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Classification Vascular → arterial → Lymphatic → Venous Infection → Chronic Osteomyelitis TB,Syphilis Systemic DM, Sickle cell anemia Neoplastic Sq.

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Presentation on theme: "Classification Vascular → arterial → Lymphatic → Venous Infection → Chronic Osteomyelitis TB,Syphilis Systemic DM, Sickle cell anemia Neoplastic Sq."— Presentation transcript:

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3 Classification Vascular → arterial → Lymphatic → Venous Infection → Chronic Osteomyelitis TB,Syphilis Systemic DM, Sickle cell anemia Neoplastic Sq. cell carcinoma, Melanoma Metastatic Traumatic Radiation

4 Classification

5 Pathogenesis Venues 40% arterial 20% others 40%

6 Venous Ulcer Pathogenesis :- Venous hypertension ry reflux 70% ( genetic) ry reflux 30% (DVT) W.B.C activation V. Hypertension Or Fibrin Cuff Dermatolibosclerosis ulceration ulcer

7 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.

8 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

9 Investigation Duplex Study Arteriography Plethysmogaphy Ascending Phlebography Descending CT Scan Isotope – scanning MRA

10 Treatment General Treatment Conservative Topical Therapy Surgical Reconstructive Debridement Skin graft

11 Treatment Conservative Bed rest + limb elevation ( effective therapy but impractical ) Drugs Zinc Pentoxiphylline I.v. prostaglandin

12 Treatment Gradient compression =Dynamic ( unna boot ) =Static: - Stocting, - Multilayered elastic wrapped dressing

13 Treatment Sclerotherapy: Foam injection

14 Treatment Surgical V Vs surgery: High tie Stripping Perforators ligation Multiple avulsions

15 Treatment Arterial bypass. Debridment. Skin Graft.

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