Komla S AMOUZOU | University of Lome (original) (raw)

Papers by Komla S AMOUZOU

Defects located on the lower leg and the foot represents a challenging task for the reconstructiv... more Defects located on the lower leg and the foot represents a challenging task for the reconstructive surgeon, especially in high voltage electric burned patients. We admitted a 29-year-old male patient for forefeet defects following high voltage electric burns in our national burn and plastic surgery center. There was an exposition of metatarsal bones on both forefeet. We performed the distally-based superficial artery fasciocutaneous sural flap in a one-stage surgery separately for each side; the fascio subcutaneous pedicles were 5 cm wide buried under skin tunnels. We noticed suture dehiscence on the right foot and tip necrosis on the left foot. The bones were still covered. We used a V-Y advancement flap and split-thickness skin graft to complete the reconstruction. The wounds healed without any infectious complication. The ambulation was normal. The patient was satisfied with the flaps and did not complain about the donor sites.

Journal de la Recherche Scientifique de l’Université de Lomé, 2019

French Title: Le syndrome De Beckwick-Wiedemann neglige revele par une macroglossie severe The Be... more French Title: Le syndrome De Beckwick-Wiedemann neglige revele par une macroglossie severe The Beckwick-Wiedemann is a congenital syndrome (BWS) characterised by macroglossia, and other symptoms as abdominal wall congenital defect or hemihypertrophy. Some of the hallmark symptoms can appear lately after birth rending the diagnosis difficult. We present a case of macroglossia revealing a BWS in a 12-year-old girl, the social implications and the early surgical outcome. After a history of abdominal wall repair in early childhood, the girl was admitted to our Plastic and Reconstructive surgery department for dysarthria caused by the overgrowth tongue. The severe macroglossia, the congenital laparoschisis, and a hemi-body overgrowth lead to the BWS diagnosis. The surgical glossectomy using a keyhole technique provided good cosmetic results. The girl was lost in the follow-up screening. The frequency of congenital abnormalities is still underestimated in Africa especially in remote areas. The presence of a macroglossia might urge clinical examination seeking other BWS symptoms. Keywords: Macroglossia, Beckwith-Wiedemann syndrome, congenital abnormality, glossectomy, Africa.

PubMed, Dec 31, 2018

Burn in pregnancy represents a threat to the mother and the fetus. Burn care in pregnant women is... more Burn in pregnancy represents a threat to the mother and the fetus. Burn care in pregnant women is not well codified. An aggressive treatment including oxygen supplementation, smart fluid resuscitation and early excision has been reported. Nevertheless, auto-transplantation of amnion-chorion membrane in a pregnant woman with burns has not been reported to date. We present our first case of auto-transplantation of fresh amnion-chorion membrane in a pregnant woman admitted to our department with 14% TBSA deep and superficial burns associated with inhalation injury. The chorion-amnion membrane harvested after caesarean section was used to cover the excised and autograft sites. Outcome was good and all wounds healed. The child was healthy also.

Nigerian Journal of Plastic Surgery, 2017

Negative pressure wound therapy (NPWT) has become a popular tool for wound healing. The use of do... more Negative pressure wound therapy (NPWT) has become a popular tool for wound healing. The use of domestic material has been reported, but it is still not completely documented. We present the use of a domestic NPWT on traumatic wounds to achieve a final minimal reconstructive surgery. We treated three patients presenting with traumatic skin loss of the abdomen, lower leg, and foot with domestic NPWT. A wall suction was used as the source of negative pressure and gauzes as interface over the wounds. We documented the size of wounds, the anatomic structure exposed, the number and the length of cycles of NPWT, and the final reconstructive procedure. The cycles of NPWT ranged 3–5 days. A good granulating tissue appeared in range 17–21 days. Exposed urinary bladder, fractured metatarsal, and fractured lateral malleolus were covered by a good granulating tissue. There was no infectious complication. All the wounds healed with a split thickness skin graft. The cost of the procedure per patient ranged from 65 to 85 US Dollars. Domestic material for negative pressure has been a reliable technique in the management of traumatic wounds and helped pass down the reconstructive ladder.

