HOMOEOPATHIC MANAGEMENT OF COMMON SURGICAL INFECTIONS

Definition – Surgical infections are infections of skin, sub‑cutaneous tissue or deeper structures that often require surgical intervention such as incision‑drainage or debridement.

Common surgical infections – boil, carbuncle, cellulitis, erysipelas, hidradenitis suppurativa.

Boil (furuncle)
a. Cause – Staphylococcus aureus entering through hair follicle or minor trauma.
b. Clinical features – Localised painful swelling, erythema, fluctuant centre, possible pus discharge.
c. Management – Incision → drainage → clean wound; systemic antibiotics if extensive or systemic signs.
d. Homoeopathic medicines – Belladonna – acute hot painful red swelling; Hepar sulphuris – marked suppuration and offensive discharge.

Carbuncle
a. Cause – Coalescence of several furuncles, usually Staphylococcus aureus, common in diabetics or immunocompromised.
b. Clinical features – Larger area of induration, multiple sinuses, systemic fever, malaise.
c. Management – Incision → drainage of all loculi → irrigation; antibiotics covering Staph.
d. Homoeopathic medicines – Silicea – promotes complete suppuration and healing of deep sinuses; Calcarea carbonica – for patients with poor tissue resistance and chronicity.

Cellulitis
a. Cause – Streptococcus pyogenes or Staphylococcus aureus entering through skin breach.
b. Clinical features – Diffuse erythema, warmth, swelling, tenderness, possible fever.
c. Investigations – CBC, blood culture if systemic signs, wound swab if drainage present.
d. Management – Empirical antibiotics (penicillin or cephalosporin) → adjust per culture; limb elevation, analgesia.
e. Homoeopathic medicines – Apis – for hot, swollen, stinging pain with buzzing sensation; Echinacea – to enhance host resistance in early stage.

Erysipelas
a. Cause – Streptococcus pyogenes involving upper dermis, often after minor trauma.
b. Clinical features – Bright red, sharply demarcated plaque, raised edges, fever, chills.
c. Management – Prompt high‑dose penicillin → supportive care; monitor for spread.
d. Homoeopathic medicines – Belladonna – for sudden onset, intense redness and heat; Rhus toxicodendron – for itching and burning after initial hot stage.

Hidradenitis suppurativa
a. Cause – Follicular occlusion with secondary bacterial infection, commonly Staphylococcus aureus; associated with obesity, hormonal factors.
b. Clinical features – Recurrent painful nodules, abscesses, sinus tracts in axillae, groin, perianal region; malodorous discharge.
c. Management – Antibiotics (clindamycin + rifampicin) → incision/drainage of large abscesses → consider surgical excision for chronic disease; lifestyle modification.
d. Homoeopathic medicines – Hepar sulphuris – for tender, suppurative lesions with offensive discharge; Thuja – for chronic recurrent abscesses with foul smell.

Septicaemia (blood‑borne infection)
a. Definition – Presence of viable bacteria in the bloodstream with systemic inflammatory response.
b. Causes – Dissemination from surgical site infection, contaminated catheters, intra‑abdominal sepsis.
c. Clinical features – Fever, chills, tachycardia, hypotension, organ dysfunction.
d. Investigations – Blood cultures (two sets), CBC, renal and liver function tests, lactate.
e. Management – Early broad‑spectrum antibiotics → source control (drainage, debridement) → fluid resuscitation → vasopressors if needed.
f. Homoeopathic medicines – Echinacea – to stimulate immune response in early septic picture; Carbo vegetabilis – for profound weakness, coldness, and collapse; Lachesis – when there is marked hemorrhagic tendency and throbbing pain.

Pyemia (septic emboli with pus)
a. Definition – Dissemination of pus‑filled emboli from a primary focus to distant sites, producing multiple abscesses.
b. Causes – Deep‑seated infections such as osteomyelitis, infected thrombus, or severe cellulitis.
c. Clinical features – Multiple painful nodules, fever, signs of organ involvement depending on embolic sites.
d. Investigations – Blood cultures, imaging of suspected secondary sites (ultrasound, CT).
e. Management – Same principles as septicaemia plus drainage of secondary abscesses.
f. Homoeopathic medicines – Carbo vegetabilis – for extreme debility and foul‑smelling discharge; Hepar sulphuris – when pus formation is abundant and painful; Belladonna – for sudden high fever with intense throbbing pain.

Role of Homoeopathy in surgical infections – provides adjunctive symptomatic relief, may enhance host immunity, and can be used as supportive therapy alongside conventional antibiotics and surgical measures, especially in early or mild cases and for chronic recurrent conditions.