Classification Vascular → arterial → Lymphatic → Venous Infection → Chronic Osteomyelitis...
-
Upload
greyson-strutton -
Category
Documents
-
view
214 -
download
1
Transcript of Classification Vascular → arterial → Lymphatic → Venous Infection → Chronic Osteomyelitis...
Classification Vascular → arterial → Lymphatic
→ Venous Infection → Chronic Osteomyelitis
TB,Syphilis
Systemic DM, Sickle cell anemia Neoplastic Sq. cell carcinoma ,
Melanoma Metastatic Traumatic Radiation
Classification
Pathogenesis
Venues 40% arterial 20% others 40%
Venous Ulcer
Pathogenesis :-
Venous hypertension ------ 1 ry reflux 70% ( genetic)
------ 2 ry reflux 30%
(DVT) W.B.C activation V. Hypertension Or
Fibrin Cuff
Dermatolibosclerosis ulcerationulcer
Diagnosis
History up to 35% of the adult
population have some of the following V. Disease , DM, T.B, tumour ……… etc.
General exam ------ Anaemia (healing)
------- Jundice (tumour )
Local exam Site , Size , Shape and Edge.
Investigations
General: C.B.P, W.B.C, E.S.R, C.R.P.…
Specific: according to the primary diagnosis
Vascular Duplex Infective C & S
Neoplastic Biopsy
Investigation
Duplex Study Arteriography Plethysmogaphy Ascending Phlebography Descending CT Scan Isotope – scanning MRA
Treatment
General Treatment
Conservative
Topical Therapy
Surgical Reconstructive
Debridement
Skin graft
Treatment
Conservative Bed rest + limb elevation
( effective therapy but impractical ) Drugs-------- Zinc
------- Pentoxiphylline
------- I.v. prostaglandin
Treatment
•Gradient compression =Dynamic ( unna boot )
=Static: -
Stocting , - Multilayered elastic
wrapped dressing
Treatment
Sclerotherapy: Foam injection
Treatment
Surgical V Vs surgery:
• High tie
• Stripping
• Perforators ligation
• Multiple avulsions
Treatment
Arterial bypass. Debridment. Skin Graft.