ABSTRACT: Buruli ulcer is the most common mycobacteria disease after leprosy and tuberculosis. The purpose of our study is to make our contribution to the surgical treatment of Buruli ulcer and to asses our results.
One hundred eighteen patients presenting progressive Buruli ulcers were operated on. The surgical procedure included excisions for necrotic lesions and grafts for clean wounds. The results were estimated on the time of hospitalization and appearance of complications.
Seventy-three patients (62%) were subjected to excision followed by thin skin grafts and 35 patients (30%) were subjected to grafts only. The number of excision times varies from 1 to 7 per patient and from 1 to 4 for the skin grafts. All our patients heal within a period of 120 days with extremes going from 14 to 265 days. We deplored 26 complications (22%): eight new focus, seven infectious complications, six recurrences, five stiffnesses and ankyloses.
The treatment of Buruli ulcer by excision and grafts is efficient but does not prevent recurrences and new focus from happening and for their prevention, it is necessary to discover pharmaceutical molecules that are efficient on Mycobacterium ulcerans.
Annales de Chirurgie Plastique Esthétique 03/2004; 49(1):11-6. · 0.41 Impact Factor
ABSTRACT: We report the first two published cases of a facial localization of Mycobacterium ulcerans ulcer (Buruli ulcer). M. ulcerans is the third most common mycobacteriosis, after leprosy and tuberculosis. Clinical manifestations involve large necrotic ulcerations with protruding edges, mainly localized on the limbs. Both of our patients, 9 and 45-year-old females, resided in endemic areas of Buruli ulcer in the Ivory Coast. The ulcers were located on the left zygomatic malar region in one patient and the submental region in the other. Treatment involved resection of the ulcer followed by total skin graft. Ulcer healing was observed after two months hospitalization in one patient. The other patient died.
Revue de Stomatologie et de Chirurgie Maxillo-faciale 10/2003; 104(4):231-4. · 0.25 Impact Factor
ABSTRACT: Thirteen percents of the patients suffering from Buruli ulcer in Ivory Coast show sequels at a result of their spontaneous healing. The purpose of our study is to report and estimate the first series of the sequel treatment of Buruli ulcer, with standard reconstructive procedures used in plastic surgery.
Sixteen patients totalizing 18 sequels were classified into 2 groups:13 patients showed functional sequels in connection with cicaticial retractions about level with joints;3 patients showed aesthetic sequels with no repercussion on the functional aspect. The surgical treatment included for the functional sequels, the excision of the retractile scar, the restoration of the underlying structures followed by the coverage of the defect with skin grafts or muscle or musculo cutaneous flaps and for aesthetic sequels, the excision of the scar tissues and the coverage with full-thickness skin grafts.
The results were considered good because the patients found an acceptable physical activity again that enable some of them to resume a professional activity and others a school activity. Motherless, a certain number of complications are to be deplored:1 case of distal necrosis of a skin flap autonomized which required excision and conducted healing but without repercussions on the functional result;1 residual edema about level with the fingers at the time of the covering of a hand with a groin flap;1 haematoma at the donar site of a full-thickness skin graft.
Distance flaps are more advisable for hand sequels in Buruli ulcer considering the regional character of the disease and the necessity to preserve the main vascular axes about level with the hand. On the lower limb, autonomized skin flaps enable provide important tissue and preserve the major vascular axes of the lower limb.
Annales de Chirurgie Plastique Esthétique 03/2003; 48(1):13-9. · 0.41 Impact Factor