各种溃疡的鉴别诊断课件

单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,*,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,*,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,*,各种溃疡的鉴别诊断,各种溃疡的鉴别诊断各种溃疡的鉴别诊断,各种溃疡的鉴别诊断各种溃疡的鉴别诊断各种溃疡的鉴别诊断,WOUND TYPES,ARTERIAL(ISCHEMIC)ULCERS,VENOUS(VARICOSE,LEG,STASIS)ULCERS,LYMPHEDEMA(CHRONIC DERMAL DISRUPTION)ULCERS,PRESSURE(DECUBITUS)ULCERS,LATE EFFECT OF TRAUMA,UNCONTROLLED INFECTION,AUTOIMMUNE ULCERS(PSORIASIS,LUPUS,ETC),2,WOUND TYPESARTERIAL(ISCHEMIC,ELEMENTS COMMON TO MOST WOUNDS,VASCULAR COMPROMISE(ARTERIAL,VENOUS,MICROVASCULAR),REDUCED TISSUE OXYGEN CONCENTRATION(TCpO2),METABOLIC COMPROMISE,3,ELEMENTS COMMON TO MOST WOUNDS,ARTERIAL ULCERS,4,ARTERIAL ULCERS4,Arterial Ulcers,5,Arterial Ulcers5,ARTERIAL ULCERS,Usually have a“punched out”appearance,Full thickness defect,Most often occurs in diabetics,May be the result of embolic“showering”into the toes,Can occur anywhere on the extremities,6,ARTERIAL ULCERS6,VENOUS ULCERS,7,VENOUS ULCERS7,Venous Ulcers,8,Venous Ulcers8,VENOUS ULCERS,Most often accompany varicose veins,Most often affect distal leg and ankle,Are usually painful and heavily exudative,Are often recurrent,Exhibit varying depths,even within the same ulcer,Can become huge,9,VENOUS ULCERS9,LYMPHEDEMA ULCERS,10,LYMPHEDEMA ULCERS10,LYMPHEDEMA ULCERS,Are invariably foul and dirty,Surrounding skin is indurated,Are heavily exudative,Can expand to encompass the entire lower leg and top of the foot,Are usually infected with multiple organisms and yeasts,Occur most often in association with obesity,11,LYMPHEDEMA ULCERS 11,PRESSURE ULCERS,12,PRESSURE ULCERS12,PRESSURE ULCERS,Can occur anywhere following sustained pressure,Can become life threatening,Are often extremely foul and infected,13,PRESSURE ULCERS13,AUTOIMMUNE ULCERS,14,AUTOIMMUNE ULCERS14,AUTOIMMUNE ULCERS,Can mimic other ulcer types,Are often complicated with arterial/venous insufficiencies,Are common with severe lupus,psoriasis and pemphigoid syndromes,Are frequently recurrent,15,AUTOIMMUNE ULCERS15,ULCERS OF MIXED ETIOLOGY,DIABETIC PLANTAR ULCER,BKA PRESSURE ULCER,DIABETIC/ARTERIAL ULCER,VENOUS/ARTERIAL ULCER,16,ULCERS OF MIXED ETIOLOGYDIABET,ULCERS OF MIXED ETIOLOGY,PRESSURE/VENOUS ULCER,VENOUS/ARTERIAL ULCER,PRESSURE/VENOUS/ARTERIAL,DIABETIC/PRESSURE ULCER,17,ULCERS OF MIXED ETIOLOGYPRESSU,CONCLUSIONS,Single-etiology ulcers are uncommon,We should suspect arterial involvement in any ulcer that is accompanied by diabetes,Venous leg ulcers often have a pressure component and,in diabetics,an arterial compromise,Any ulcer may be compromised in the presence of autoimmune diseases,18,CONCLUSIONS18,谢谢观赏,谢谢观赏,