How to cure a fistula after surgery. What is a fistula after surgery, what does it look like? Ligature fistula of a postoperative scar, fistula at the seam after childbirth, cesarean, appendicitis: signs, causes, treatment, excision

Fistula after surgery: treatment and consequences

A fistula is a channel that connects deeply located tissues, organs, cavities of the body with the surface of the body.

Causes

Fistulas are acquired and congenital. There are many reasons, but there are the most common causes of fistula formation. One of the causes of acquired fistulas are fistulas that occur after operations. Most often there are postoperative intestinal fistulas. An intestinal fistula is a communication of the intestinal cavity with the surface of the body or internal organ. There are two main categories of causes of postoperative fistulas:

1. In abdominal cavity by the beginning of the operation there is a purulent-inflammatory process.

2. Technical and tactical mistakes made during the operation. Poor management of the postoperative period.

In the first case, intestinal fistulas are formed after opening and draining (a tube is installed in the area of ​​​​abscess of the abdominal cavity, through which the purulent discharge of the wound comes out) of abscesses (abscesses) of the abdominal cavity due to inoperable decaying malignant tumors, gangrenous forms acute appendicitis. After surgical removal purulent focus inflammation passes to the surrounding tissues (intestine), as a result of which a defect is formed in the intestinal wall and the intestinal contents enter the wound. This is how a fistula is formed.

Mistakes

Errors of a technical nature include the wrong choice of anesthesia, access or a small incision, which create difficulties for a qualitative revision of the abdominal cavity (cleansing the abdominal cavity from pus, sources of inflammation). to remove pus) from hard rubber in the abdominal cavity, which leads to the development of decubitus ulcers of the intestinal wall.

Treatment

The treatment of external fistulas is difficult task. It includes both operational and conservative treatment. General principles treatment consists of three factors: 1. local treatment. 2. general treatment. 3. Surgical treatment.

Local treatment:

1. Treatment of a purulent wound (ointment dressings, dressings with antiseptics, etc.)

2. Protection skin surface from the digestive effect of the intestinal contents of the fistula (pastes, ointments, powders that prevent contact of the intestinal contents with the skin, colostomy bags for collecting intestinal discharge).

General treatment:

1. Treatment of inflammation in the abdominal cavity.

2. Balanced diet (protein diet), parenteral nutrition(nutrient solutions through a vein).

3. Reducing the effects of intoxication.

4. Enhance defensive forces body (vitamins, polyoxidonium).

Surgical treatment is used for long-term non-healing fistulas, with formed (labial) fistulas of the thick and small intestine because such fistulas do not heal.

The essence of the operation is to completely remove the epithelial cover of the fistula. Sometimes they resort to resection of a part of a hollow organ.

If the fistula is not treated, the patient develops severe dermatitis of the skin areas in contact with the intestinal discharge. Severe intoxication develops when the purulent process reaches a large size. Patients progressively lose weight, because through the fistula the intestinal contents containing the products of digestion of food, amino acids, carbohydrates, etc. are lost.

Fistula after tooth extraction

Fistula after tooth extraction is an infrequent complication. It is usually accompanied by the presence of an unrecognized purulent process in the tissues of the gums, jaw or sinuses.

By itself, the fistula is a channel that connects the place of accumulation of pus with the surface of the gums. It can form in weak areas of the gums, such as a damaged gum surface at the site of a tooth extraction.

How to treat a fistula on the pope

A fistula in the buttocks can be a symptom of chronic paraproctitis, actinomycosis, tuberculosis, epithelial coccygeal passage (coccyx fistula), Crohn's disease, osteomyelitis of the pelvic bones.

First of all, etiotropic treatment is carried out. For example, with actinomycosis, specific immune therapy, antibiotic therapy is prescribed, according to indications - surgical operation. With an epithelial coccygeal course, treatment is only surgical.

