chest wall tuberculosis debridement

Chest wall tuberculosis is a local manifestation of systemic tuberculosis infection. Therefore, systemic anti-spasm treatment must be performed first. After the systemic and local conditions are stable and the erythrocyte sedimentation rate is stabilized, local lesions are removed and the wound is sutured. If the cold abscess has a secondary purulent infection, it should be used for incision and drainage. After the secondary infection is controlled, the lesion is removed. Treatment of diseases: chest wall tuberculosis Indication Chest wall tuberculosis is a local manifestation of systemic tuberculosis infection. Therefore, systemic anti-spasm treatment must be performed first. After the systemic and local conditions are stable and the erythrocyte sedimentation rate is stabilized, local lesions are removed and the wound is sutured. If the cold abscess has a secondary purulent infection, it should be used for incision and drainage. After the secondary infection is controlled, the lesion is removed. Preoperative preparation 1. Preoperative treatment with anti-tuberculosis drugs (streptomycin, isoniazid) for two weeks to prevent the spread of tuberculosis caused by surgery. 2. Patients with pupils should be treated with penicillin before surgery. Surgical procedure 1. Position: Take the supine or lateral position according to the lesion, and the lesion is upward. 2. Incision: Take the abscess as the center and make a skin incision along the rib. If there is sinus or local skin involvement, you can make a fusiform incision, remove the sinus and involve the skin. 3. Excision of superficial abscess: general chest wall cold abscess is divided into two parts: shallow and deep. The principle of surgery is that the superficial abscess should be completely removed; the deep abscess should be scraped off the lesion, and the tissue covering the abscess should be removed to facilitate filling the muscle flap. When the superficial abscess is removed, after the skin is opened and subcutaneously separated to a suitable large extent, the muscle layer is cut, and the abscess is separated from the muscular layer to the shallow, deep abscess junction of the rib plane, and the superficial abscess wall is completely resection. 4. Clear the deep abscess lesion: probe the deep abscess in the inner surface of the rib along the sinus; remove the affected rib and the rib, periosteum, and intercostal muscle covering the abscess to reveal the bottom of the abscess; then, the bottom Caseous necrotic tissue and granulation tissue were scraped off. 5. suture the incision: wash the local area with saline, sprinkle the streptomycin powder into the residual cavity, according to the size of the residual cavity, then separate the nearby muscle into a valve, transfer the filling cavity, and suture the muscle flap with the gut line. The bottom of the cavity, and finally the skin. If there is a sinus before surgery, it is advisable to put a rubber sheet for drainage. The incision is pressure bandaged.

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