surgical procedures and management

Apr 15th, 2015
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Tropical leg ulcersTropical leg ulcers-Defn.Chronic ulcers of the lower limb which occurs incountries where tropical socioeconomicconditions pertainEpidemiology Sex ratio M:F 2:1 Age: 80% 15-50 years Generally 1-5 years before seeking helpEtiology Trivial trauma Secondary infection Anaerobes-35%-fusobacterium nucleatum/ulcerans Coliforms-60%: Pseudomonas auruginosa and proteusmirablis vulgarisAnaerobes act synergistically with aerobesFactors involvedTropical countriesPovertyPoor educational standardsMalnutritionChronic anemiaLack of hygienic facilitiesRudimentary agricultural toolsPoor medical facilitiesSigns and symptoms Pain- initially Peri-malleolar ulcerComplicationsPeriostitisOsteomyelitisMalignant changesStiffness of ankle joinCross union between tibia and fibulaChronic lymphedemaTreatment Conservative Surgery Debridement Excision and skin cover amputationDiabetic footIt has been forced upon me that diabeticgangrene is not heaven-sent but earth-born.Joslin (1934)Definition Any foot problem that results directly fromdiabetes or its long term complications( Boulton 2002).Diabetes,30:36,2002Etiology Neuropathy Sensory Motoor autonomic Vasculopathy Poor wound healingCritical triad Neuropathy Trauma Foot deformityis present in the majori

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