Fistula of the anus

A rectal fistula is a canal that passes through adipose tissue anal and rectal region and connects the rectum to the surface of the body. It is also called anal-rectal fistula. Often a fistula develops as a result of acute purulent paraproctitis (purulent inflammation of the perirectal and anal tissue). In 5-10% of cases, a tuberculous cause is found.

Fistula on the gums of a child

A fistula is a pathological canal connecting tissues, cavities and organs with outer surface body.

A fistula on the gums in a child usually occurs due to inflammation in the area of ​​​​the apex of the root of a tooth.

Postoperative is pretty frequent complication, which can be formed by different reasons. As a rule, a fistula is formed after surgery on tubular organs or during abdominal operations. This purulent channel may not heal for a long time and lead to damage to the body in different places and sometimes even malignant tumors. It is evidence that a serious inflammatory process is taking place in the body.

A fistula on the leg after surgery usually develops due to eventration, suppuration of surgical scars, if suture material contaminated and infected by pathogenic microorganisms. A seal (granuloma) is formed around the fistula, which consists of a ligature thread and cells with fibrous tissue, macrophages, collagen fibers, etc.

Most often, fistulas are formed due to the use of silk threads.

Any operation can be the reason: with a leg fracture, muscle injury, etc.

The fistula may not form immediately, but several months or even several years after the operation. Usually develops in conditions of reduced immunity.

Symptoms

With the development of a fistula, the symptoms are very pronounced and pronounced. The most obvious signs include:

• seals and hot tubercles (granulations) form around the infected suture;
• the scar becomes very inflamed;
• pus is released from the wound in small or large quantities;
• this place is much redder than the surrounding tissues;
• edema forms in this place;
• pain in the affected area of ​​the leg;
• body temperature rises to 39 0 C.

Why are fistulas dangerous?

If suppuration does not go away for a long time and reaches a large size, an abscess may begin. In this case, general intoxication of the body may occur, which can lead to any consequences up to disability.

Also, do not start the process so that it does not become chronic.

The constant discharge of pus can lead to the development of dermatitis.

Treatment

Treatment of a fistula on the leg after surgery may not be required if the ligature thread comes out on its own. But you should not hope for this, and with the formation of a fistula, you should immediately seek help from a doctor.

Most often, the treatment consists in removing the festering ligature thread, after which a course of anti-inflammatory therapy and antibiotics is carried out. You also need to take vitamins and drugs to increase immunity. In order for the wound to heal faster, it is washed with a solution of furacilin or hydrogen peroxide to ensure disinfection.

In addition to removal, cauterization of the wound is carried out and all purulent granulations are carefully scraped out.

Treatment of fistulas with ultrasound is also practiced. This is a more modern and gentle method.

With the formation of several fistulas, the wound is opened, washed and new stitches are applied.

Prevention

Prevention should be done by the surgeon during the operation. He is obliged to comply with all security measures to ensure sterile conditions for the operation. The suture material must be clean and sterile, and the wound must be washed.

New modern self-absorbable threads, such as Dexon or Vicryl, are also good in this regard.

due to inflammation or surgical intervention a so-called fistula can form - a channel connecting two cavities to each other or an organ to the surface of the body. Inside the fistula is filled with exudate, so over time the inflammation progresses. Such a pathology cannot heal on its own, a mandatory drug treatment or surgery.

What is a fistula

As a result of various pathological processes, purulent fluid accumulates in the focus of inflammation - it consists of bacterial cells along with their metabolic products and dead leukocytes. During the development of pathology, the amount of exudate gradually increases, it does not fit in the cavity, so the body tries to give it an outlet. This is how a fistula is formed - a fistula (tube, channel), which connects the affected cavity or organ to the exit site of the exudate (the surface of the skin or another cavity).

Through a fistula, the surface of which is covered by an epithelial layer or granulation tissue, a purulent secret constantly passes, multiplying inflammation, therefore spontaneous healing of such a pathology is problematic, but in some cases it is possible. In addition, fistulas often have multiple branches, which makes it difficult to surgically remove the pathology.

