Panaritium is one of the most common diseases that are treated by a surgeon. Inflammation of the fingers, which can occur even due to a small scratch or splinter, usually does not look like a serious problem. However, without timely treatment, the inflammation can also spread to bones, joints, and tendons, leading to severe complications.
What is a panaritium
Panaritium is an acute purulent disease that affects the tissues of the fingers or toes, most often in the periarticular region. His symptoms usually appear suddenly and actively increase. The first signs are soreness and redness of the skin, often accompanied by swelling. Later, a general malaise appears, and body temperature rises. An abscess forms on the finger, a place filled with pus that causes severe pain when pressed or moved.
Causes of occurrence
The cause of the disease is usually the penetration of various microorganisms into the finger tissue, most often Staphylococcus or streptococcus. Various skin injuries, such as microtrauma, scratches, and insect bites, become the entrance gates for infection.
There are also factors that can provoke the development of a pathological process. These include:
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non-observance of hand hygiene;
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injuries sustained during manicures and pedicures,
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fungal nail lesion,
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chronic diseases that weaken the immune system;
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violation of blood circulation in the extremities;
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work involving constant contact with water or harmful substances;
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decreased overall immunity (for example, due to stress, lack of sleep, or poor nutrition);
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practicing certain sports associated with the risk of injury to the hands (boxing, basketball, etc.).
It is important to remember that panaritium is not just a cosmetic defect, but a disease that requires mandatory treatment under the supervision of a surgeon.
Forms of the disease
The forms of panaritium are divided into superficial and deep.
Surface shapes include:
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Cutaneous panaritium is an inflammation of the upper layer of the skin caused by microtrauma or scratches. It is characterized by redness, swelling, and soreness when pressed.
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Subcutaneous form – affects the subcutaneous tissue of the finger. Symptoms include severe pain, swelling, general malaise, and fever.
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Subcutaneous form – inflammation occurs under the nail. It is characterized by severe pain and the presence of pus under the nail plate.
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Paronychia is an inflammation of the periarticular roller. Typical symptoms are soreness, redness, and swelling.
Deep panaritium forms:
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Bone – affects the bone tissue of the finger. It can occur in an acute form (rapid development of symptoms) or in a chronic form (slow development of symptoms, relapses).
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Tendonous form is a lesion of tendons. Typical symptoms are severe pain, inability to move a finger.
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Articular form – inflammation affects the joint. Patients experience acute pain, swelling, and the inability to move their finger.
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Osteoarticular form – inflammation affects both the bone tissue and the joint.
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Pandactylytis is a purulent–necrotic lesion of all finger tissues.
The initial stages of the disease are called serous. At this stage, conservative treatment is effective: antibacterial therapy, the use of local antiseptics, physiotherapy procedures. However, patients rarely see a doctor at this stage, as redness and tolerable pain do not seem to be a serious problem.
The next stage of development is the purulent stage. In the presence of an abscess, surgical intervention is essential. Self-medication or squeezing out pus is unacceptable, since the spread of infection into deep tissues can lead to life-threatening conditions.
Opening a panel
Surgical treatment is performed in cases of deep forms of the disease and advanced stages. The purpose of the operation is to remove the pus and ensure its outflow.
The technique of the operation depends on the form of the disease:
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With subcutaneous panarization, an incision is made in the area of maximum skin tension, pus and necrotic masses are removed, and the wound is drained.;
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The subungual form requires the removal of part or all of the nail plate to ensure the outflow of pus;
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bone panaritium requires more complex surgical intervention, including resection of the affected part of the bone;
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in case of pandactylysis, amputation of a finger may be required if the infection has spread to all its tissues.
Autopsy of subcutaneous panaritium in uncomplicated cases does not require special training. The operation is performed on an outpatient basis, without hospitalization. If bone structures are affected, the patient should also consult a traumatologist. In this case, additional examination may be required, for example, X-ray of the hand or foot.
Care and prevention after the procedure
It is important to properly care for the wound to prevent re-inflammation and promote rapid healing. As a standard, patients are prescribed antibiotics, as well as local antiseptics for treatment. Avoid contact with water until the wound is completely healed.
The healing time of the wound depends on its depth and size, as well as on the general health of the patient. On average, with proper care, the affected area heals within 1-2 weeks.
If the inflammation has spread to bones, joints, or tendons, full recovery may take longer. In this case, rehabilitation measures are indicated, including physical therapy and exercises to restore motor function.
There are no specific disease prevention measures. It is important to avoid any micro-injuries to prevent the development of bacterial infection. When performing dangerous work, hands should be protected with gloves. It is important to perform manicures and pedicures with sterile instruments.
Treatment of paronychia in the EMC clinic
At the EMC Surgical Clinic, we perform the removal of panaritium using modern equipment and minimally invasive techniques.
Although panaritium looks harmless enough in the initial stages, this disease requires proper treatment under the supervision of a surgeon. Do not delay your visit to the doctor and make an appointment if you notice redness, pain, or swelling of your fingers and near-elbow area.
Question-answer
How long does paronychia last?
Paronychia can take place from several days to several weeks, depending on the stage of the disease and the adequacy of treatment.
What happens if you don't treat paronychia?
Without treatment, the inflammation will become chronic. Possible deformation of the nail, loss of the nail plate, and in severe cases of the disease, the development of hand phlegmon and sepsis.
List of sources and literature
- Pillai S, Campbell E, Mifsud A, Vamadeva SV, Pahal GS. Hand infections. Br J Hosp Med (Lond). 2020 Nov 2;81(11):1-14. doi: 10.12968/hmed.2020.0234. Epub 2020 Dec 2. PMID: 33263466.
- Barger J, Garg R, Wang F, Chen N. Fingertip Infections. Hand Clin. 2020 Aug;36(3):313-321. doi: 10.1016/j.hcl.2020.03.004. PMID: 32586457.
- Connolly B, Johnstone F, Gerlinger T, Puttler E. Methicillin-resistant Staphylococcus aureus in a finger felon. J Hand Surg Am. 2000 Jan;25(1):173-5. doi: 10.1053/jhsu.2000.jhsu025a0173. PMID: 10642489.
- Macneal P, Milroy C. Paronychia Drainage. 2023 Jun 5. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 32644572.
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