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Buy Cialis Professional online

Buy Cialis Professional online

Gunshot wounds of the urethra are common in wartime and the average 30-40 % of the injuries of the urinary system . Basically urethral injury occurs , much less - and at the same time there is injury of the pelvic bones , large intestine . Wound expires urine . Closed injuries of the urethra occur in fractures of the pelvis. The urethra is torn directly underneath the prostate in its membranous department. In the fall there is a break on the perineum perineal urethra . Closed injuries hanging urethra are extremely rare. In partial tears urine mixed with blood, painful urination always . In total tears urethra comes complete urinary retention , accompanied by an extremely painful for the patient tenesmus . Stand out from the urethra drops of blood . Quickly show signs uroplania .
Testis and epididymis damage more often fire origin.
open
- partial
complete.
Damage to the penis or are
Management of patients :
patients require urgent surgical intervention . When closed injuries of kidneys used conservative methods of treatment , which consist of a destination of peace, use styptic , replenish blood loss. When conservative treatment of urethral injuries is valid only for small ruptures of the urethra with preservation of normal urination.
postoperatively
In the assigned patient care with timely holding dressings and supervision in the absence of bleeding , development of streaks , suppurative complications . If necessary, use antimicrobials .
In patients undergoing surgery , it is necessary to monitor the temporary drainage : they can become blocked by blood clots , mucus , salts , which leads to urinary retention . Need time to wash the drain tube or replace it with a new one. Make a doctor or a specially trained nurse . Hair on the skin near the drainage tube carefully shaved . If the operation is assigned to the constant wearing of the bag , you need to follow the rules of care. As filling the urinal removed, poured urine and washed under running water. Periodically (at least 1 time in 2-3 days) urinal boiled or treated with a disinfectant solution . For patients with limited movements are of particular importance timely change bandages, rubbing the body and linen .
surgical infection
primary suppurative focus .
Surgical infection is associated with the formation and accumulation of pus in the tissues and organs. Microorganisms enter the body through abrasion , cracks , lesions of the skin or mucosa. At the point of introduction is formed from the primary lesion microorganisms can be distributed to all organs and tissues. In the propagation of lymphatic or hematogenous route formed boils, carbuncles and otherwise , for a total of purulent infection marked sepsis, metastatic abscesses . Infection can pass from neighboring tissues .
For wounds festering inflammation characterized by the development pattern with all its typical manifestations. In the primary focus of inflammation occurs accumulation of microorganisms . This leads to the accumulation of leukocytes, the gradual degeneration and necrosis of the tissues under the influence of proteolytic enzymes secreted by leukocytes . Microorganisms , leukocytes, tissue molten form pus. Amount of pus and its composition can be different at different purulent processes . 3 different main stages of wound healing :
• necrotisation - resorption of dead cells and tissue hemorrhage ;
• Granulation - the development of granulation tissue filling the defect , formed as a result of their death ;
• epithelialization - development of regenerative regenerative processes which result in scar formation .
primary
secondary
Initially, there is congestion, impaired vascular permeability , edema and inflammation develop leukocyte infiltration of tissues . Swelling causes compression of vascular stasis , thrombosis , tissue anoxia and necrosis. Gradually, in the zone of dead cells and tissues begin to develop the focus of inflammation reduction regenerative processes . Congestion and decrease the amount of wound , is the development of granulation tissue and then scar connective tissue. Granulation tissue is composed of thin-skinned tissues and blood vessels. Wound healing occurs and tension. In the primary tension when the edges of the wound surface and walls close together, the wound heals quickly and without complications . Secondary intention wound healing through the development of granulation tissue in the presence of a large cavity wounds, dead tissue .
On the speed and completeness of healing festering wounds affect tissue resistance , local conditions in purulent foci and overall health. Accelerate the healing process following local conditions : good blood supply , innervation continuing . The presence of seizures in the outbreak of dead tissue , foreign bodies , active microorganisms impedes wound healing. The total resistance of the organism is determined by the state of its major defense systems , especially the circulatory system and the immune system.
In the formation of purulent foci in the tissues (such as abscesses, carbuncles, abscess , mastitis , etc.) is showing signs of intoxication. The body temperature rises , sometimes up to high numbers with a significant scale fluctuations , there is a general weakness, loss of appetite, pain in the affected area . In the overall picture of blood marked increase in the number of leukocytes with a shift to the left leukocyte , increased erythrocyte sedimentation rate .
Depending on the location emptying suppurative focus may occur through the skin , organs communicating with the external environment ( rectum , bladder, vagina , etc.). Abscess may burst into the cavity ( abdominal, chest , joint ) . Most often suppurative focus breaks out . When you exit the pus may come out self-healing . If insufficient emptying of the cavity remain long-term healing fistula. A break in the abscess cavity develop severe complications (peritonitis , pleurisy , meningitis, etc. ) . The spread of infection from an abscess can lead to lymphangitis , lymphadenitis , phlebitis , and sometimes general purulent infection - sepsis.