Under certain conditions, microorganisms from the purulent fluid can "migrate" to the surrounding organs and tissues, provoking the appearance of new foci of inflammation. The composition of the separated substance directly depends on the organ with which the channel is connected; the more aggressive the secret, the more it damages the skin or nearby tissues. When fistulas occur, there is a loss of fluid, intoxication of the body, which leads to metabolic disorders and water-salt balance.

Fistulas can exist in the body for a long time and, if not properly treated, affect several organs. If the inflammation of the original organ is stopped, the canal ceases to receive purulent discharge, it closes and heals. When the pathological process resumes, the fistula begins to function again, accumulate and secrete exudate - a relapse occurs.

What does a fistula look like

There are internal fistulas, which connect the cavities inside the body, and external ones. The fistula on the skin looks like inflamed wound from which pus oozes, the edges may resemble lips. An external fistula occurs on the skin of a person near cavities - for example, in the throat and nose. In some cases, a person may not be aware of the presence of an inflammatory process in the body until a fistulous opening appears on the surface of the skin. In severe injury internal organs not only purulent exudate can be released from the canal, but also fecal, urinary, bile.

What does it come from

As etiological factor may be gram negative anaerobic bacteria, streptococcus aureus, staphylococci, some types of fungi, etc. Fistulas are formed by the following reasons:

• tuberculosis infection;
• Crohn's disease (severe chronic disease gastrointestinal tract);
• actinomycosis − chronic diseases arising from infection with a fungus;
• complications after surgery (for example, a ligature fistula is formed due to suppuration around the sutures on the blood vessels);
• chronic ENT diseases;
• the presence of sequesters - dead areas of the bone;
• injuries of the intestinal tissue;
• dental pathologies (periodontitis, caries);
• paraproctitis - inflammation in the crypts of the anal canal of the intestine;
• neoplasms (benign and malignant) on the rectum;
• suppuration around foreign bodies inside the body (for example, a bullet or its fragments).

Symptoms

The signs of a fistula in most cases are similar, depending on the location of the focus of inflammation and the affected organ. With pathology, the patient observes the following symptoms:

• subfebrile temperature body due to the presence of an inflammatory process in the body;
• signs of intoxication - weakness, headaches and muscle pain, sleep disturbance, decreased performance;
• characteristic pain syndrome if the fistulous course affects the nerve endings (for example, the fistula of the rectum is accompanied painful sensations in area anus, which increase during defecation);
• the pain subsides after the bubble breaks through at the end of the canal and the secretion is released onto the skin or into the cavity.

Kinds

There are several classifications of fistulas. By origin, the following types are distinguished:

1. Congenital fistulas are formed due to malformations of the embryo; some of them (for example, umbilical fistula) are detected by doctors before or during childbirth.
2. Acquired pathological channels arise as a result of inflammatory processes, injuries or operations (for example, a fistula on a leg or arm may occur due to a fracture or bruise).
3. Artificially created fistulas are designed to remove fluids from the body (purulent, urinary, fecal, bile).

By location, fistulas are divided into the following types:

1. Urinary - installed on the ureters, bladder or urethra possibly formed as a result of trauma.
2. Biliary fistulas occur due to operations performed on gallbladder. The secret secreted by such a fistula leaves burns on nearby tissues, so treatment should be started immediately.
3. Purulent canals can occur anywhere on the body, often they appear on the gums due to a poorly healed tooth. In rare cases, a purulent fistula can heal on its own, but more often a relapse occurs and purulent exudate begins to flow through the canal again.
4. Salivary fistulas are formed due to inflammatory processes in the cheek, neck or ear, saliva is secreted through them.
5. Bronchial - connects bronchi to pleural cavity.
6. Gastric fistulas are artificially established for enteral feeding of the patient after resection of the stomach with deviations digestive system and gastrointestinal tract.
7. There are fistulas of the upper and lower divisions small intestine. The former arise due to injuries or operations, often heal on their own with proper care, the latter are created by surgeons to divert stool with intestinal obstruction or peritonitis (fecal fistula).
8. Canals in the large intestine are caused by injuries, operations, or are artificially installed. Often heals on its own, but requires special care– use protective ointments to avoid injury.

