SYLLABUS [Link]. Topics Clinical GENERAL SURGERY 10 a. GENERAL: i. vi. vii. viii, ‘Anaesthesia types, Effect, indications and contraindications and common postoperative complications Haemorthage and Shock, classification, description and treatment Water & Electrolyte imbalance Inflammation —acute & chronie-signs, symptoms, complications & management Wounds & Ulcers, Cellulitis — classification, healing process, ‘management, bandaging, Dressing solutions and its uses and debridement Procedure, hand washing and universal precautions. Enumerate Common abdominal surgical incisions — classification, indications, opening — closure, advantages and disadvantages, complications (including burst abdomen and feacal fistula), minimally invasive surgery. Mastectomy and oncosurgery— approach, complications & management Amputation — types, sites, complications ‘& management Burns ~ causes, complications, cation & management veins and PVD Hemias-surgery, precautions and complications Transplantation approach, risk problems related to donor and receipient, precautions. 10 iv. NEUROSURGERY Head Injury — management |. Intra cranial & Spinal tumors |. Intracrani: ‘Aneurysm and AV malformation Post operative Neurosurgical careSr. No. ‘Topics: Didactic Hours Clinical i © ENT Surgery i, Tracheostomy ~ indications, surgical approach & management ii, Surgical procedures in VII" cranial nerve palsy iii__Vertigo d. Ophthalmie Surgery Surgeries for I”, IV", VI" Cranial Nerve palsy ‘CARDIO VASCULAR AND THORACIC SURGERY is a. Introduction, Cardiorespiratory resuscitation, cardiopulmonary bypass, Special investigation procedures in cardiac surgery, Basic techniques in cardiac surgery approach, incisions, Types of operation, Complications of cardiac surgery, Lines, drains and tubes. b. Brief description of indications, surgery, complications for following surgery : i, Surgeries of thorax i, Surgeries of the lung ii, Surgeries of pleura and pericardium iii, Surgery for coronary artery disease iv. Valvular surgeries v. Surgery for Congenital Heart Disease vi. Peripheral arterial disorder, Burger’s disease, Raeynaud’s disease and Aneurysm vii. Gangrene, Amputation, DVT PLASTIC SURGERY / RECONSTRUCTIVE SURGERY a. Skin grafts & flaps — Types, indications with special emphasis to burns, wounds b. Ulcers, complications and postoperative care c. Tendon transfers, with special emphasis to hand, foot & facial paralysis, & repair of Flexor & Extensor Tendon Injuries 4. Keloid & Hypertrophied scar management e. Reconstructive surgery of peripheral nerves f, Micro vascular surgery- reimplantation and revascularization ‘CLINICAL (10 hrs) OLBay Spb horgunt Ae [ou 85}| Farlow affecting waund YT haohisgs” C5 24 @®) 86h Lomyalicatians of blood tnorsptian [524 532) Horgan - = Compplicaliore—__— fgg 5G, | Dercribe Varaus edges al oy tere) —[fr1u21_ ah Varccore Venn - CF fat Burgers. disease. |72 fan He Spihecomaidl Lys) Zl (oat Burro ~ Dehra Delorsily Describe Prspio = ———————— | Pleamerphic Adenema FO Loves 