Therapeutic Management and Evolution of Chronic Ulcerations of The Legs In Bangui, Central African Republic

Abstract

Kobangue Leon, Ngarhio Luc, Nzouloutou Davy Steve, Issa Alfred Mapouka and Nali Nestor Mamadou

Introduction: The therapeutic management of leg ulcers faces many challenges in resource-limited settings. The purpose of the work was to describe the treatment and evolution of these ulcers in Bangui.

Material and methods: This was a cross-sectional prospective study involving patients aged 18 and over hospitalized from October 2014 to June 2016 for a leg ulcer in the Bangui Surgery Department.

Results: A total of 41 patients were included. Cutaneous infection (41.5%) was the main cause of leg ulcers, followed by trauma (34.1%). In 63.4% of cases, the leg ulcer had evolved for less than 12 months. Self-medication was observed in 48.8%, while 29.2% was previously treated by traditional practitioners. The Para clinical examinations were hemogram (26.8%), HIV serology (26.8%) and histology (2.4%). All patients received medical treatment with antibiotics (ceftriaxone + metronidazole or Ciprofloxacin), antitetanus serum (1500 IU) and analgesic in case of pain. Blood transfusion was done in 17.1% of patients. Land treatment was prescribed for 46.3% of patients. All our patients had received local treatment depending on the state of the ulcer. Surgical treatment in 35 cases (85.4%) was done by mechanical debridement at the scalpel blade (71.42%), skin grafting (17.14%), amputation (8.57%) and excision (2.85%). The average duration of hospitalization was 33 days. About 36.6% of the patients had died. The cost of care is approximately 414,800 FCFA or 829.6 dollars per patient.

Conclusion: The mortality rate is still high. It is essential that strategies based on the information of the patients, the sensitization of the population and the training of the medical and paramedical personnel be developed in order to reduce the long duration of evolution of the disease and therefore of care.

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