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Входящие и исходящие упоминания
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Привлечение подписчиков
октябрь '26окт. '26
октябрь '26
+273
в 4 каналах
| Дата | Привлечение подписчиков | Упоминания | Каналы | |
| 30 октября | 0 | |||
| 29 октября | 0 | |||
| 28 октября | +1 | |||
| 27 октября | 0 |
Посты канала
| 2 | 🔰Leg Ulcers
▪︎Most Common Type Of Ulcer in The Developed World
🔷Causes Of Leg Ulcers
1. Vascular (Arterial Or Venous Insufficiency) ➡️ Venous Insufficiency is The Most Common Cause Of Leg Ulcer
2. Trauma (Burns Or Bites Or Self-induced)
3. Infection
4. Metabolic Disorders (DM/Gout/Calciphylaxis)
5. Autoimmunity (Vasculitis/Systemic Sclerosis/RA)
6. Malignancy (Squamous & Basal Cell Carcinoma)
🔷Mx Of Leg Ulcer ➡️ According To The Cause
🔰Pressure Ulcers (Bed Sore/Decubitus Ulcer)
▪︎Localized Skin Ulcers Occur Over The Bony Prominents Due To Prolonged Period Of Immobilization
▪︎Skin's Blood Flow Compromise When The External Pressure Exceeds 30mmHg
🔷Risk Factors For Pressure Ulcers
1. Prolonged Immobility
2. Cognitive Impairment
3. Sensory Impairment
4. Exposed To Moisture (Urinary Or Faecal Material) Due To Incontinence
5. Diabetes/Dehydration/Malnutrition
5. Poor Wound Healing
6. Poor Circulation (Arterial Or Venous Insufficiency)
7. Old Ages
8. Friction & Shearing Forces
🔷Most Common Sites For Pressure Ulcers
1. Ischium
2. Greater Trochanter
3. Sacrum
4. Heel
5. Malleolus (Lateral More)
6. Occiput
🔷Stages Of Pressure Ulcers
1. Only Non-Blanchable Erythema (Intact Skin)
2. Partial-Thickness Skin Loss (Exposed Dermis)
3. Full-Thickness Skin Loss (Skin & Subcutaneous Tissue)
4. Full-Thickness Skin Loss & Underlying Tissue Damage
🔷Prevention Of Pressure Ulcers
1. Regular Repositioning Of Bedridden Patients Every 2-4h
2. Use Of Pressure Distribution Devices
3. Nutritional Support
4. Patient Education On Self-Care
5. Early Identification & Tx Of Risk Factors
🔷Mx Of Pressure Ulcers
1. Ulcer Swab For Culture & Sensitivity
2. Surgical Debridement Of Necrotic Tissue
3. Antibiotics
4. Daily Wound Cleaning & Dressings Change
5. Surgical Reconstruction (Large Fascio-Cutaneous Or Musculo-Cutaneous Flap)
6. Other Measures
▪︎Vacuum Assisted Closure
▪︎Hyperbaric Oxygen Therapy
▪︎Topical Tissue Growth Factors
▪︎Urinary & Faecal Diversion | 22 |
| 3 | 🔴Chronic Wound (Ulcers)
▪︎Ulcer is Breaking in The Continuity Of The Epithelium (Epithelial Defect) That Fails To Progress Through The Normal Stages Of Wound Healing
▪︎Chronic Ulcers Unresponsive To Dressings & Simple Tx & Need Biopsy To Exclude Malignancy (Squamous Cell Carcinoma)
🔷 Types Of Ulcers
1. Ischemic Ulcer (Venous Or Arterial)
2. Decubitus (Pressure/Bed Sore) Ulcer
3. Neuropathic (Trophic) Ulcer (Diabetic Foot)
4. Malignant Ulcers (Marjolin's & Rodent Ulcers)
5. Corneal Ulcer
6. Genital Ulcer (Syphilis/Herpes/HPV)
7. Mouth Ulcer (Aphthos Ulcer)
8. Peptic Ulcer
🔷Hx & Examination Of Ulcer
📍1. When Was The Ulcer 1st Noticed شوكت بدكت عندك
📍2. What Drew Your Attention ليش انتبهت عليها