61%| Bronulation Tinue 22. - _£w23 Skin byrelp -clorifization ® Indication [524 47 bum potiant. [524 Z| | | | , £8 RE BR \ Reh | | | :ANAESTHESLA Dep,” => Tp as 0 State endured lo lemporonly block Ue Senbolion of Fuornen typiolly wed during Surgital tot Pedizal Prstecluce . Tom be achioud trragh Meditation called Anarsthetic, which Wark by Rikeclng Nevuawn pystim Clonijizalion =% Fate B-Moin Type © genesal @ Regeénal Q) sperotk @ idurad o(feazal Pracshast] > 7 porn abl ol sadn tah Pain, Partum % Temp tuuth o State of Rouswibla ler af Cortiaudrwd Th ho» got 3 comporunts’s Analgesic , Hyprents , Pune aelexore! 27 Pnawsifutia fiyerts :- i? Valatile fractrulic. wpGartaus Proesthelicr Wy Fahour 7 Paty VoPauidt tn Room fin Nituoun oxide are > Mer, GY? Muepentont % yceprapone sat Paoprofot i : Jenlory Mune Repco ?- (MR) Depalorsing PR “7 Thay ockob level of fcr axceptor ushich uidlon Melee Pend af Musee. 09. + Suxometbonivrn culeuge Non Deyralowing mp “7 Tey blak the Chomrreh of enluy O} fier Pry ou bong fdig « = 4 '- Foneuonivm Vecuroniam jfeunenivn a BEREEEe| HT Lge Uv TT“? Rersaval Agents * Thay ont ontichelenestrrose daugs which incruore Unt Ach , thos Qt ar onlagenising agént ‘or Non-depslorsing MR ? Thuy Caune Brodytordia ©]: Nesntinmine commonly vod ath obnapine Edraphenium Pyridestigoni General Anracatheria Indication => |y major punguzal Proudure Complication Wadoruvial Surgery It Hypertension U1) Theroeee Soagey 27 AROS IY Neuro Sugey 4 Respi : . pPrrabory. Jatlure 2? brrecpentits 4 . 7 Pobird joctre Aen ; I) Arnel Cardise annhythrnia Usemtospuatice poteerd ee Loryagtal & Drona! Sposrn- 4 Drucott proudune : Aiugional Frnoestrwsial Did 0. lype of onarbrasia Urs lrsprorily black» romeation ino specific. Ragcon of Dre body while allowing Paliin! lo atrmatn Contiao pou ustd 27 Ligmocatnt , Vaaint ; Protarmt Frdicotion > 17 Surgual procealunes of Lawn Limb Surgerien by uper Lin surgerten a widd bth 3° Orienic Pat monogement 40 Pos ip flain conthol PPA ARAMA ASPinal Pravrthesta> Tt iso injection of local fractthshis inf, Yt Subarodmerd spoct (aoing les of symp lene, Semrokon 3, Motor lunctian = The xyrapoatetis blosk to 3 Segaritnt higshee Uson Sortoxy block, Males blak & 3 regment laut thon Dtnooy black | Quip uci =) Lignetaine ; Bupinecaint , nthacaink | Aduontoge Dieaduortage Cortraindiiation | IT Econeynical 17057 look WPlordint Poliint — | 2? Adlequate (oloaoliin in ovhd 2? Irofpttion 2 $0pdi0 ‘Spinal Tumor aap conpliston os las WMeringtom 3) Bask Pain 4? Ponopligta, 4 Sprpal discon: pl | Qidunob | Pt is0 palentiah spre ble das by | |B Ligomentim Yourrn porteiory which hous migalis Promos iro fduontoge 7 Wed lor Continous uptaled Paolonged Prassthsio. > lon be used Jn Poor ap amcalgetc > Con be Kept Yor borneol dos i WJSHOCK 2 Types (chowsification) cy Shock@L 645 9) Hypovalemic Spork @ [18 ® Debint shock 8 cloily Yorvrac ty [-w20 RQ Sppbicumic Shock~ C4, innealgation , ponogimerd Eo O Hypeuelemiz Sock cous ‘@ [524 D4" => Trin Selina a's WB cof Lirdue Belin hpi