Be watchful -- a tiny cut, scrape or prick may open the door to an invasion by germs, not visible to the naked eye, which will result in an abscess.
Germs or micro-organisms are all over, but a breach in the skin may leave a person vulnerable to these germs, mainly bacteria, and allow them to burrow deep into the tissue planes and cause trouble, explains Consultant Surgeon, Dr. D.J. Anthony who is also a Senior Lecturer at the Colombo Medical Faculty.
Such an infection by germs may result in an abscess, MediScene learns.
An abscess is a collection of pus and could occur anywhere in the body, according to Dr. Anthony.
Commonly occurring in the skin, these “le gedi” as patients call them, may also form in deeper planes, beneath the skin such as in the muscles or cavities including the thorax, abdomen and pelvis.
Whenever there is a breach of the skin, whether the invasion by germs would cause an abscess will dependent on the person’s health, it is understood. “If a person’s immunity is good, there will be a battle and the germs will get destroyed. If the immunity is low due to diabetes, Acquired Immuno-Deficiency Syndrome or other illnesses including kidney disease or due to taking certain medications, an abscess may be formed,” he says, pointing out that even though immunity may be strong, the body may not be able to ward off a “big dose” of bacteria. They may be too much to handle.
Although abscesses may form anywhere, the “common sites” would be where germs proliferate such as the armpits, groin and the anal area (around the anus from which excreta is put out of the body), it is understood.
The danger zones would also be where there are dense hair follicles such as the scalp, armpits, groin and pubic area, says Dr. Anthony.
What are the symptoms when an abscess is
Intense pain – an excruciating, dragging (adum kanawa) and throbbing at the spot, as the pressure is very high inside the abscess.
Swelling, sometimes visible, at other times not so.
Before the formation of the abscess proper, there may also arise an infection which spreads under the skin, resulting in a swelling (oedema) – there will be pain, redness and fever, but no pus or fluid. This is cellulitis which, in turn, can lead to an abscess.
He picks out the example of some people who are prone to frequent abscesses in the armpits due to their immunity being down as well as the area having many hair follicles. “Cut the hair in that area short but don’t shave it off, as when it grows back the prickly ends would injure the opposite wall of the armpit causing abscesses,” he advises, adding that hair-removal creams may be used, after which an antiseptic cream could be applied.
Dealing with the treatment of abscesses, this Consultant Surgeon is specific. “Most abscesses need to be drained. Surgery is usually essential and entails an incision on the abscess, allowing the pus to drain out.”
However, in some exceptions, particularly if the doctor is treating a small abscess, aspiration of pus using a needle may be an alternative, he says.
After surgery, until the wound heals, regular dressings should be done but how regular would be the doctor’s decision as well as whether antibiotics are needed.
Anal abscesses and cellulitis
Two among the range of abscesses that may afflict a person are perianal (around the anus) abscesses and cellulitis.
Perianal abscesses, according to Dr. Anthony are in a “complicated place”. While some abscesses could come up due to infected skin close to the anus, some may affect other structures in the area. They are caused by the glands around the anal canal getting blocked and becoming a good site for bacterial infection.
The glandular walls, MediScene understands, are the ideal grounds for germs to settle on and cause very painful abscesses.
Drainage of such abscesses is essential but should be handled with skill, both from the exterior and the interior. Such operations are done in stages, he says, adding that if unskilled hands meddle in that area, fistulas could occur, prolonging the agony of the patient.
Cellulitis, meanwhile, generally occurs at the limb extremities of the hand or foot, it is learnt, and needs no surgery but antibiotics. The heavily-swollen limb has to be kept elevated at all times and the person may need hospital admission for antibiotics to be administered intravenously.
Referring to some who may be more vulnerable to cellulitis than others, Dr. Anthony puts those with already swollen legs into this category.
Lymphoedema where the lymph vessels (small whitish vessels) malfunction and get blocked causing the accumulation of fluid in the limb is the major culprit of cellulitis. Lymph is good nourishment for bacteria, points out Dr. Anthony, explaining that even a tiny mosquito-bite can trigger cellulitis. Antibiotics such as penicillin in the long term will clear the problem, he adds.
A simple measure after suffering a small injury will help prevent the formation of abscesses, MediScene learns.
Whenever there is an abrasion, wash the affected area thoroughly with soap and running water for about 10 minutes, stresses Dr. Anthony, which will drastically reduce the number of germs gaining access into your body, for it is within the first half an hour that there will be a major entry of organisms.
Of course, if it is a heavily-bleeding wound, the person will have to see a doctor immediately, he adds.
He also urges the scrupulous maintenance of hygiene with daily baths and thorough washing in day-to-day life to prevent abscesses.