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Phlegmon: causes, symptoms and treatment

What is phlegmon?

Phlegmon is an acute suppurative inflammatory process that occurs in the fatty tissue and spreads to the surrounding tissues, including the tendons and muscles.

The disease occurs at any age, equally common in men and women. The inflammatory process can develop on its own or is a complication of other purulent processes - carbuncles, boils, abscesses, and others.

Where does phlegmon occur?

Phlegmon, abscess cleaning, photo

Phlegmon, abscess cleaning, photo

Inflammation of adipose tissue may occur as a result of violation of the integrity of the skin by penetration of pathogens into the wound.

However, as practice shows, the disease most often develops where there have been no injuries and injuries. The favorite places of localization of the pathological process are:

  1. Chest;
  2. Anterior abdominal wall;
  3. Back;
  4. Thighs;
  5. Buttocks.

Quite often there are phlegmon of the face and neck.


Causes of phlegmon

Causes of phlegmon

If the skin is damaged, the cause of the acute inflammatory process is obvious - the penetration of bacteria from the outside. In the formation of phlegmon "out of the blue" its exact causes are not established by medical science.

However, it is believed that chronic foci of infections in the body or weak immunity can cause the development of the inflammatory process.

Predisposing factors are:

  • Diabetes or other disorders of the endocrine organs;
  • Depletion of the body, for example, in cancer patients;
  • Medication, detrimental to the immune system;
  • Immunodeficiency states;
  • Severe intoxication of the body.

Forms of the disease

There are several forms of the disease:

Serous phlegmon - inflammation due to the accumulation of pathological exudate (fluid). Cellulose becomes turbid in appearance as a result of feeding it with accumulated fluid.

The boundaries of the pathological focus and non-infected tissues are almost invisible.

Purulent phlegmon - tissues surrounding the pathological focus begin to melt, resulting in a large amount of pus. In this form of the inflammatory process, fistulas or ulcers are often formed next to the lesion, from which a green-yellow liquid is released.

As phlegmon progresses, the disease spreads to the muscles and fascia, as a result, the tissue acquires a gray patina and is saturated with pus.

Putrid - at this stage there is a destruction of the structure of tissues and the formation of gases, as a result, the neoplasm exudes an unpleasant smell of rot.

The site of localization of the pathological process and the tissues located close to it acquire a pasty shape of a dark color. This condition leads to severe intoxication of the whole organism.

Necrotic form - necrotic foci (dead skin) form on the surface of the neoplasm, which are subsequently rejected by the body, and in their place are bleeding wound surfaces.

Often, after necrotic phlegmon abscesses are formed, the treatment of which is carried out (mostly) by surgery.

Anaerobic - the inflammatory process spreads over large areas of fatty tissue, causing the formation of necrotic foci with gas. The affected tissues acquire an earthy hue and an unbearable unpleasant odor.

When probing, a crunch (crepe) is clearly audible due to the accumulation of gases. The tissue around the anaerobic phlegmon resembles boiled meat.

Symptoms of phlegmon, photo

Manifestations of cellulitis face and neck, photo 3

Manifestations of cellulitis face and neck, photo 3

The clinical picture of the disease is acute. At the initial stage, the site of localization of the inflammatory process is sharply painful, hot to the touch, edematous. The softened areas of the neoplasm indicate accumulation of pus under the skin.

As the disease progresses, general symptoms are added:

  • Increase in body temperature (up to 39.0-40.0 degrees);
  • Fever;
  • Growing weakness;
  • Increased thirst (often with phlegmon, patients complain of severe dry mouth);
  • Shortness of breath, palpitations;
  • Severe headaches
  • Pallor of the skin and lowering blood pressure.


Against the background of general intoxication of the patient, the patient may experience vomiting, anuria (or oliguria), a weak filamentous pulse.

Treatment of phlegmon

Phlegmon finger photo 5

Phlegmon finger photo 5

When diagnosing phlegmon requires hospitalization in the department of surgery. In the acute period shows strict bed rest. If pus has accumulated at the site of infiltration, it should be removed immediately by prompt dissection and drainage.

In the event that the disease is detected at the stage of infiltration, that is, before the tissues soften and accumulate pus, the inflammatory process is treated by conservative methods - using thermal procedures, ultraviolet radiation, and mercury ointment.

When the compaction is formed and the body temperature is high, the patient is prescribed a phlegmon operation to ensure a high quality outflow of pus.

After the discharge of pus, the cavity is washed and special tubes are inserted. A sterile gauze bandage moistened with 10% sodium chloride solution is applied to the wound.

Mandatory order for patients with acute inflammation of adipose tissue is prescribed broad-spectrum antibiotics, as well as parallel fortifying drugs and vitamins.

To eliminate pain, it is advisable the appointment of analgesics, to relieve fever - antipyretic drugs.

To accelerate the rejection of dead tissue sites prescribed ointment Iruksol or other local products containing enzymes.

For the speedy healing of open wounds, Troxevasin ointment or Methyluracil ointment is prescribed.

Operation phlegmon photo 4

Operation phlegmon photo 4

Recovery after surgery with phlegmon requires several months, and the patient must strictly follow the recommendations of the doctor, so that the disease does not recur and become chronic.

Complications of phlegmon

A complication is the spread of infection throughout the body with blood or lymph, which is fraught with general intoxication of the body and the development of sepsis or lymphadenitis.

Phlegmon and abscesses of the maxillofacial area can lead to the spread of infection to brain tissue, which leads to the development of meningitis or purulent meningoencephalitis.

Cellulitis of the neck can lead to suffocation, and the involvement of the surrounding arteries in the inflammatory process and the subsequent destruction of the vessel walls causes massive arterial bleeding and death.


Strengthening the risk of phlegmon will help reduce the patient's immune system, timely and adequate treatment of boils and carbuncles, normalization of metabolism and the eradication of chronic bacterial foci in the body.

What kind of doctors to treat with phlegmon?

If you identify the first symptoms of phlegmon, the patient is advised to contact a surgeon.

Dentists-surgeons are engaged in the treatment of tumors of the maxillofacial zone, while the development of the disease as a result of a fracture or other trauma is a traumatologist.

Phlegmon - code on the ICD 10

In the international classifier of diseases of phlegmon be in the class XII (L00-L99)

L00-L99 - Diseases of the skin and subcutaneous tissue

  • (L00-L08) Infections of the skin and subcutaneous tissue

(L03) Phlegmon

  • (L03.0) Phlegmon of fingers and toes
  • (L03.1) Phlegmon of other parts of the limbs
  • (L03.2) Phlegmon of the face
  • (L03.3) Phlegmon Torso
  • (L03.8) Phlegmon of other localizations
  • (L03.9) Phlegmon, unspecified

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