luuibe, cite nadesced exygen delintiyy @ 2°" CTE" wlilisalion 0 vntwored. Or tonouaplion with cbreullatosy Jailu Pact prrfuoiew =) Nowmal metobalic (Perobic) in nob mointoined due by hyparefusion * Ghock lo meort by imadequoats Perluotion! bo maintain ound oxgan Yynf DIhi cnibally rovnsible but becomes inanerroible eutrituclly if net bealed leading Mult gen laibusne % death. Elet> af Sheth => Hiant + Late petvoron Late VR > os Cndice > Nypatoion 97. . Lungs! Tntunlitial oedema? ¥ gorau txchonge Ffachpneea> PROSTine af Shack =? 7 type 4) \osov0gal sheck ;- Lt co sudden dilatation o pouphaa & Splamehmie vessel Caurong se Candeae wutput ond Shack ney be lye Urreatering due to Hyprda 1y Nenogenic Shock '- Th is dus bo spi lod trp which Couns dilatation of, Splonchnte \isooly 2 Thou will be Bradycordia. ,Hysratension ve 6O,Rabylna 2 Tualed wilh \avatenshicter Duugs x ; ‘ | HyPouolaeme Shock | Haemeanhoge may be due b injury b the Lnive, Splom, Done Jrockex? Vorculor injury f ? Vomiting » Diorrrata dus to ony Cause TYP 0 <- 1} Cour’ omponvoted Hyeralemia. NV ute? Comperiatid Hypanalemia INDecomperaled Hypeuclomea, | Lina! Fealuns '- In Sorly dtoge *¥ ta raceme ali, Tn tobe tages => Cypnevis,orunio, Taundlis , daausired =Vkicatlion :- PAR OS "y Roop Jatlune MW? Revol failure I? Ler ailut V> Sleep» ulen WP Hyponcio- WY Condiogente Shack :- Def"=) This o tixulatoy, Iailure casing 27 Tt & lernmenty jeom in Heute ME DPDPPD.D. aan a» a REEL ES 5? Cardise Compassion Shock * Th in prabobly. aus ty prrizordiak Tompenade , hunting of gro vert Morne pulmonary Embaliom - & Feature f- Tathytordia , Hypotension , Pulmenaye atdema . 7 eS & & 6) AnoPrylocliz Sreck *- Om} '- sudden & a Droncresposm, Yernralirtd Rochen , ledime. < Hypolenoton , ecb puboe e, ee = Martality 107Tr Geplic Shack ‘Zt 0 polenteally Jatt medial tonditian, Yrdl cectunn whin vepsie leads te dongerourly law GP 2 Abnevmolitivs in ollulor metabalism Caucilint worgariom !- Grom be-ve) REve) Grgaratona , Yyngi Vinny =7 Septic Shock wo Lytally a Varedilatoy hock usbrore in Peripheral voredilatotion tausimg Hiypatensiem VUUdee eee > & peme } Blood Text 2y Tmoge Studia 3} Hakmedapromic Mentoug uae oy (HC 09 chet X- Poy oy BP. SS 6 Blocd cultine bY wltroraund b> doaduat coutput me Crk ET CPT MRT Yon GY Gntaal venaur Uaifgin meme SLIT ; Saburoton (4y% — peeeg (OUD 3 - IBocdouial Infection (Post common tan) — 2) Healhtou Arroiated Infection — 37 Fumgal Irfecicon ( Condudla — 4 enol Infection Ccouid 14, Influnmga. a! |) Porosikic Infaction e | a =? Sloges of Seppe Shack _ oY Hypedynomic (worm Shox BY Rypedynomic npouclome Splic ok — J Abd oferurviblo otoge 7 Tryttervible stage FT 7 Salloratory fropor isd) 7 Pysopnic. axporee io abort An 7 Fenn lodryoroia % FT Terypnaia (tn) Cy ese Paige Resporme b© Treatonen! *— > Covreclion of uid ® Slactralyte by Cypelia bab ami ? Antebiatics (3°9 gen Cephalespowm AAVQ\ANAQAReY ? Treat count or lots ~ drainage of 07 abner 7 Paw, wine ,bload, bile uultune 7 (teol Cort, e2ygen, Ventilator