The development of phlegmon of the foot occurs in the area of the fascial-cellular spaces of the foot.
The disease occurs due to stab-lacerated or gunshot wounds, with injuries that are accompanied by generalization of intense hematomas. Sometimes phlegmon is a complication of untreated purulent acute diseases of the feet or fingers.
The most severe form of this disease is the phlegmon of the sole. Phlegmons of the foot differ in the depth of localization, they are supraponeurotic, that is, superficial, or subaponeurotic, or deep. Localization of deep phlegmon of the foot occurs in the medial fascial bed of the sole.
Symptoms of foot phlegmon
You can recognize the disease by identifying a number of symptoms, the manifestation of which it is characterized. This may be redness, swelling of the tissues, with palpation of certain areas – a manifestation of pain. Also symptomatic manifestation of lymphadenitis, lymphangitis, rarely thrombophlebitis. The developing purulent process is usually accompanied by a serious condition of the patient, with an increase in temperature to 38 or 39 ° Celsius, and blood leukocytosis, a neutrophilic shift is observed in the analyzes. Diagnosis and treatment can be difficult if the cellulitis of the foot is deep plantar. In this case, there is no redness, no swelling, and there are no visual changes on the sole. With such a disease, the diagnostician’s delusion can be caused by active swelling of the rear of the foot, stimulating phlegmon. As a rule, in such a situation, a puncture or a scrupulous study of all the symptoms that are observed in the pathology that has arisen can help. It can be severe pain, a manifestation of soreness when pressing on the sole. Visual observation of the smoothness of the arch of the sole, an increase in the volume of the foot, a feeling of pain when moving the fingers also indicates the presence of phlegmon.
If a diagnosis is not made in a timely manner and an operation is not performed, then complications are possible: an infection from the fascial spaces of the sole can move to the rear of the foot or even to the back of the leg and ankle joint. The infection can affect the tendons, bones, or joints of the foot. If you do not treat phlegmon, then you can earn a total infection of the entire foot, the development of thrombophlebitis or sepsis.
Treatment of foot phlegmon
Treatment of phlegmon of the foot occurs in an operative way. Its success depends entirely on how correctly the incision is made. Treatment of phlegmon of the rear of the foot is carried out through the center of the focus of suppuration. When performing a surgical operation, it is very important not to touch the artery of the rear of the foot. The line along which the artery passes is determined from the first interphalangeal space to the middle of the ankle joint.
Plantar cellulitis is usually treated through lateral incisions, which should match the placement of the fascial septa. The disease can progress, and there is a danger that it will affect the back of the leg. Then the incision is made between the calcaneal tendon and the posterior border of the middle ankle.
After opening the phlegmon, it is mandatory to drain the cavities in which suppuration was present. The limb is fixed with a plaster cast, antibiotic and physiotherapy are performed.