▪︎Pain (Commonest Cause)
▪︎Bleeding
▪︎Discharge
▪︎Disfiguring
📍3. Symptoms Of The Ulcer
📍4. Change (Progression) in Size/Shape/Symptoms
📍5. Similar Ulcer On Other Sites
📍6. Hx Of Trauma At Site Of Ulcer
📍7. Base (Floor) Of The Ulcer القاعدة
▪︎Poor Granulation With Exposed Underlying Structures (Tendons) ➡️ Ischemic Ulcer
▪︎Bluish Unhealthy Granulation ➡️ TB Ulcer
▪︎Yellow-Grey Wash-Leather ➡️ Syphilitic Ulcer
▪︎Solid Brown-Grey Dead Tissue ➡️ Full-Thickness Skin Death
▪︎Redness Of The Granulation Tissue Or Pale Layer Over The Granulation Tissue ➡️ Healing Ulcer
📍8. Edge Of The Ulcer الحافة
🔺I. Flat Or Slightly Sloping شوية مايلة للداخل ➡️ Healing Ulcer
🔺II. Punched-Out (Square-Cut)
▪︎Due To Rapid Full-Thickness Skin Death & No Attempts Of Repair
▪︎Seen in ➡️ Tertiary Syphilis & Diabetes (Trophic Ulcer)
▪︎More in The Leg
🔺III. Undermined اكو فجوة بالداخل
▪︎Due To Infection Affect Subcutaneous Tissue More Than The Skin
▪︎Seen in ➡️ TB Ulcer & Pressure Necrosis Of The Buttocks (Pressure Ulcer)
🔺IV. Rolled (Rodent Ulcer) الحواف مرتفعة
▪︎Due To Slow Tissue Growth At The Edges
▪︎Pale-Pink Or White Edges
▪︎Seen in ➡️ Basal Cell Carcinoma (Diagnostic)
🔺V. Everted كلها مرتفعة ومغطية الجلد الجواها
▪︎Due To Rapid Tissue Growth At The Edges That Covers The Normal Skin
▪︎Seen in ➡️ Squamous Cell Carcinoma (Marjolin's Ulcer)
📍9. Measurement Of The Ulcer (Length/Width/Depth)
📍10. Type Of Discharge From The Ulcer
📍11. Ulcer Relation To Surrounding Tissues (LN/Deep Structures)
📍12. State Of Local Tissue (Blood Supply & Innervation Of The Skin)
📍13. General Examination Of The Patient | 18 |
| 4 |  ❇️Lines Of the Abdomen
•Two horizontal & two vertical lines
✖️The upper horizontal (Transpyloric)
Runs along the lower margin of the costal cartilages (10th costal cartilage)
✖️The lower horizontal (TransTubercular)
joins the two tubercles of the iliac crests.
✖️The two vertical lines (R & L)
each of them run along a line connecting the middle Clavicular point and the mid inguinal point | 30 |
| 5 | ❇️Clinical features of raised ICP
▪︎Headache
▪︎Nausea and vomiting
▪︎Restlessness, agitation or drowsiness
▪︎Slow slurred speech
▪︎Papilloedema
▪︎Ipsilateral sluggish dilated pupil which then becomes fixed (“blown pupil”)
▪︎Cranial nerve palsy (e.g. CN III palsy with ‘down and out’ pupil)
▪︎Seizures
▪︎Reduced GCS
▪︎Abnormal respiratory pattern
▪︎Abnormal posturing, initially decorticate and then decerebrate
▪︎hypertension
▪︎bradycardia | 23 |
| 6 |  ❇️Signs of skull fractures
▪︎CSF (clear fluid) leaking from nose or ear
▪︎Raccoon (Panda) eyes: bruising around the eyes (Fracture of the base of the skull)
▪︎Battle sign: bruising behind the ear over the mastoid process (Fracture in the posterior Cranial Fossa)
▪︎Haemotympanum: blood noted behind the tympanic membrane on otoscopy | 225 |
| 7 | #Wound_infection@Clinicalsurgeryround | 19 |
| 8 | 🔴Wound Complications
🔷Most Common Wound Complications
1. Woune Infection (Surgical Site Infection)
2. Dehiscence (Incisional Hernia)
3. Chronic Wound (No Healing/Ulcer)
4. Scar Formation & Contractures
