皮肤与软组织外科伤病(普外科).ppt

Signs and symptoms 黑色素瘤——高度恶性肿瘤 Most melanomas are brown to black looking lesions. Signs that might indicate a malignant melanoma include change in size, shape, color or elevation of a mole. Other signs are the appearance of a new mole during adulthood or new pain, itching瘙痒, ulceration or bleeding. Melanoma 黑色素瘤 Treatment Options for Squamous ,Basal Cell Carcinoma and Melanoma 治疗 基底细胞癌：放疗敏感 鳞状细胞癌：手术为主，周围2CM正常组织 黑色素瘤：大块切除及区域淋巴结清扫 机遇垂青于每一位有准备之人。 pain relief antibiotic therapy elevating and immobilizing the hand患手抬高固定 consulting an experienced hand surgeon专业手外科医师处理 incision and drainage切开引流 Management： Depending on the extention of tissue destruction组织破坏程度 bony involvement累及骨 preexisting vascular insufficiency systemic complications (bacteremia, sepsis) Prognosis： 窦道与瘘管 瘘管：Fistula cannulas 两个开口 窦道：Sinus tract 一个开口，病理性盲管 慢性溃疡Chronic ulcer 肿瘤性溃疡 血运障碍性溃疡 结核性溃疡 褥疮 Chapter 4 浅表软组织肿块soft tissue tumor nevus痣 皮肤良性色素斑块 皮内痣：无活跃痣细胞，常有毛发 交界痣：有活跃痣细胞，一般无毛发 混合痣：同时存在 Clinical Findings The lesions are often flat扁平 at birth, brown to black in color. They often grow proportionally to the body size as the child matures. As they mature, they often develop thickness厚, and becomes elevated隆起. Prominent terminal hairs often form, especially after puberty. With maturity, the nevus can have variation in color, and the surface might be textured with growths. Treatment Surgical excision手术切除 is the standard of care. The use of hair removal laser for the treatment is likely safe and effective for small congenital nevus.对于浅表较小的色素痣也可使用激光 if malignancy developed from a deep component of the nevus that is not reached by the laser. Lipoma脂肪瘤 A lipoma is a benign tumor composed of fatty tissue. These are the most common form of soft tissue tumor.最常见体表良性肿瘤 Lipomas are soft to the touch质软, usually moveable活动度佳, and are generally painless. Many lipomas are small (under one centimeter diameter) but can enlarge to sizes greater tha