Panaritium
| Classification according to ICD-10 | |
|---|---|
| L03.0 | Phlegmon on fingers and toes |
| B00.8 | Other forms of infection by herpes viruses - Panaritium by herpes viruses |
| ICD-10 online (WHO version 2019) | |
A panaritium , German nail ulcer, finger circulation or briefly Umlauf (formerly also the "unnamed" and the "finger worm") is an infection of a finger or toe with melting of tissue.
causes
The cause is usually a small injury, as a result of which bacteria can penetrate the nail edge, nail fold (nail wall) and skin cells. Even improperly and unsanitary nail care on fingernails and toenails can allow micro-injuries and the penetration of germs.
Symptoms
Panaritium can occur on fingernails or toenails. But it can also only affect the soft tissue tip. Often there is a red line around the nail edge and severe swelling. This is followed by stabbing, pulsating pain and a sensation of heat in the affected areas, as well as tenderness and sensitivity to knocking. The inflammation can be accompanied by the formation of pus, pus blisters become visible. The signs of advanced infection are fever, chills, and feeling sick. If left untreated, there is a risk of blood poisoning .
to form
There are superficial and deep forms of panaritia. As a panaritium progresses, tendon sheath phlegmon can develop. If the 1st finger (thumb) or 5th finger (little finger) is affected, a V-phlegmon can result. The anatomical structures in the area of the fingernails and toenails make it difficult for pus to drain outwards and thus promote the spread of the infection into the surrounding soft tissue structures, as well as into bones, joints and tendon sheaths. Panaritia must therefore always be treated as quickly as possible.
The following panaritia can be distinguished according to localization or spread:
-
Panaritium cutaneum - affecting the skin surface
- with the special shape of the collar button (Panaritium cutaneum with connection to a Panaritium tendinosum or Panaritium articulare )
- Panaritium subcutaneum - under the skin
- Panaritium paraunguale ( paronychia or, colloquially, nail bed inflammation or "circulation")
- Panaritium subunguale
- Panaritium tendinosum
- Panaritium articular
- Panaritium ossale
therapy
Therapy consists of surgical sanitation in the form of an incision or drainage of the pus and removal of the inflamed and / or dead tissue. By injecting a local anesthetic at the level of the non-inflamed finger or toe phalanx near the hand ( phalanx proximal phalanx ), a line anesthesia according to Oberst is performed to eliminate pain before the operation.
- Therapy on the toe: The surgeon will use a scalpel to cut out the outer edge of the nail and the ingrown parts as well as the inflamed tissue in a wedge shape and remove the nail root there as far as possible so that the ingrown nail cannot re-establish itself. The nail bed is smoothed with the help of a scratching spoon. It is then sewn shut.
- Therapy on the finger: Depending on the location of the inflammation focus, the procedure is the same as for the toe or the focus is punched out on the finger.
If the inflammation is more advanced and extends beyond the finger or toe, plexus anesthesia or general anesthesia (general anesthesia) may also be indicated for the procedure. The hand should be elevated and cooled. In the case of extensive inflammation, therapy with an antibiotic must be carried out.
A soft, non-constricting, thick wound dressing is applied because it can bleed again. The bandage must be changed every day after the operation. Pain relievers (such as ibuprofen or metamizole ) are indicated because of the pain in the wound. The sutures are removed about seven days after the operation.
See also
Abscess , phlegmon , paronychia , fish mouth cut , V phlegmon
literature
- W. Ewert: Panaritium. In: Hans-Ulrich Comberg (Ed.): General medicine: 39 tables. Georg-Thieme-Verlag, Stuttgart 2004, ISBN 3-13-126814-X , p. 429.
Web links
Individual evidence
- ↑ Nicole Saddle Enzler, Gabi Hoffbauer: Dictionary of Medicine , Southwest Verlag, Munich 2001, ISBN 978-3-517-06318-8 , S. 124th
- ↑ Panaritium. In: Pschyrembel (Medical Dictionary) .
- ↑ Max Höfler: The Unnamed. In: Journal of the Association for Folklore. 12, 1902, pp. 225 f.
- ↑ Thomas Gleinser: Anna von Diesbach's Bernese 'Pharmacopoeia' in the Erlacher version of Daniel von Werdts (1658), Part II: Glossary. (Medical dissertation Würzburg), now at Königshausen & Neumann, Würzburg 1989 (= Würzburg medical-historical research , 46), p. 290.