Diagnostic methods

To make an accurate diagnosis, the doctor gets acquainted with the patient's history, palpates the inflammatory focus, evaluates the number and appearance secreted fluid, asks the patient about complaints about violations of the functioning of internal organs. After that, the doctor directs the patient to further diagnostic measures:

• A blood and urine test, blood culture for the presence of pathogenic bacteria can indicate the presence of inflammation and its nature.
• CT ( CT scan), MRI (magnetic resonance imaging) are often used as a means of diagnosing fistulas.
• One of the most effective methods is radiography with the introduction of a contrast agent into the fistula cavity to determine the size, length, branching of the fistula.
• The probing method is considered no less effective; it is used only in cases of external fistulas, in which the outer edge comes to the surface of the skin.
• Studies of purulent fluid are used to determine primary organ which gave rise to the pathological channel.
• During the operation to remove the fistula, specialists inject staining substances (for example, methyl blue) to assess the entire structure of the canal and exact definition original organ.
• Ultrasound is rarely used to diagnose fistulas, because this method is less informative.

Fistula treatment

In fact, a fistula is a tube with dead bacterial remnants, often its treatment consists in excising the canal, cleaning it with chemical or mechanically and removing the inflammation of the organ from which the fistula began. For example, when getting rid of the fistula of the rectum by the most effective method is an surgical intervention. Full recovery the patient occurs in 20-30 days, at this time the patient is recommended to take therapeutic baths and refrain from physical activity to avoid injury to the sphincter.

Also used to treat fistulas local funds(baths, ointments, powders, antiseptic solutions for washing, etc.). In some cases, the doctor prescribes antibiotics to eliminate bacterial infection, painkillers and antipyretics to improve the patient's condition. As drugs used for the treatment of fistulas, the following medicines are used:

Any surgical intervention is associated with the risk of complications. Surgical childbirth is no exception. Common complications include the appearance of a ligature fistula after a caesarean section. Fistulas are dangerous because they are a source of infection. If you do not pay attention to the pathological phenomenon in time, then intoxication of the body may occur. What to do if a fistula appears? Apply for qualified help, only in this way it is possible to avoid the risks associated with the inflammatory process.

To avoid complications after the surgical birth process, all recommendations of doctors should be followed.

Cesarean, like any other surgical intervention, ends postoperative care cut places. Final stage surgical delivery- suture. For this, a ligature is used - a surgical thread. It helps stop bleeding. The thread prevents subsequent blood loss. The surgical material should not cause worries to the patient. However, during childbirth of an operational nature, there is a high probability that the threads will rot, as a result of which an abscess forms in the tissues.
An incision in the abdominal cavity, which is mandatory for cesarean delivery, is always treated before suturing. If bacteria enter the wound or pathogenic microorganisms are on the thread, then suppuration occurs. This ultimately leads to complications.

The thread that tightens the edges of the incision "overgrows" with a granuloma - tissue compaction. Suture material, fibroblasts, collagen fibers can get into the seal. Under the influence of microbes, suppuration of the seam occurs. After a breakthrough, purulent discharge oozes. A part of the surgical thread can also come out with it. The place where suppuration is opened begins to “whistle”, because a through hole appears - a fistula. Usually suppuration breaks in one place, but there are breaks in several areas. It all depends on the cause and characteristics of the inflammatory process.

A complication may appear a couple of days after surgery, that is, when the patient is still in the hospital. A fistula may appear after discharge. Sometimes the inflammation fades, the breakthrough closes, but after a while everything repeats. This happens when proper therapeutic measures and the factors of suppuration are not eliminated.

Causes of complications

The formation of a fistula after cesarean is due to a number of reasons. Complications occur when:

• initial infection of the suture;
• infection of the surgical material with the contents of the wound;
• using low-quality thread;
• violation hygiene procedures during caesarean and after it;
• insufficient seam processing.