duppor , Nerodrenclnt 2 mamta OP %& wurt cwubpul ~ fictuated £ poluns proven wheat of xllomonatey, Mehitn’ => eniter te potiont by Plt exmety , Condioe stotvo, wun cutout frttial Blood yoo onal poTINILALIMATION LNILATUUATION Dey” *- Diflommalean & delimtd on Vu local Response of being Gapanismr—te Mommaton Larue lo Injuy Trem ony agent. De i tre body's defent Maction in (order to diminate 07 linyip Lit Spread of Taj uriacs ager? Type :— Depending upon Li delpnse topocly af tne hao! 8 duration of eoporce dtimaled tro 2 type AD Acute Irylommalion > Ty off shart Duration [ leon thon [Link]) Main Jeabunts !- i} feaumulakion of Und %plosme at offedsa side iy lrowortulor oclevation | Platelets lily Polymeyphronuclior néutrephils od Cnllorrmeate, ab. % hermit Frflommatiinn > larger dunakion Bosco afpe delag 7 I] the caridine axgoniom of Aeute tnllorimation Ptrrish ln long durotion « 2 bum Y, Irflorametion .- 17 fubsr (Redness) UT dumor (yucelling ) UIT @lei > (heat) \v) deter (pain) « VY Los of, YoochionV bacaleged Sgmplon Ny Spslorné. Symptom °F Redness 0) Feuer 8? Ouelleng 07 Fakgue &? Heat cYHeodact 9? Pasa d) lunes achts 270% of Jurebion =7 Monogement 1 Libe styl. edification 27 Medizabions ~ Exercise regulorly - NSAIDS - Monoge olesod - Corkicoterad —Anli inllornatory Du - DMARD ~Mainlacin 0 healthy wtight ~ Blabogics (TNF inhibitor ) -Arldiotormme 3y Meduca! Ipatemention Ylomplicalion Physical Thenohp 1 Chaomic direose ~ CVS dedeones - Cold & Heot Trenopy Diabeles - Surgery BY Tisouty aunt Pomege - frathrnitis Fibrosio 4) Splomic. Lompliotion - SepdioWOUND 2X WouND HEALING. ° Aoostfication of waund @ [516,518 ” Lied healing odds @ lwis >” Ubaumd bdged @ [wit * useuind heading @ [519 57 Stages of heabing @ls3 Ol 8 OY) bw Tidy 8 unbidy vuatnd. Momogeran of feale wound @ [wa3 1) Tactows Atlching wound healing @ [524 Deh” :- This 0 batok im dnbegithp of Vt Skin 1 Tare ofen a which may be oxpaciated with dinuplion of Vet Shuctne ® °° buntlin . 7 blaund to Simple dionuphiom a omy Tisdut ~ Sap laste @ On bom 9% Ualernal Ogor ~ ylenr b ober o lype a wound. 7 Ue to dionuplion on buak in continucty. of ony bis oT omay be Slum , mutouw membore 0 other» . Cla»ification of waundr ae wm 7) Bonk 8 wakefield clonilvation ~ me Tey town’ |__brutly wand ~~? Lusund in coustd by Shop abject tuaund in caused by Canning, B® -7 wounds ov Like Sugual Incision Pyare 3 Vantulor njury = Proce ; mp “7IT io urcined , cleon, Hedthy wound : ad umaledyirg tort may ‘ ony lao of tispue be Pwsens = : > yraund infection bdelayed = > Pumoy Sutrung dont : binp be Tiong = ? Secondo Suleung o done => = = TO IL? chosnilication loved tn 7 luaund - A? Cheon trxived wotend !- Jp vr 0 Simple, leon, tidy ea > Peaured dus ty ShorP abject = 7 Tutated by parmoy. suturing = — Dh Locrated wound :- I+ he» nogged edger with some Pon a the Te dinput + gettong deuttoliged a a CY Brute 1 Contuvien !