Experiences with Surgical treatment of chronic lower limb ulcers at a Tertiary hospital in northwestern Tanzania: A prospective review of 300 cases (Record no. 18826)

MARC details
000 -LEADER
fixed length control field 03619nam a22001817a 4500
008 - FIXED-LENGTH DATA ELEMENTS--GENERAL INFORMATION
fixed length control field 210821b |||||||| |||| 00| 0 eng d
100 ## - MAIN ENTRY--PERSONAL NAME
Personal name Fidelis Mbunda
9 (RLIN) 22875
245 ## - TITLE STATEMENT
Title Experiences with Surgical treatment of chronic lower limb ulcers at a Tertiary hospital in northwestern Tanzania: A prospective review of 300 cases
260 ## - PUBLICATION, DISTRIBUTION, ETC.
Place of publication, distribution, etc. Mwanza, Tanzania
Name of publisher, distributor, etc. Catholic University of Health and Allied Sciences CUHAS - Bugando
Date of publication, distribution, etc. 28 September 2012
520 ## - SUMMARY, ETC.
Summary, etc. Abstract<br/><br/>Background<br/><br/>Chronic lower limb ulcers constitute a major public health problem of great important all over the world and contribute significantly to high morbidity and long-term disabilities. There is paucity of information regarding chronic lower limb ulcers in our setting; therefore it was necessary to conduct this study to establish the patterns and outcome of chronic lower limb ulcers and to identify predictors of outcome in our local setting.<br/><br/>Methods<br/><br/>This was a descriptive prospective study of patients with chronic lower limb ulcers conducted at Bugando Medical Centre between November 2010 and April 2012. Ethical approval to conduct the study was sought from relevant authorities. Statistical data analysis was done using SPSS version 17.0 and STATA version 11.0.<br/><br/>Results<br/><br/>A total of 300 patients were studied. Their ages ranged from 3 months to 85 years (median 32 years). The male to female ratio was 2:1. The median duration of illness was 44 days. Traumatic ulcer was the most frequent type of ulcer accounting for 60.3% of patients. The median duration of illness was 44 days. The leg was commonly affected in 33.7% of cases and the right side (48.7%) was frequently involved. Out of 300 patients, 212 (70.7%) had positive aerobic bacterial growth within 48 hours of incubation. Pseudomonas aeruginosa (25.5%) was the most frequent gram negative bacteria isolated, whereas gram positive bacteria commonly isolated was Staphylococcus aureus (13.7%). Twenty (6.7%) patients were HIV positive with a median CD4+ count of 350 cells/μl. Mycological investigation was not performed. Bony involvement was radiologically reported in 83.0% of cases. Histopathological examination performed in 56 patients revealed malignancy in 20 (35.7%) patients, of which malignant melanoma (45.0%) was the most common histopathological type. The vast majority of patients, 270 (90.0%) were treated surgically, and surgical debridement was the most common surgical procedure performed in 24.1% of cases. Limb amputation rate was 8.7%. Postoperative complication rate was 58.3% of which surgical site infection (77.5%) was the most common post-operative complications. The median length of hospital stay was 23 days. Mortality rate was 4.3%. Out of the two hundred and eighty-seven (95.7%) survivors, 253 (91.6%) were treated successfully and discharged well (healed). After discharge, only 35.5% of cases were available for follow up at the end of study period.<br/><br/>Conclusion<br/><br/>Chronic lower limb ulcers remain a major public health problem in this part of Tanzania. The majority of patients in our environment present late when the disease is already in advanced stages. Early recognition and aggressive treatment of the acute phase of chronic lower limb ulcers at the peripheral hospitals and close follow-up are urgently needed to improve outcomes of these patients in our environment.
700 ## - ADDED ENTRY--PERSONAL NAME
9 (RLIN) 22908
9 (RLIN) 15821
9 (RLIN) 22633
9 (RLIN) 15820
9 (RLIN) 22909
9 (RLIN) 22889
942 ## - ADDED ENTRY ELEMENTS (KOHA)
Source of classification or shelving scheme ddc
Koha item type RESEARCH ARTICLES
Holdings
Withdrawn status Lost status Source of classification or shelving scheme Damaged status Not for loan Collection Home library Current library Shelving location Date acquired Total checkouts Barcode Date last seen Price effective from Koha item type
            MWALIMU NYERERE LEARNING RESOURCES CENTRE-CUHAS BUGANDO MWALIMU NYERERE LEARNING RESOURCES CENTRE-CUHAS BUGANDO   08/21/2021   RA0027 08/21/2021 08/21/2021 RESEARCH ARTICLES
Catholic University of  Health and Allied Sciences - CUHAS
Directorate of ICT @ 2024