The risks of developing an inflammatory process increase if the immune system is weakened. Functions in parturient women immune system reduced, due to the process of gestation, birth stress. Sometimes this leads to cellular rejection foreign body(thread) or provokes the appearance allergic reaction for surgical material.

What is dangerous fistula

Timely diagnosis of pathology is the key to a quick recovery

Fistula - dangerous phenomenon requiring immediate action. With large purulent accumulations, the likelihood of secondary infection is high. When purulent discharge is intense, skin irritation occurs. This leads to dermatitis. If a pathological process ignore and allow its development, then severe intoxication of the body can occur - with a breakthrough, there is a high probability that bacteria that cause inflammation enter the bloodstream. Because of this, the patient may become disabled. Lethal outcomes are also recorded.

Fistulas are dangerous and their complications. The presence of a purulent focus can provoke severe reaction organism, expressed extremely high temperature. An exacerbated temperature reaction is called toxic-resorptive fever. It leaves an imprint on all organs and systems. Phlegmon is also referred to fistulous complications. This is the name of the process of spreading purulent deposits subcutaneously. Pus flows into fatty tissue. If purulent discharge melts the wound after a cesarean, then organ prolapse may occur.

Risks can be reduced only by timely detection of a fistula. After the diagnosis of the pathological process, it is necessary to carry out treatment, including measures to prevent complications.

Symptoms of a pathological phenomenon

Ligature fistulas can be identified by a number of symptoms. It is not difficult to identify pathology, because it is accompanied clear signs. Notice the fistula at the incision site from caesarean woman can at home. This is important, because the complication does not always appear immediately after surgery, sometimes it occurs after a couple of months.
What are the signs of complication? You need to pay attention to:

• seals around the wound;
• hot to the touch area of ​​the wound channel;
• redness near the scar (more often goes in the course of suturing);
• swelling of the tissues around the wound;
• pus (sometimes purulent contents are separated into minimum quantity: the sutured wound gets a little wet).

Almost always, the formation of fistulous openings is accompanied by a significant increase in temperature. On the early stages temperature deviations from the norm can be minimal, but do not ignore them.

Diagnostics

It is difficult not to notice the fistula. You can only miss the beginning of the formation of the inflammatory process. As it develops, it becomes obvious. However, if the patient after caesarean section undergoes regular examinations, the doctor will notice infection of the sutured wound. Diagnostics includes:

A fistula may present as a late complication of CS. A woman after a surgical delivery should regularly examine the wound. Noticing alarming manifestations (even if so far they are insignificant), you should immediately consult a doctor. A qualified diagnosis will allow you to identify a complication even before it begins to develop. This will make it possible to quickly take measures aimed at eliminating risks to the health and life of the patient.

Treatment Methods

If complications occur after a cesarean section in the form of a ligature fistula, you should consult a doctor. Only a specialist can prescribe a treatment that will bring results. Self-medication is strictly prohibited. This leads to irreversible consequences. Opening suppuration and cleaning the fistula at home are fraught with an increase in the inflammatory process. There is also no need to wait for the spontaneous exit of the thread. Waiting can lead to the spread of infection to nearby tissues and even to the entire body. Severe cases often end in disability or death.

Conservative therapy

If a fistula occurs after CS, the doctor determines the exact location of the infected area, finds the cause of the inflammation, assesses the degree of development of the pathology and possible risks. Only after that the doctor determines the method of treatment.
If the case is not neglected, it is possible to turn to conservative therapy. This method consists in removing the infection using various antibacterial solutions, antiseptics.

The site of inflammation is treated daily with special medicines that kill bacteria. Frequent washing of the wound is necessary to remove pus and disinfect the suture site itself. It contributes rapid healing cut places. When the infection can be stopped, the fistula closes on its own. If the infection has spread, the doctor may prescribe a course of antibiotics. Additionally, the patient is prescribed vitamin complexes, the action of which is aimed at increasing immunity. When protective functions body return to normal, the process of dealing with complications after CS accelerates naturally.

