на ране, обрабатывая последнюю растворами или мазями с антисептическими компонентами. Повязки с изотоническим (10%) раствором NaCl помогут уменьшить количество экссудата и ускорят очищение раны.
Особенности лечения гнойной раны
Лечение гнойной раны в домашних условиях самое трудное: важно не только купировать гнойный процесс, но и предотвратить его распространение на соседние, здоровые ткани. Поэтому при каждой перевязке необходимо тщательно удалять с поверхности раны гнойно-некротические массы, для чего используются растворы антисептиков, например, хлоргексидин. После этого на поверхность раны наносят антибактериальные препараты, например, мазь «Сульфаргин®». Ее активные компоненты оказывают антимикробное действие, купируя воспалительный процесс и ускоряя восстановление поврежденных тканей 1,2,3 . Мазь наносится непосредственно на рану тонким слоем, поверх мази накладывается стерильная повязка, которая предохраняет рану от дополнительного инфицирования.
Помимо местного антибактериального лечения врач может рекомендовать прием антибиотиков. При этом важно помнить, что даже те антибиотики, которые можно приобрести в аптеках без рецепта, недопустимо применять самостоятельно, без назначения специалиста. Только врач может подобрать необходимый препарат, с учетом чувствительности бактерий в ране. Неграмотное, без назначения врача, лечение антибактериальными препаратами может спровоцировать появление на поверхности гнойной раны микробной флоры, устойчивой к антибиотикам, бороться с которой в дальнейшем будет ещё сложнее.
Когда нужно обратиться к врачу?
В некоторых случаях необходима консультация специалиста:
- когда не удается остановить кровотечение из раны, особенно если оно интенсивное и есть подозрение на повреждение крупного сосуда: вены или артерии. Вероятно, понадобится ушивание сосуда или перевязка его в ране, что в домашних условиях сделать невозможно;
- когда не удается очистить рану от загрязнений, если в ране остались осколки стекла, щепки, куски металла;
- если у раны неровные, размозженные, рваные края — то есть при укушенных, скальпированных, рваных, ушибленных ранах. В таком случае понадобится иссечение нежизнеспособных краев раны;
- если рана широкая, зияет — без ушивания она будет заживать долго и с образованием грубого рубца;
- если рана получена при укусе животного — может понадобиться введение вакцины против бешенства;
- если рана загрязнена землей — может понадобиться введение противостолбнячной сыворотки;
- если рана нанесена ржавым металлическим предметом — такие ранения опасны сепсисом (заражением крови);
- если развилось нагноение раны — для назначения местной и общей антибактериальной терапии;
- при ухудшении общего состояния больного: повышении температуры, ознобе, тошноте, что также указывает на развитие гнойного процесса.
При соблюдении рекомендаций врача, заживление ран в домашних условиях проходит без каких-либо осложнений, однако важно не переоценить свои силы и при малейших сомнениях обращаться за помощью к специалисту.
1. Алексеев А.А. Журнал «Комбустиология» №44, 2011;
2. Применение серебросодержащих мазей для лечения ожоговых ран (учебно-методическое пособие РМАПО ФГУ «ИНСТИТУТ ХИРУРГИИ им. А.В. ВИШНЕВСКОГО», 2011 ISBN 978-5-7249-1603-5);
3. Атясов И.Н. Журнал «Хирургия» №5, 2011
Чтобы выздоровление раны прошло быстро и безболезненно требуется ее правильно и сразу же обработать, а затем лечить медицинскими различными средствами.
Делать обработку и лечить следует как можно быстрее и очень осторожно сначала с раны правильно удаляется грязь и мертвая ткань, так чтобы не прикасаться к ране.
Рекомендуется сразу же обратиться к врачу даже если раны не глубокие эту помощь должен оказывать специалист, который сможет быстро и рационально наложить швы, если это будет требоваться.
Что такое рана?
Зона ранения имеет стенки, дно ранки и раневые объемы, могут быть двух основных типов, то есть случайными или операционными.
Виды ранений
- Укушенная, то есть vulnus laceratum. Может быть из-за укуса животным или человеком, особенности те же самые что и у рваной раны, главный момент здесь это разрозненные, глубокие и обширные повреждения, а также большая инфицированность микрофлорой рта животного.
