Cellulitis is an acute purulent inflammation of the tissue and superficial soft tissues, accompanied by restriction of movement of the affected area.
In most cases, phlegmon is primary, although the possibility of its secondary development cannot be ruled out when a purulent inflammatory process occurs. For example, subcutaneous phlegmon in children can be the result of a diffuse abscess, and cellular phlegmon can be the result of sequestration of bone tissue (during the tuberculous process). The spread of infection into the tissue is facilitated by poor hemostasis or deep venous thrombosis and vasculitis. Unlike the primary acute inflammatory reaction, which is characterized by an infectious process, phlegmon is a multi-axial complication caused by the underlying disease. The reasons may be: - traumatic tissue damage; - bone fragments, infected wounds, fractures; - chemical or thermal burns; - boils, carbuncles with reduced body resistance; - operations with poor conditions (small incisions, dirty operating equipment); - complications of diabetes mellitus, systemic lupus erythematosus, diseases of internal organs. When a purulent process occurs at the site of bacterial exposure, an inflammatory reaction develops: hyperemia and swelling of the soft tissues. The high virulence of the microflora and the weakening of the body's defenses lead to the spread of the pathological process beyond the point of entry of the infection - to the cellular spaces.
Phlegmon is characterized by the presence of a hygroma, a capsule or several serous-fibrous layers that separate the source of inflammation from the surrounding tissues and organs. The progression of the infection leads to the germination of the necrotic area of tissue inward and the development of edema. The contents of the abscesses die over time, which aggravates the clinical picture of the pathology. In addition to the general manifestations of intoxication (fever, sweating, depressed consciousness), local symptoms are observed - the presence of severe pulsating pain, limitation of movement and increase in the volume of the limb, associated pain, purulent discharge from the wound. When pus breaks out, a fluctuation is noted, and when a retrograde outflow of effusion forms, pronounced edema occurs. There is an increased temperature, an altered pulse pattern, a general decrease in immunity, the addition of hemorrhagic syndrome and pain shock. Diagnosis is based on clinical signs and bacteriological culture results.