A conservative method of treatment is not always possible. After such therapy, the likelihood of relapse remains, because the surgical thread remains intact. If the causes of complications were directly related to the thread, and the doctor could not determine this, then the development of fistulas may recur.

Operational Methods

In some cases, immediate medical attention is required

Treatment of fistulas most often involves surgery. Especially if the pathological process was not fixed immediately. The operational method has two options:

• thread removal;
• fistula excision.

Extraction of the surgical thread is carried out through a small incision. First, the surgeon releases pus, cleans the cavity, thoroughly rinses the wound. The thread is removed blindly. This does not always work out the first time, so exacerbations are possible, during which the thread is again removed. If the surgical material can be obtained the first time, then the fistula is permanently tightened.
Why not make a wide incision? This would provide a 100% result, because the ligature thread, which led to inflammation, could be seen. The use of such an incision is dangerous by infecting "healthy" threads, and the risk of developing phlegmon increases.
After evaluating the fistulous canal, the doctor may decide not to make an incision at all, but to use it to extract thin tool, for example, a special clamp. It is inserted into the fistula. The instrument penetrates the canal and removes the surgical material. After removing the thread that caused the complication, the wound is treated with antiseptics, dressings are made.

There is another way to remove the thread - under the control of ultrasound. Plus this method- the doctor knows exactly where the material is localized. However, this method is not practiced in all clinics, because the procedure requires modern equipment.

Removing the thread is considered sparing operational method, but there is also a radical one - excision of the fistula. The advantage of this procedure is efficiency. First, the doctor treats the operating site, conducts local anesthesia, and then makes a single block excision. The fistula is removed, and with it the ligature thread. The final stage procedures - treatment of the place of removal and suturing. The condition of the wound is monitored for the next five days, and it is treated. The procedure involves the removal of sutures when the excision site is delayed.

Preventive measures

It is impossible to completely exclude the possibility of fistulas after surgical delivery. Complications can arise even if the most aseptic conditions were observed during the operation. Microorganisms can penetrate even when it would seem impossible. No one can predict a rejection reaction at all.
However, there are a number of preventive measures that need to be taken to prevent complications after a cesarean. These include:

• compliance with the rules of asepsis / antisepsis;
• careful preparation of the wound;
• the use of modern surgical materials and their thorough verification.

Will the preventive measures- depends on the doctor, so you need to choose the right specialist who will perform the caesarean section. It is important to assess the conditions of the hospital where the operation will take place. There is no absolute insurance against the appearance of a fistula, however, timely detection and subsequent treatment makes it possible to give a favorable prognosis.

Article prepared by:

Ligature fistula- suppuration in the area of ​​application surgical suture. Violation occurs when using non-absorbable threads. Pathology can manifest itself only after surgery. The complication is rare. First, a fistula appears in the area of ​​​​the seam, and then a fistula is formed. Pathology is characterized by the development of the inflammatory process. Needs to emergency treatment and accompanied large quantity unpleasant signs.

Fistula formation - abnormal reaction organism. The threads may be synthetic or natural origin. A violation is usually indicated by the presence of a dark discharge. Deviation becomes source infectious diseases. Represents a huge danger to the life and health of the patient. The present violation cannot be categorically ignored.

In this article you will learn:

General information about the complication

Ligature fistula is a complication caused by a previous surgical intervention. It is the result of suppuration and contamination in the area of ​​​​the seam. Pathology is characterized by rapid development. You need to see a doctor at the first signs.

A ligature is a thread that is used to bind blood vessels. A seam using such material is required to stop internal bleeding. Required for most surgeries.

Ligature fistula is an inflammatory process in the area of ​​​​suturing the wound. The fabric begins to thicken rapidly. Violation can lead to the development of an abscess.

When carrying out operations, a non-absorbable thread is often used - a ligature.

The root causes of the formation of a violation

The root causes of the fistula are varied. Provoking and predisposing factors are listed in the table.