- ~ Th eceunn diss ty bloat blot jus bt F Blood veel undemeath ov domoged - DY Hasmatoma Tb is a locolized Collection af bleed after blunt Luma b afin wey. ous vy |” Reromon 374 0 suyperjival Injury 3? Punctore wweumda Bites PZ anuall 0 otob yuavnd waidh Pointed cabject. © cewoh envy U Teochion ®ovuloion Taji O Gumshot Fava W Irjurp by Wome, Prkery ,Vein ,dotpe organ TL Y Clorifization bored on Thickness af wound ipSupericial vvound ‘- involing only qpidennbs % dame papillae iTr Rental Thicenes» :- tuound ib Sty lo» uple dermis MF Michrsd 2 wind with lowe Ontne tin Bsubeloran NY Deep wound i They tatlond daapee accor dip bia in macct. V7 compliolid wound ‘= bsaund LiLDh jay te News om blood veel | Uy ponsteaing uaurd :~ This usswnd pirebrole “inks Neloal or contin tr Organs -wh Wit IV} Clospijization bond tin bmbohutmint Of Styutture I? Semple wound Frualving only ant tegon on Linus Witit i i i : ; V> Closilicatian Ulared an Teme CLapyed T} Reuke mound *- Sram bypical sygp a heiibess Quralian Ley thon 4 week &9*- Surgial o barmalit waund 7 Healing aceurs in Leimelp Rordely, loshen 2? Unenic weund"- lwaund ip Conridered Vrronc if heabig daw net acer within expected prod of bat. Chron utadind 02 of Type! > Atypical type TTT viy LU lauds 17 Clon waund. 27 Lean tontominoted waund Al 37 Cantominetid waund Ei WHa. ee . SLE Ob Wound Healing A ” Parry taking (Ft tin) ? Gccand inn Cleon tnined asund 6 maga woterd: 7 tsound edlger ore oprutiratid with Sutures TF Utaund heals nopidly with Complete clone P Geor will be Lintor , goneath ® sypple BY Secondo Healing (second Inibnbisn 7 DP teceens to 0 tuaund with Crlenriut Soff tabu Lebd “7 Hoole slaudy with Jitrori 7 ltods b nude $lor , pr moy Lead bo diobility C7 Healing by Third Intention (Terbioy Ward heoling 27 Athen sound debudement 8 Corttealo| lea! érlection , wound bo cond with fulue on counted ustrY hin Yrayf > Puirory Contorrinated lire wvaund heal by 2 enbonbian=> Slagee_of lsaund peop WY lage of bronulolion linpue Vem % oyanisalien i) $loge eo eplhelesation IVY Stoge of $400 levmoation & Reye-plon 27 Yacdors Making tuoond Henled A desol cs, OY gore lado “ik Galeclvon Ire» obey Smoking > wn) Poor blood supp 27 Anema INY Henemotorea 3) Molignory IW) Tisous Loroior 4Y Unaemia VY Prorence Nenotic trout 57 Joundz b7 Duabetes 17 HIN 8 vatonin Dri 8 9 VOUT TUCO UCU CUT eee eee eeSRuagenont tf taund. ” Feist Ure wound i> onened prspurly only ther luntheor Leatmert off the wiaurnd jy duided 1? usaund Cloning :- sr aplimins Un tuetind htaling Omiscnr™y % waund bed prapanalion . Zivally ct in dove bn antplic Cnditiond . Waumd dioning is doru with Saline & Yun non-sticky duning bb placed. Funtier beeatmen bi 07 Ath istics 67 bleed Frombjesten [I] ture to exceroin blood Lory] 6? Cectalyte moragtment dF Yelorus Toxaed Fp)schion 4) Anti tetornd YobudinSCAR Tg QT Hypechaphic Scan Momagerntre! @ [sn = QP Diff blu Hypabrephic $001 & Kelaias @ Lue Dy” :- Gton in defined, ar Javmation of Ynal alowed , tandemly arrayed callagen burdles (ype!) with Iprmati, of Matund sar TV Tnitially cmmatue $101 io Jerrad dining numedeling Phase this Stor See % dinengonised & contain {yet callogen Se 7 This S01 by ralved , ley , pord & pink om lola oe —=e ui > Maluad Scou 2D Sob}, supple pale & Yat without ony itch ee 12 Wf Flor ‘- 1) Matune $01 we iY Aleophic Sor —a ill} Lyypeetrophc olor crammed Wr Kelaid = mmm =) keloid :- Jt lo Che oxcersiue abnovmaly Strte/ad callogin 3 Linut bundles arranged with aligning un tht Sor plom on the epidermis but extondo beyond the wnigindt flor morgin which Cortinuns ty grow for longen puted > keloid b commen mm plack> & ymale 7 Th adiurd dut tb dolttt im maturation § stabilligation bb Gllagen Yibails PTE eeeFela :- Common our Slam ; eye anon, rial sell Pillrnentiol Qiagresio ‘- ~ Mapetephe 2° Teeeabrnent '7 Slecaid injection = exeidin- Shed YO? 2 Methatuccats \Vik A BC Brerapy o” Kebaid Y sibione Gd vucting 4 Loner Theropy BY Vit E/ palin aotl raosrage = Ruuvune nate b voy high 2 Hypeabuphic Sor Dh in the bmi Jormation of abnowmal $lon taoue conloining ype il ebllegen alin offtn Vascular but confond iter te Mergen of orginal yand -7 wtiwr onyher (2) be body Growl unually Unita upte 6 morthe 7 pris flals- braun vr colour , Not patnpsl rontonder b Corner nents conballed by. Prune Gourds > flouioven kyon af $to7 > Une. 3 Wiomtinaot inj iy tu #9 lst of pp Ja Hyptapic son dgmplivohion = Often brio stor bas asptatedly & carry. injection 7 Mr feptaed breatdaun Lt may buen tate Morjaliry's lax>= ULCER. ape @) Come tleer, bo forks with Diaguorn % dasrificatiion [si6,. 2 Mes 2) Ulex Dischorge @® bwie : —~> 27 Ekdalogy of Peptic leer Dineore © [ay TE 4) Arn ulcor @ [20 =a 5? Tnaphic ulcer - Elisbogy. ,Monagtment? QB) [w22 | 6? Vanicooe wleer - £245 i : — Edialogy |, investigation RMorgemint © [wre <> 7? Diabetic Joa! ules ~ Monagemsr! 8 Pwuntiog O Duo — D¢""- An wlter és 0 break in contiruthy of the Couseing G2iteliung , tithe skin 071 mucad mumb de ty Maleuler duath mame fort of on Ulcer :- - —e i Mangin : Tr may be nagalor or inugalon «| : el 7it may be naunded on auak ft E r 7 sem lit Edge : Zt conmeds the Yoo of ularly mogin \t pt, 7 Yo] dquo :- Hopping edge Jtes en -Pardud aub edge — ~Raiveh® buabeh edge a ~ buerted edge > — Vil} Flows ¢ This Uv one which ipneem. Tr 7 Hlon may contain desdrorge, 4 : wach Leu Cor Alougs a Vd Bose * 7p is dhe one on which ulen mesh |Chay a: Levitation ” destination | ain I g Reedy ween - ” Hose edger ane inlomoed , ianugulor 8 txcleraatiaud PT? bs 07 Feute pasnlel wlewr , 7 Foe dss nab conan aly Spomlin tas 04 CEE — Prowler dothorgs © Slabs 2 gal pn nde ou tg 8rd do les 7 Ther in annociated Jouer, frasin, iarpadzorent! of unclinn / SS pw to local disbrction of tans little enidanes ol aepenein 2 weer 2- Edge ts vloppy with paallly perk aed Matty, Hage fy teh wh Zhe bo b¢onty /minimal Secu disthorg in Livan . 