- Рана, раздавленная или размозженная, то есть vulnus conqvassatum. Может образоваться из-за действия тупых предметов, где общая поверхность достаточно широкая, а также при наличии твердой опоры, то есть иных предметов или костей. Ткани могут иметь обширные ранения и быть раздавленными, зияние тут широкое, кости могут разрушаться, края раны достаточно сложные, болевой общий синдром яркий, а потери крови минимальные.
- Рубленная, то есть vulnus caesum. Может образоваться из-за действия острых определенных предметов, таких как шашка, сабля или топор, ранение при этом идет только перпендикулярно или под углом к тканям. Здесь характерны глубокие различные общие повреждения, имеется широкое зияние, а также сотрясение и ушибы тканей, занимает среднее положение между раной ушибленной и резаной.
- Рана резанная, то есть vulnus incisum. Может возникать при действии острых предметов, таких как бритва, нож, осколки металла и стекла. Такая общая большая рана отличается максимальным разрушением тканей в сторону раневого канала и других тканей, края у этих тканей могут быть гладкими, ровными и сложными. Кровотечения из-за резаной раны обычно значительные, болевой синдром умеренный, могут быть повреждены еще мышцы, сосуды и сухожилия.
- Колотая, то есть vulnus punctum. Может возникнуть из-за глубокого общего проникновения длинных и острых инструментов, таких как штык и заточка, шило или спица. Главная особенность это минимальное входное отверстие, а также малые повреждения тканей, рана быстро склеивается и создается условие для развития разных инфекций.
- Ушибленная, то есть vulnus contusum. Может возникнуть из-за действия жесткого и тупого предмета, поверхность ушиба обычно достаточно широкая, часто разрушается мышечная ткань и кости человека, которые могут быть ушибленными и размятыми.
- Рваная, то есть vulnus laceratum. Может возникнуть при действии предмета под определенным углом к коже человека, таким предметом может быть пила или трансмиссия, объемы повреждений здесь значительные, часто случается отслойка кожи, зияние достаточно широкое, а кровоизлияние значительное.
- Рана vulnus venenatum. Может образоваться при укусе различных ядовитых змей, главное отличие от других это попадание ядовитых веществ в ранку, может образоваться еще из-за радиоактивного и даже бытового загрязнения.
Неотложные действия при получении раны
Медицинская общая и самая первая помощь человеку при получении раны это комплекс различных мероприятий, цель которых устранить действие фактора и убрать угрозу для жизни человека.
Также такая медпомощь служит для облегчения страданий и подготовки человека к отправке в лечебное учреждение для дальнейшего лечения.
Такие действия относятся к простейшим, а выполняться они должны в самые минимальные сроки прямо на месте происшествия, для этой цели рабочий персонал должен пройти спецподготовку и владеть самыми простыми техниками, что имеет большое значение в данном случае.
Рана сопровождается обычно разрушением целостности кожного покрова или слизистой человека, ранения могут отличаться по глубине, размерам и форме.
Такая общая медицинская помощь должна оказываться максимально быстро и очень грамотно, для каждого типа раны будут свои симптомы, а также общие принципы в виде ухудшения функций, отека, болей и так далее. Здесь мы освещали вопрос об отеке мягких тканей лица.
Рекомендации, об оказании помощи при ранении человека:
- Требуется освободить самого пострадавшего от опасного разрушительного фактора, это может быть механическое действие, электроток, вода или химические вещества, которые приносят вред человеку. Для этого могут использовать ряд средств оказания первой общей помощи, а также требуется владеть безопасными для себя и других приемов который должен знать каждый.
- Следует оценить состояние и освободить человека от одежды если она стесняет его дыхание, если требуется, то лучше вывести его туда, где воздух будет свежим. Определение степени и характера самого повреждения, для этой цели аккуратно обнажается поврежденный участок или часть тела, а затем сразу же требуется принять меры медпомощи человеку.
- Остановка кровотечения. Требуется знать, что если потеря крови составляет до 2 литров, то это приводит к гибели, здесь скорость потери крови зависит от размеров сосуда, места повреждения и глубины ранения. Чем больше размер такого сосуда, тем меньше будет времени, в течение которого идет потеря крови, такое кровотечение может быть венозным при ранении кожи и артериальным при ранении артериального сосуда. Если ранение было артериальным или даже паренхиматозным, то есть из-за поражения органов, то самостоятельно его остановить точно не получится, требуется обращаться срочно к врачам для этой цели.
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