The risk of a violation will increase with a lack of vitamin and mineral complexes, as well as deviations in metabolic processes. Most often, pathology is formed by ignoring the basics of personal hygiene in the wound area and non-compliance with the doctor's recommendations.

Failure to comply with antiseptic rules leads to the ingress of pathogenic bacteria. An inflammatory process is formed. The tissues thicken and a fistula appears.

Symptoms of the violation

Symptoms of a ligature fistula include:

• redness;
• increase in body temperature;
• seal;
• soreness in the suture area;
• bleeding and discharge mixed with pus.

The fistulous passage may be closed for a while. However, it will open again after a while. The temperature in the presence of a deviation rises to a maximum of 38 degrees. It is possible to eliminate signs only when exposed to a provoking factor.

Most often, pathology is formed against the background of the use of a synthetic thread. Over time, peculiar compacted cones appear near the seam. Pus flows out of them. The quantity may vary. Small lesions may not cause discomfort to the patient a long period time. Near the seam, as a rule, redness, swelling and swelling appear. There may be signs of intoxication of the body. With untimely assistance, irreversible complications are formed. The patient may become disabled.

A fistula is characterized by the presence of an external opening when the risk of dermatitis is high. In severe cases, body temperature can reach 39 degrees.

Possible Complications

Complications of a ligature fistula include:

• phlegmon;

• eventrations;
• sepsis;
• toxic-resorptive fever.

During the formation of an abscess near the seam accumulates a large number of pus. It is always the result of an inflammatory process. The deviation is accompanied by a significant increase in temperature.

Phlegmon - the development of purulent formations under skin. Inflammatory process affects connective tissue. Defeat has no clear boundaries. The complication needs timely treatment. The disorder affects the muscles and tendons.

Eventration is a process in which internal organs prolapse through a formed tissue defect. Pathology can be external, internal and subcutaneous.

Sepsis is a complication in which the infection enters the bloodstream and spreads throughout the body. Pus enters the cavity of the skull, chest and abdomen. The patient must be hospitalized immediately.

Toxic-resorptive fever is a consequence of absorption toxic substances at purulent inflammation and tissue breakdown.

The condition is characterized by a spontaneous deterioration in well-being, while body temperature indicators can increase to 39-40 degrees.

Diagnostic methods

Primary diagnosis is carried out during dressings using a visual examination. However, it is worth noting that the pathology can manifest itself not only immediately after surgery, but also a year after the operation. It is important that the patient pays attention to the signs present.

• detect possible complications;
• determine the location of the fistula.

A patient with suspected development of a disorder may be given a referral for fistulography. The method is required for the development of a fistula in the thickness of the tissues. The study uses contrast agent and x-rays are taken. The resulting picture clearly shows the deviation.

Therapeutic methods

Treatment should be started as soon as possible. The complication is dangerous and can cause secondary infection. Pathology can lead to lethal outcome. Therapeutic methods are selected by the doctor.

Treatment may be:

• conservative;
• operational.

Most patients are advised surgery. The operation to eliminate the fistula is to remove the infected ligature. Beforehand, doctors make a small incision so that all the pus comes out, and then they close the defective formation. After the procedure, the patient is prescribed a course antibiotic therapy. The wound is washed with special solutions. Referral to physical therapy.

Conservative treatment is possible only with timely handling to the doctor and the presence of a small amount of pus. In this case, the doctor removes dead tissue near the fistula. The patient is prescribed antibacterial drugs and drugs to improve protective functions.

Preventive methods

Prevention does not directly depend on the patient, but on the surgeon. It is important that the doctor carefully observe antiseptic rules when performing an operation. All suture material must be sterile.

Before starting the operation, the wound must be washed. Before the procedure, the doctor must check the threads. The material must:

• have allowable period suitability;
• hermetically sealed;
• be sterile.

Only if all the recommendations of the doctor are followed can the risk of developing a deviation be significantly reduced. However, it is impossible to exclude it completely. After the operation, the patient must comply with all doctor's prescriptions. The wound needs to be treated regularly.