5. Haematoma Formation
6. Compartment Syndrome
🔴Wound Infection (Surgical Site Infection SSI)
▪︎Invasion Of Microorganisms into The Tissue After The Breakdown Of Local & Systemic Host Defences Leading To Tissue Infection (Cellulitis/Lymphangitis/Abscess/Bacteraemia)
▪︎After Tissue Breach (By Surgery Or Trauma) There's 4h Interval Before Bacterial Growth & Tissue Infection (Decisive Period)
🔷Body Mechanisms To Prevent Tissue Infection
1. Intact Epithelial Surface (Intact Skin)
2. Low Gastric pH (Gastric Acidity)
3. Humoral & Cellular Immune System
🔷Sources Of Infection
📍1. Endogenous (Most Common Source Of Infection) ➡️ Organisms Present In Or On The Patient At The Time Of Surgery (Wound Contamination After Bowel Or Appendix Perforation)
📍2. Exogenous (Hospital Acquired Infection HAI) ➡️ Organisms Acquired From Outside (From The Operation Theater Or Ward)
🔷Risk Factors For Wound Infection
📍1. Impaired Host Response Due To
▪︎Malnutrition (Obesity Or Weight Loss)
▪︎DM/Ureamia/Jaundice
▪︎Immunodeficiency (AIDS/Steroids/Chemotherapy & Radiotherapy/Methotrexate/Malignancy)
📍2. Poor Surgical Techniques
▪︎Excessive Dead Space Or Hematoma
▪︎Devitalized (Dead) Tissue Not Well Removed
▪︎Foreign Bodies (Drains & Sutures Specially Silk)
📍3. Poor Tissue Perfusion (Due To Systemic Shock Or Local Ischaemia)
📍4. Bacterial Colonization Of The Upper Git Then Translocation To Mesenteric Nodes & Cause The Release Of EndoToxins
📍5. Virulent Organism & Large Tissue Contamination
🔷Most Common Organisms Responsible For Wound infection
🔸A. Gram +Ve
📍1. Streptococcus
▪︎Group A Beta-Haemolytic Streptococcus (Strept.Pyogenes) ➡️ Most Pathogenic
▪︎Streptococcus Faecalis (Enterococcus)
📍2. Staphylococci
▪︎Staph.Aureus (MRSA)
▪︎Staph.Eipdermidis (Albus Or Coagulase -Ve Staph)
📍3. Clostridia
▪︎C.perfringens
▪︎C.Tetani
▪︎C.Difficile
🔸B. Gram -Ve
📍1. E.Coli
📍2. Pseudomonas
📍3. Klebsella
📍4. Proteus
📍5. Bacteroides Fragilis
🔷Types Of Wound Infection
📍1. Minor ➡️ Wound Infections With Only Minor Pus Or Serous Fluid Discharge
📍2. Major ➡️ Wound Infections With
▪︎Significant Amount Of Pus Discharge
▪︎Systemic Features (Pyrexia/Tachycardia/Leukocytosis)
▪︎Need Secondary Surgery To Drain it
▪︎Delay Return To Home (Prolonged Hospitalization)
🔷Prevention Of Wound Infection
📍A. Preoperative
1. Good Glycemic Control
2. Smoking Cessation >4w Before Surgery
3. Screening For UTI & Bacterial Vaginosis
4. Bowel & Bladder Empty Before Surgery
5. Chlorhexidine 4% Wash Or Wips At Nigh & Morning Before Surgery
📍B. Intraoperative
1. IV Antibiotics Cover 60 Minutes Before Incision
2. Skin Sterilization Using Iodine Or Chlorhexidine
3. Use Electric Clippers With Single Use Head For Hair Removal At Surgical Site حلاقة مكان العملية بمكينة زينة
4. Sterile Surgical Tools & Techniques & Good Hemostasis
5. Maintain NormoThermia & EuVolemia (Prevent Hypotension)
6. Limit The Duration Of Surgery
7. Wound & Intra-Cavity Lavage
📍C. Postoperative
1. Good Dressing Care
2. Maintain Glucose <180 & Maintain EuVolemia
3. Discontinue Urine Catheter As Soon As Possible | 21 |