7 Mginelgnoh ce ey mer ne be elerge bo i lege alusays nonr tender. ‘ ; 5 yp B tons ore eboemued un healing wer i} Darewodt wud Tort af heallly portation Lisnue. jip middle bluion 20nd 84 yrouing tpthilsin jfiy paler wsulish Lone of Jibrar® Non- healing uléer:- Tt may be 0 chose ulcer How edge will be dependug 07 UY au ? Regtinal byenph mock vay enloaged bait 1007 ford Huet Tee + callow (sltionny) ule TH iso monte normaly = F Wor contains Pole unbsalityy, abby witioh ommelation tan % thin Stomly Sera» ditharge > Bove io indurated , portend» % offen Yaed. STP > len do rab shaw omy tenleney. to heok- ame J} lost Ya, mabits bb yeor- ame => Clovification I Cored on Carat! i i metas ey meme 1 tule ulin! Durgtiag leo Dhon 2 wtek - = Te 2” Aone ular 2 Duration is mov Lon 2 wiek. — ma 77 Conifization it (Fatholagicol} =” I Specific. uber? Tubereuour nypriltiliz sr ae =— WMiolignen} ; Palonatis, Carcinemataud Ti, 27 Non specabic ulcer: Taaumalic ulesr ee ts Aberial ule. Nabe uletro=> - WAYNER'S g Raving. 5 Grade 0 - Hoaled wen Grade 1 - Superficial uleer Grade 2 Stier ap) chinames ions pig of § Laout 02 bone. Lrode 4 — Hbvecer Yormation — fyade 4 — Longrene of part af the tisrue Grade 5- bangur of enliie or arta. =) Monogement af on ule “> Cause orould be Yound > tasaled! > (ometluine of oroemia. Aefjcienestd Like of protein > props umusligation 00 nesiced > Thonn tuoton of blood il atquustec! > Control. bu fain 8 infution ‘ > ost ommnob dgnmobiligption , deuotion , cugidonce af atprated Lrauma - ap (oe of wlisn by debridement, ulew dong ® chiming a af excurtird fporulalion biput => peer Ueoning % dresding to done daily.> Trepiol ontbistico Yer trfected ules ? Noceusme fyisted Closure (vac) Prnapy 7 Pmnien to Promete 1o-epithalalsabir UUUELEE eee! Ht X t cS H | a 7 Magget debridement therapy. CUE 2 T0ppic wlicr (trarsyre $or8) i PD Pasrvvre dors to Lupus meeravia dutty \wlevotion dus t prelorgd Pusu TS 7 Ulood Unw st92 b Shin one tar. produ becom mot thon 30mm & ths aww tosue hypo , necronis 3 ulceration. 7 Tt is dwt b - yrpouid ruddition ; defulive blood bufpply ;raunslegucal Tag deficit , Preapvre, Pnaemia , injury ,rnpislare sul a - . . . — Sikto i cntr inchia) Laberesity , Focruen, heel, butlack , Shoulder cam —7 Ved foe are Luphic ular 7 -y Seat :- Th acer yn $7 of Ll peopitalie palents ima 2D Painless oltep; nerrmable * 7 Iroligation '- Studly of aliovrorge , bleed sugar , butdge bicphy Tym the edge . a eh Wd° Monagemenk i Bure spautd be treated Y Corclioy af Diabeles ® Protmia ~? Nubribioaat. supplementation ~? Rast j antibiotics ) Slough exciouén > Vacuum: firioted deue (AC) a ? Onte Wen gronulotes uel! , kun Yraffing 2 done - 7 Exeinton uf, Uler % Skin Yroftig > Cultured rots talespovition F Prope tow: Chong? Perilion ont: in Lhw Becher eee ents in lov » Diobtte we | ner Fe tat Glatos in bine pracipitabs irbition 9 Piabdiz. mivorglapatlyy which affect micaodineu lation, 7 Diobeliz neuropathy. imuauing ol oemeny , meter compononts hile} - Je plonter orpect [mest common pite] ~ bask , UL, leg, Goetum rt kon Distrorge Yor Cullure %& Statnrilivity DRAM NNN PPPPPPPPPPPPPETTPIEECELTERT IAA= me Nomagement ~~ insulin ns 9 Lonta) oY diabeler v9 =, ) me 2 foot | lay / toe frridation : 7 Minallaler rubber (rip) srate bo Prmend eitry.