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cysts , ulcers and sinuses

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cysts , ulcers and sinuses . – PowerPoint PPT presentation

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Title: cysts , ulcers and sinuses


1
CYSTS , ULCERS AND SINUSES
  • ??.??????? ????????????????
  • ????????????????
  • ??.????????????????

2
????????????
  • 1. ??????????????????????????? TRUE ??? FALSE
    CYSTS
  • ????????????????????????????? ULCER
  • 3. ??????????????????????????? SINUSES ???
    FISTULA ?????????????????????? SINUS ????????? ?

3
CYSTS
  • ? KUSTIS
  • ? TRUE AND FALSE CYSTS
  • EPITHELIAL LINING
  • ? CONGENITAL OR ACQUIRED

4
CYST CLINICAL FEATURES
  • ? DEPEND ON SITE AND SIZE
  • ? PAIN ENLARGING (HEMORRHAGE
    OR INFECTION )
  • ? SUPERFICIAL , DEEP SEATED
  • TRANSILLUMINATION
  • ? COMPLICATION INFECTION ,HEMORRHAGE
  • TORSION , OBSTRUCTION, CALCIFICATION

5
ULCER
  • ? BREAKING OF CONTINUITY OF EPITHELIAL SURFACE
  • ? DESTRUCTION OF EPITHELIUM AND GRANULATING
  • BASE
  • ? NON SPECIFIC , SPECIFIC , MALIGNANT
  • ? ACUTE INFLAMMATION , CHRONIC INFLAMMATION
  • ? DELAYED EPITHELIAL HEALING ( ISCHEMIC
  • INFECTION)
  • ? INDURATED ULCER

  • ? NEUROPATHIC ULCERS
  • DEEP BASE c SHARPLY CUT EDGE

6
ULCER CLINICAL FEATURES
  • 1. SITE 6. BASE
  • 2. SIZE 7. DISCHARGE
  • 3. SHAPE 8. LYMPH NODE
  • 4. EDGE 9. PAIN
  • 5. FLOOR

7
ULCER
  • GENERAL EXAMINTION SIGNS
  • PATHOLOGICAL EXAMINATION BIOPSY , SEROLOGICAL
    TEST
  • MARJOLIN S ULCER CARCINOMATOUS CHANGE AT
    THE EDGE OF
  • CHRONIC VENOUS ULCER , ANY
    LONG STANDING
  • BENIGN ULCER

8
MANAGEMENT ULCER
  • ? ETIOLOGY ( HX , PE , BIOPSY )
  • ? TREAT UNDERLYING INFECTION , VENOUS OR ART
    INSUFFICIENCY , DM
  • ? ADEQUATE DRAINAGE , DESLOUGHING
  • EXCISION DEAD TISSUE

9
MANAGEMENT ULCER ( CONT )
  • ? NEW TISSUE COVERAGE SKIN GRAFT , FLAP
  • ? ANTIBIOTIC ( INFECTED , CELLUKITIC TISSUE )
  • ? CLEANING WITH NSS
  • ? IDEAL DRESSING SOFT , ABSORBENT ,
  • NON-ADHERENT, NON ALLERGIC
  • HYDROCOLLOID GELS ? LEG ULCER ,
    PRESSURE SURE
  • ALGINATES ? MODERTE TO HEAVY
    EXUDATES
  • MICROPOROUS POLY URETHANE FILM ?
    SHALLOW LESION

10
SINUSES
  • ? BLIND ENDING TRACT WITH GRANULATION
  • TISSUE
  • ? CONGENITAL OR ACQUIRED ( FB , INFECTION
  • NECROTIC MATERIAL )
  • ? FISTULA TWO END EPITHELIUM LINED
    SURFACE

11
CLINICAL FEATURES SINUS
  • ? ASYMPTOMATIC
  • ? RECURRENT OR PERSISTENT DISCHARGE
  • ? PAIN
  • ? MICROORGAMSM INFECTION BACTERIA
  • ACTINOMYCOSIS , TB
  • ? SINOGRAM IDENTIFY TRACT , HYPAQUE

12
MANAGEMENT SINUS
  • ? DEFINITIVE REMOVAL CAUSE
  • ? EXCISION FOR DIAGNOSIS AND
  • TREATMENT

13
COMMON ACQUIRED SINUSES
  • POST SURGICAL ABDOMINAL AND PERINEAL SINUSES
  • - SUTURE SINUS REMOUAL OF SUTURE
  • - INTRAABDOMINAL ABSCESS OR ANASTOMUTIC
    LEAKS DRAINAGE
  • LOCALIZED ABSCESS
  • PERINEAL SINUS
  • - POST PROCTOCOLECTOMY ESP. FOR CROHN S
    DISEASE
  • - OPENING AND DECORTICATION OF CAVITY

14
  • PILONIDAL SINUS
  • - LOOSE HAIR SHAFTS , FORCED INTO DEEP
    TISSUE
  • BY GLUTEAL CONTRACTION
  • - SINUS TRACT
  • - ADEQUATE EXCISION
  • - RECURRENCE ? 40
  • HYDRADENITIS SUPPURATIVA
  • - APOCRINE SWEAT GL. ABNORMALITY
  • - AXILLA , GROIN , PERINEUM , AROUND NIPPLE
  • - RECURRENT ABSCESS AFTER PUBERTY
  • - TETRACYCLINE , RADICAL SURGICAL EXCISION

15
CONGENITAL SINUSES
  • 1. PREAURICULAR SINUS
  • ? ASYMPTOSNATIC
  • ? INFECTED
  • ? INCISION AND DRAINAGE , EXCISION
  • 2. UMBILICAL SINUS
  • ? CONTINUED PRESENT OF UMBILICAL END OF
    VITELLINE DUCT
  • ? PERSIST IN PART OR ENTIRETY
  • ? EXCISION

16
  • 3. URACHAL SINUS
  • ? CONNECT BLADDER TO UMBILICUS
  • ? PERSISTENT , INFECTED
  • ? EXCISION
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