Surgical Management of Buruli Ulcer Disease: A Four-Year Experience from Four Endemic Districts in Ghana
Identifieur interne : 004B20 ( Main/Curation ); précédent : 004B19; suivant : 004B21Surgical Management of Buruli Ulcer Disease: A Four-Year Experience from Four Endemic Districts in Ghana
Auteurs : Ejk Adu [Ghana] ; E. Ampadu [Ghana] ; D. Acheampong [Ghana]Source :
- Ghana Medical Journal [ 0016-9560 ] ; 2011.
Abstract
To study the impact on surgery of prior treatment of MU disease with rifampicin and streptomycin.
Retrospective, from September 2004 to September 2009.
Asunafo, Amansie West, Ahafo Ano and Amansie Central districts of Ghana.
Patients who have completed 8 weeks or a minimum of 4 weeks treatment with rifampicin and streptomycin but have unhealed lesions were selected for surgery.
132 patients had surgery for MU disease; 51 at Tepa (Ahafo Ano); 36 at Agroyesum (Amansie West); 16 from Jacobu (Amansie Central); 29 from Goaso (Asunafo) districts. Their ages ranged from 4 to 98 years, with mean age of 29.90 years, standard deviation of 20.74. Sites involved were: head and neck 1 (0.74%), upper limb 40 (29.63%), lower limb 92 (68.15%), trunk 2 (1.48%) (N=135). The clinical forms were: papule 1 (0.74%), nodule 2 (1.48%), oedematous lesion 4 (2.96%), osteomyelitis 2 (1.48%), ulcers 124 (91.85%), contractures 2 (1.48%). 139 surgical procedures were performed: excision 25 (18.11), skin grafting 36 (26.1%), excision and skin grafting 54 (39.1%), debridem net 10 (7.2%), sequestrectomy 2 (1.4%), regrafting 10 (7.2%), release of contractures 2 (1.4%).
Treatment of MU disease with rifampicin and streptomycin improved the condition and minimised the extent of surgery. Combination of surgery and antibiotics is necessary to prevent the development contractures.
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PubMed: 21572818
PubMed Central: 3090092
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Ampadu</name><affiliation wicri:level="3"><nlm:aff id="A2">National Buruli Ulcer Control Programme, Korle Bu, Accra</nlm:aff><country>Ghana</country><placeName><settlement type="city">Accra</settlement><region nuts="2">Région du Grand Accra</region></placeName><wicri:orgArea>National Buruli Ulcer Control Programme, Korle Bu</wicri:orgArea></affiliation></author><author><name sortKey="Acheampong, D" sort="Acheampong, D" uniqKey="Acheampong D" first="D" last="Acheampong">D. Acheampong</name><affiliation wicri:level="1"><nlm:aff id="A3">Accident and Emergency Unit, Komfo Anokye Teaching Hospital, Kumasi, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Accident and Emergency Unit, Komfo Anokye Teaching Hospital, Kumasi</wicri:regionArea><wicri:noRegion>Kumasi</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">21572818</idno><idno type="pmc">3090092</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3090092</idno><idno type="RBID">PMC:3090092</idno><date when="2011">2011</date><idno type="wicri:Area/Pmc/Corpus">002E17</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">002E17</idno><idno type="wicri:Area/Pmc/Curation">002E16</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">002E16</idno><idno type="wicri:Area/Pmc/Checkpoint">002D22</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">002D22</idno><idno type="wicri:Area/Ncbi/Merge">004350</idno><idno type="wicri:Area/Ncbi/Curation">004350</idno><idno type="wicri:Area/Ncbi/Checkpoint">004350</idno><idno type="wicri:doubleKey">0016-9560:2011:Adu E:surgical:management:of</idno><idno type="wicri:Area/Main/Merge">004B52</idno><idno type="wicri:Area/Main/Curation">004B20</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Surgical Management of Buruli Ulcer Disease: A Four-Year Experience from Four Endemic Districts in Ghana</title><author><name sortKey="Adu, Ejk" sort="Adu, Ejk" uniqKey="Adu E" first="Ejk" last="Adu">Ejk Adu</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Surgery, School of Medical Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Department of Surgery, School of Medical Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi</wicri:regionArea><wicri:noRegion>Kumasi</wicri:noRegion></affiliation></author><author><name sortKey="Ampadu, E" sort="Ampadu, E" uniqKey="Ampadu E" first="E" last="Ampadu">E. Ampadu</name><affiliation wicri:level="3"><nlm:aff id="A2">National Buruli Ulcer Control Programme, Korle Bu, Accra</nlm:aff><country>Ghana</country><placeName><settlement type="city">Accra</settlement><region nuts="2">Région du Grand Accra</region></placeName><wicri:orgArea>National Buruli Ulcer Control Programme, Korle Bu</wicri:orgArea></affiliation></author><author><name sortKey="Acheampong, D" sort="Acheampong, D" uniqKey="Acheampong D" first="D" last="Acheampong">D. Acheampong</name><affiliation wicri:level="1"><nlm:aff id="A3">Accident and Emergency Unit, Komfo Anokye Teaching Hospital, Kumasi, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Accident and Emergency Unit, Komfo Anokye Teaching Hospital, Kumasi</wicri:regionArea><wicri:noRegion>Kumasi</wicri:noRegion></affiliation></author></analytic><series><title level="j">Ghana Medical Journal</title><idno type="ISSN">0016-9560</idno><imprint><date when="2011">2011</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><title>Summary</title><sec><title>Background</title><p><italic>Mycobacterium ulcerans</italic> (MU) disease causes extensive destruction of tissues leaving large ulcers on the body. Management which consisted of surgical excision of the lesions is gradually being replaced with chemotherapy.</p></sec><sec><title>Objective</title><p>To study the impact on surgery of prior treatment of MU disease with rifampicin and streptomycin.</p></sec><sec><title>Study Design</title><p>Retrospective, from September 2004 to September 2009.</p></sec><sec><title>Setting</title><p>Asunafo, Amansie West, Ahafo Ano and Amansie Central districts of Ghana.</p></sec><sec sec-type="methods"><title>Methods</title><p>Patients who have completed 8 weeks or a minimum of 4 weeks treatment with rifampicin and streptomycin but have unhealed lesions were selected for surgery.</p></sec><sec sec-type="results"><title>Results</title><p>132 patients had surgery for MU disease; 51 at Tepa (Ahafo Ano); 36 at Agroyesum (Amansie West); 16 from Jacobu (Amansie Central); 29 from Goaso (Asunafo) districts. Their ages ranged from 4 to 98 years, with mean age of 29.90 years, standard deviation of 20.74. Sites involved were: head and neck 1 (0.74%), upper limb 40 (29.63%), lower limb 92 (68.15%), trunk 2 (1.48%) (N=135). The clinical forms were: papule 1 (0.74%), nodule 2 (1.48%), oedematous lesion 4 (2.96%), osteomyelitis 2 (1.48%), ulcers 124 (91.85%), contractures 2 (1.48%). 139 surgical procedures were performed: excision 25 (18.11), skin grafting 36 (26.1%), excision and skin grafting 54 (39.1%), debridem net 10 (7.2%), sequestrectomy 2 (1.4%), regrafting 10 (7.2%), release of contractures 2 (1.4%).</p></sec><sec sec-type="conclusions"><title>Conclusion</title><p>Treatment of MU disease with rifampicin and streptomycin improved the condition and minimised the extent of surgery. Combination of surgery and antibiotics is necessary to prevent the development contractures.</p></sec></div></front></TEI></record>Pour manipuler ce document sous Unix (Dilib)
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