☻Ulceration and ulcers

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III-ULCERATION AND ULCERS

Definition: -

Ulceration is the loss of superficial epithelial tissues leading to exposure of sub-epithelial of skin or mucous membrane with formation of wound has no tendency to heal. It differs from gangrene in that the latter term denotes the simultaneous loss of vitality of a considerable portion of tissue.

Causes: -

1-Trauma

2-Infection

3-Neoplasm

4-Repeat irritation of a wound (dog's ear, tip of the tail and angles of flexion)

5-Presence of foreign body or necrotic tissue that causes infection and prevents healing

6-Loss of innervation

7-Poor blood supply

Classification: -

1-Traumatic ulcer due to trauma

2-Specific ulcer due to infection as in ulcerative lymphangitis, glanders, or T.B.

3-Malignant ulcer as rodent ulcer, epithelioma, and fungating ulcer due to streptococcus farciminosus

Symptoms: -

1-More or less rounded breach on the surface and varying in depth

2-The center of the lesion may be flat or concave and show necrotic spots

3-The borders may be hard or soft, and of the same level of the surroundings or higher

4-Usually it has serous, purulent, bloody, or grayish discharge

5-Old ulcer is surrounded by fibrous tissue and the edges are cut perpendicular and hard (callus ulcer).

6-If gangrene occurs at the level of the ulcer and extends rapidly in its depth due to bacterial destruction, the ulcer is called phagedenic ulcer

Diagnosis: -

1-History

2-Clinical signs

3-Clinical examination

Treatment of ulcers:

1-Remove the cause

2-Apply antiseptic fomentation with moderate pressure bandage to promote healing or

3-Astringent, thermo-cautery, or caustic applications can be used if the granulations are excessive or unhealthy, or for callus ulcer or

4-Excision of the ulcer then suturing of the wound is the best treatment

5-Specific treatment for specific ulcers