More Related Content Similar to Ulcers & wounds Similar to Ulcers & wounds (20) 2. Definition Wound Breach in the continuity of skin or mucous membrane Ulcer Persistent breach in the continuity of skin or mucous membrane associated with cell death 9. Management of Wounds Incised Primary Suturing Lacerated Excision & Primary Suturing Crushed Debridement, excision Delayed Primary Suturing Deep devitalised Debridement Secondary Suturing/ Grafting 10. Compartment Syndrome Calf, Forearm Closed injury>Hematoma>Increased Pressure/Fracture Compression of vessels Pallor, Paraesthesia, Pulselesness, Pain, Swelling, Coldness Rx-Fasciotomy 11. Crush Syndrome Crushing of Muscles>Extravasation of blood>Myoglobin release Earthquakes, Industrial accidents, Air crashes Renal failure, Toxemia, Septicemia, Gas gangrene Rx- Multiple deep incisions, Mannitol, NaHCO3, Hemodialysis 12. Degloving injury Shearing force between tissue planes as traction-avulsion One or multiple planes Machine, RTAs Debridement, Excisions, Dressing, Grafts, Flaps 22. Wagner’s Classification Grade 0- Preulcerative/Healed Grade 1- Superficial Grade 2- Deeper to subcutaneous Grade 3- Abscess formation Grade 4- Gangrene of part of tissue Grade 5- Gangrene of entire limb 34. Base On which the ulcer rests Palpated Indurated in malignancy 35. Traumatic Ulcers Anywhere on body Limbs-Shin, Malleoli, Joints Chronic- Staph Eg Plaster Sores, Dental Ulcers, Footballer’s Ulcer, Skin burns, Caustic ulcers 36. Arterial Ulcers Inadequate skin circulation Limbs- Repeated pressure/trauma Causees Atherosclerosis- Ant & lat legs, Dorsum, Heels Buerger’s disease- Painf, Claudication, Punched out ulcers Raynaud’s disease 37. Venous Ulcers Commonest on leg Medial lower 3rd leg Pigmentation, Oedema Causes Varicose veins-Perforator incompetence, Stasis DVT-ValvelessRecanalisation 38. Trophic Ulcers Neurologic deficit, Impaired blood supply & nutrition Sites Sacrum, Heel, Buttocks, Occiput Bedsores, Perforating Ulcers Causes Diabetic Neuropathy, Paraplegia, Leprosy, Spinal injury, Peripheral injury, Peripheral neuritis 41. Tuberculous Bursting of Caseous LN Slightly painful Neck, Axilla, Groin Undermined thin reddish-blue edge, Sero-sanguinous discharge & induration Enlarged LN Lupus Vulgaris- Cutaneous TB- Face & Hands 42. Syphilitic TreponemaPallidum Hard Chancre- Ext Genitals Painless, indurated base(button Like) Nipple, lip, tongue, anal canal Secondary- Mucus patches, Condylomas Tertiary – Gummatous (Subcut bones) 43. Malignant Marjolin’s ulcer SCC from chronic scar Malignant Lips, cheeks, penis, vulva, mouth, oesophagus 40 yrs+ SCC, BCC, Melanoma 44. Others Soft Chancre- Ducreys Painful, Ext genitals, with Bubo Meleney’s Ulcer Post-op- Perforated viscus, Empyema Thoracis Strepto & Staph, Abdomen Martorell Hypertensive, Old age Post calf Bazin’s Women 55. Treatment Treatment of cause Correction of Deficiencies Blood transfusions Pain Mangement Debridement, Cleaning, Dressing Antibiotics Suturing, Grafts, Flaps