} Cort Bf [pat ATO Vy | Wt] \ irtd LEU TES => Tho dPrtading. inflemmmoation uf bubcutonead tire ong Jorttat plone + ne =) Infection moy Jallew a small stratch or wwolird 02 intirton on dived /snake[$egypier bile DVIt tan be Guperucl or deg? . It & tamrmenty seer in Pisbobi ,Trmuncoypprnd people & ld) People 7 Silo '- peo, Lanse 9 upper Limb & srelum 7 Caurikina Orgoniom + Stuptecercu» pyagend [Commonly] HTT ede Khebyiclla , [Link] = Clinical featur ? Iusertigation ea meeeeat LET, Bload unto Serum cralinint pe 27 Suselling [tir difuee 2 preaciong = SE? Pam, tendo, Si 08 | AVI progr Rapidy in Diabolic % Praple 5) Tndeamen won Lyonph node | | = 81 No edge, Ny pus. 7 Blood suger estimation 7 Lbume Test Yor ketone bodusd TTT Fy Vee> Reatment BP etenictony ey jolt puna Be wala wedema- 2! ntibeatics — ponkcillire , Upholoperirs 3 Drsoving 4Y Diabetes rioould be trealed cuiith Insulin 8 Lofine Cellulitis Rusrite about mun nrofting ® [527 27 Deluca Cellulitis ® units Signs of tflomation @ [ wre PPPPPPPPPPPPPRITEPRRPRRUTTRTAANAANROOOLAR BUNGLE. = Q? Carbuncle @ [S18 wig 7 Site :- Nape af the nick & Back (on ale accun tn Ghaulden, Cree, Hand ; Iprtarm aig ? Commonly Seen in Diabetics —— Sas Fritially Skin becomes rad wisth dihorging Pur = Ee Trntstigation - (Lume sugar —— - Unie Ketone bodis ~ Glood ougor ° salorant It (ortrok of Wabehes is ebertil using tyatlin Te 2? 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Type t- FiO Yongune’ BP lua omgure CY Yoo Gmgeene d) Internal Gory ure ect | Dee Gongunt | __Wet bongnene (aune | Due’ by poor blood supply. | Dut to bockuial inpeliorr - PPITITILITILITR RAR AAARAAAAYA arpeononce | Day Shaivelid black Sova, rit ® diosa of daout OS ; on blew area Raped. n : \ppbetion | Nob ataioted vith Aekion Plucp exroiichd yidh inlsction Symptom | Numbron, tld 8 Dey Skvin Ben dueling , Fant. aden = ‘abnor | Foxy on cartesig bload,, Prbiolio Bubidmod ong A: 7D accu wher issue af pyar die dust a} Ct Seuce infection “Ply 7 Tb 0 striaw condition & nique medial abention 7 (aUbO- 1¥ Reduced plead Mau 2) Innbsction OF Peripheral artoy dirtost > anes oF Frostbite CY Bload dots dt fitherorclererin elas Types ol Yonpaers in pat '- | Day Gongrene 27 et Yongrent 37 Yoo Yongrere Symploms :- Yircoloration Diagrstis '- Phypeal exomindlin ~ Fut Patin 1 numbrass ~Blocd tat bo dak oie or ; + Frnogiong (%-Ray mR json Tesobmnird !- 17 bungical Debridamnent 2 Arnliblatics ~y Foy bet B Yoo gong BY Arnputation > In reruvu corey PUPPET ETE TUTTO ee eee ee et ae Fesuantion’ Prep Jood cont 1 Momoging daobetes , fyrid smo as Tuoting waunds promptly£06 Gongrene f > I as 2b [Link] Clostudial Myerserodt = > <- out PS Ri + ‘ Ie oe gea penn dus by boctrial § Caria 3 gar pasduudion wiilluin effected trout LO! iteust inaction —--Sartplo6 *~ Ditolovoluon o Skin Fpypurio ont — Sunes para ® Swelling of rie. a ~ Rapid Lisous sueeling % Condition [psauving injphin So eh O} Pas blood supply - Foner , tov law BP BY supporlist. 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