Ludwig's angina drainage

Ludwig's angina drainage is used for the treatment of extensive oral cellulitis. The anatomical range of this gap is wide, involving the anatomy of each of the bilateral submandibular space, the infraorbital space, and the sublingual space. It is also mainly odontogenic infection, such as periapical periodontitis of the jaw, pericoronitis of the third molar, and stomatitis; followed by acute osteomyelitis of the jaw, acute tonsillitis and trauma of the jaw, oropharynx soft tissue Infected later. The infection develops rapidly and is serious, which is closely related to the pathogenic bacteria and the body's resistance. Most of the body's resistance is extremely reduced, and a variety of pathogens take advantage of it, causing the infection to spread quickly. The pyogenic bacteria are still mainly Staphylococcus aureus and hemolytic streptococcus in the maxillofacial region; the pathogens of spoilage and necrotic infection are mainly anaerobic spoilage and necrotic bacteria. Treatment of diseases: acute cellulitis, cellulitis Indication Extensive oral cellulitis is an indication for surgical incision in terms of its clinical features. Contraindications There is no absolute contraindication, even if the general condition is extremely exhaustive, it should be cut open or cut decompression surgery while correcting the whole body condition. Otherwise you may miss the rescue opportunity. Preoperative preparation 1. Active rescue, should promptly correct systemic poisoning and ensure the smoothness of the respiratory tract, if necessary, do not hesitate, decisive for tracheostomy. 2. It is necessary to apply broad-spectrum antibiotics in a timely manner, mainly by intravenous drip, and to deliver fresh blood, plasma, oxygen and cardiotonic agents. 3. Correct the metabolic acidosis in time, usually with 4% sodium bicarbonate intravenously. 4. When using antibiotics, there are drugs against anaerobic bacteria such as metronidazole and tinidazole. 5. Drainage or decompression should be cut early to reduce the absorption of toxins. Surgical procedure Incision Make a large incision from one side of the mandibular angle to the other side of the mandibular angle and parallel to the lower edge of the mandible. If necessary, add a sacral midline plus an incision. 2. Enter the abscess Cut the skin, subcutaneous tissue, platysma, and blunt dissection with long curved hemostatic forceps. It is necessary to extensively and thoroughly separate the layers of the bottom of the mouth, so that the gaps of the infection can communicate with each other, so that the pus in each gap can be thoroughly drainage. 3. Flush After repeatedly washing the wound with 3% hydrogen peroxide or 1:5000 potassium permanganate, a drain strip was placed. In the case of spoilage necrotic infection, the muscles are dark purple and anoxic, and the bloody secretions with thin bubbles are introduced from each gap. It is necessary to cut the decompression more fully, and wet the dressing with hydrogen peroxide or 3% hypertonic saline gauze.