Methodical pointing for work of students on the practical lesson

Module 2

Thematic module 5

Practical lesson №23

Theme: Purulent diseases of a hand

Theoretical questions for the off-hour independent study and discussion on practical lesson №23:

1. Features of the surgical anatomy of fingers and a hand which matter for the flow, diagnostic, treatment of a panaritium and phlegmon of the hand.

2. The classification of a panaritium and phlegmon of a hand.

3. An etiology, a pathogenesis, the clinical signs and features of the flow of different forms of a panaritium and phlegmons of a hand, methods of the diagnostic of the panaritium and phlegmons of a hand.

4. Indications to the conservative and operative treatment of the panaritium and phlegmon of the hand.

5. Methods of an anesthesia and surgical attacks at different forms of panaritium and phlegmons of a hand.

6. The technique of implementation of the test differentiating different forms of a panaritium and phlegmons of a hand by a bellied bougie.

7. To execute the differential diagnostics of a panaritium and phlegmon of a hand with other purulent-inflammatory processes of soft tissues of fingers and hand.

8. To choose the method of anesthesia and method of a surgical attack at the different forms of a panaritium and phlegmons of a hand.

Literature:

1. Butursky A. “General surgery”. (Simferopol 2004)

2. S. I. Shevchenko; A. A. Tolkoglas and etc. “Surgery” (Kharkov 2004)

3. Methodical pointing

Distribution of the marks appropriated to the students:

At learning of the theme №23 of the module №2 for educational activity to the student mark is proposed on 4th to the ball (traditional) scale which is then converted in marks as follows:

Estimation	Marks
“5”(fine)	7
“4” (well)	5
“3”(satisfactorily)	3
“2” (unsatisfactorily)	0

Methodical pointing for work of students on the practical lesson №23

Module №2

Thematic module №5

Theme: Purulent diseases of a hand

I. Topicality of the theme

Treatment of the purulent-inflammatory diseases of a hand is one of the most old and difficult problems of a clinical medicine. A panaritium is the most widespread purulent disease of a hand. It is annually observed at 0,5-1,0% population. 15-31% patients have a panaritium from the common quantity of all patients which first appealed for a help to the surgeon. The temporal loss of capacity for work at a panaritium is marked for 8-10% people workings with hands. Fatal outcomes can be observed at this disease, and they take a place at 0,8% patients from data of some authors. A serious concern is caused by the high level of unsatisfactory outcomes of treatment of panaritium, especially at his complicated forms. An anchylosis, deformations and amputations of fingers and phalanxes are a frequent finale of not only ambulatory but also stationary treatment of a panaritium. An amputation of phalanxes and fingers at the bone form of the panaritium is executed approximately for every 3th patient and duration of treatment at this form of the panaritium quite often arrives at 3-4 months. The unsatisfactory results of treatment testify that in many cases reason of disability of patients is not only weight of disease or late appeal for medical help but also defects of the diagnostic and surgical attack.

The phlegmons of a hand can arise independently and as a complication of the panaritium. It is a heavy pathology of a hand. It can often finished by the full loss of the function of the hand. A course, a clinical picture, features of a treatment of phlegmons of a hand depends on localization of process and features of the anatomic structure in the area of the defeat.

Knowledge about a panaritium and phlegmons of a hand should be know not only for surgeons but also for the physicians of other professions which must be able to diagnose this pathology and in good time to send a patient to the specialist.