| 9 | Fact :
حظك كطالب طب في دكتور أختبار العملي والشفوي أهم من حظك في شريك حياتك🤔
هل الكلام صحيح او لا 🙁 | 30 |
| 10 |  Normal liver span is 6–12 cm | 33 |
| 11 |  Renal A Bruit Auscultation ■
* To the left/Right of the Umbilicus | 26 |
| 12 |  Aortic Bruit Auscultation ●
*Near (Above) the umbilicus | 23 |
| 13 |  Bowel Sound Auscultation ■
* in the Right iliac fossa (iliocecal valve) for 30 seconds | 19 |
| 14 |  Abdominal Palpation ■
*Superficial & Deep Palpation
*Start from left iliac fossa and move in AntiClockwise direction
*Flat forearm & Hand | 23 |
| 15 |  Kidney & Liver & Spleen Palpation | 24 |
| 16 |  Нет текста... | 26 |
| 17 |  Ankle Brachial Index (ABI), a sensitive, specific, and cost-effective test for diagnosing Peripheral Arterial Disease (PAD). It highlights the step-by-step process of ABI measurement, including cuff placement and pressure measurement sequences. | 24 |
| 18 | #Shock_Hemorrhage@Clinicalsurgeryround | 23 |
| 19 | #Trauma_Protocol@Clinicalsurgeryround | 26 |
| 20 | 📍4. Circulation & Haemorrhage Control :
🔻I. Application Of Pelvic Binders To All Haemodynamically Unstable Patients (Not Removed Until Pelvic Fractures Excluded)
🔻II. Vascular Access :
▪︎At Least Two Large IV Cannula (Peripheral Access 1st Choice)
▪︎Central Access (SubClavian/Internal Jugular/Femoral Veins)
▪︎Intra-Osseous Venous Access (If No Venous Access Available)
🔻III. Blood Aspiration For :
▪︎HB Level
▪︎Cross Match
▪︎Venous Lactate
🔻IV. Assessment Of Haemodynamic State Through :
▪︎Blood Pressure Measurement
▪︎Hypotension is HypoVolaemic Shock Until Proven Otherwise
▪︎Signs Of Shock (Cold Sweaty Skin/Elevated Pulse >100BPM/Low BP)
▪︎Keep Systolic BP 70-90mmHg Or >90mmHg If Head Injury Present (Using 250ml O-Ve Blood Or Normal Saline)
🪀Control Bleeding By :
♻I. Control Source Of Bleeding :
▪︎Source Of Haemorrhage Usually From Chest/Abdomen/Pelvis/Long Bones/Arteries
▪︎Source Of Haemorrhage Should Identified Rapidly Using WBCT (Whole Body CT With Contrast) Or FAST (Focused Abdominal Sonography For Trauma)
♻II. Blood Transfusion (Massive Transfusion Protocol)
♻III. Tranexamic Acid (1g IV Over 10Min Then 1g Over 8h)
📍5. Neurological Dysfunction (Disability) Assessment Using :
🔻I. Glascow Coma Scale (GCS)
🔻II. Pupil Exam For Size & Reaction To Light
🔻III. All Four Limbs Movements Assessment
🔻IV. Rapid Identification Of Intra-Cranial Bleeding Using WBCT (CT Scan)
🔻V. Core Body Temperature Measurement & Recorded
📍6. Adequate Patient Exposure To Identify Hidden Injuries
🔸B. Secondary Survey
▪︎This Survey Done After Patient Stabilization & Haemodynamically Stable
▪︎Consist Of :
📍1. Full Clinical Examination (From Head To Toe)
📍2. Focused Hx About :
▪︎Allergies
▪︎Current Drugs Intake
▪︎Past Medical Hx
▪︎Events Related To The Trauma Injury
📍3. Imaging According To The Case (CT/MRI/Xray/US)
🔸C. Tertiary Survey
▪︎Repeating The Primary & Secondary Survey Within 24h To Identify Evolving Or Previously Missed Injuries
▪︎Usually Done in Intubated & Unresponsive Patients After Their Condition Improved | 26 |