Journal of cancer policy, Sep 1, 2018

Despite the emerging incidence of cancer, sub-Saharan African countries (SSAs) show the lowest ca... more Despite the emerging incidence of cancer, sub-Saharan African countries (SSAs) show the lowest cancer survival among the low-middle income countries while the access to cancer care is still unbalanced and unbearable compared with high-income countries. The aim of this literature review is to highlight the possible role, critical issues, and challenges linked to the implementation of teleoncology projects in SSAs. Methods: Screened studies with primary data, literature and systematic reviews reported in peer-reviewed publications were retrieved through two databases (PubMed and Google Scholar) and manual search. Results: Reported teleoncology projects were mainly related to cervical and breast cancers, and lymphoproliferative disorders performed in a small number of SSAs, using different digital tools, equipment, and information technology platforms. Although the teleoncology experiences were limited and scattered, the results are promising. A list of key success factors such as suitable telepathology and tele-radiotherapy supports and several recommendations have been identified. Beyond technical shortcomings of bandwidth, network coverage, power supply, training of healthcare professionals and financial sustain human obstacles may hinder the development of teleoncology programs. Conclusions: Teleoncology experiences in SSAs suggest the importance of identifying best practices for each local setting. Tailored teleoncology projects should be integrated into whole oncological services to amplify screening, diagnosis, therapies, and palliative care.

Objective: To describe “Sourire de l’Espoir” humanitarian missions in _X_ on cleft lip and palate... more Objective: To describe “Sourire de l’Espoir” humanitarian missions in _X_ on cleft lip and palate (CLP) repair and how it shaped the future of CLP repair in _X_. Design: Retrospective. Patients: Clinical files of patients operated for CLP during humanitarian missions from October 2008 to May 2013 in _Y_, the capital of _X_, were reviewed in a nine-month postoperative assessment from June to December 2020. Demographics, clinical, and therapeutic patterns were assessed. We also assessed the Zwisch method used for the training of local surgeons during the missions. Statistical analysis was performed with Epi Info (CDC version 7.1.3.3-2013). Results: CLP repair was performed in 201 patients during 10 missions. Patients’ mean age was 7.05 (SD 9.22) years (range: 3 months-50 years); the sex ratio was 1.05. Distribution of cases was as follows: Cleft lip (CL) 109/201 (54.23%); cleft palate (CP) 53/201 (26.23%), and CLP 39/201 (19.40%). The Tennison-Borde-Bedouelle-Malek technique was used ...

Nigerian Journal of Plastic Surgery, 2019

In Togo, reconstructive management has been based on local and regional flaps. In some severe cas... more In Togo, reconstructive management has been based on local and regional flaps. In some severe cases and in cases of failure, only a cross leg flap (if possible) or an amputation would save the patient. It has become vital to move forward in the reconstructive ladder in our setting. We report our first case of free gracilis muscle flap for the reconstruction of a foot defect in a 21-year-old male patient who was presented with a foot laceration due to a road traffic accident. The plastic surgeon had training in microsurgery. For other members of the operative team, this was the first microsurgery procedure. The gracilis muscle was harvested from the contralateral thigh and inset in the defect by microsurgical vascular anastomosis. The flap’s monitoring was done clinically. The post-operative course was uneventful. The muscle flap was resurfaced on day 5 using a split thickness skin graft. The patient was discharged on day 12. Total healing was seen on day 21. The patient was very satisfied with the procedure. The success of this first case represents an optimal motivation to build up a microsurgery team and the debut of microsurgery procedures for patients with difficult defects in Togo.

Annals of burns and fire disasters, 2020

Eyebrows have a critical functional and aesthetic role on the face. Alopecia on the eyebrows has ... more Eyebrows have a critical functional and aesthetic role on the face. Alopecia on the eyebrows has multiple origins, including scars formed after deep burns on the head and neck region. Reconstruction of the eyebrows represents a challenge for plastic surgeons due to their particular anatomical structure and variations inside of genders. Follicular Unit Transplantation (FUT) is believed to be the gold standard for the treatment of all sorts of alopecia, including that located on the eyebrows. However, FUT is technically demanding and requires skills, extensive anatomical knowledge, and equipment. In settings where FUT is still not feasible, flaps such as the superficial temporal artery island scalp flap remain reliable options. A 32-year-old male patient presented at the National Burn and Plastic Surgery Center, Casablanca (Morocco), with right eyebrow alopecia caused by fire burn on the face. We reconstructed the alopecia using a superficial temporal artery island scalp flap. The res...

Objectif : cette etude avait pour objectif de decrire les differentes pratiques en matiere de soi... more Objectif : cette etude avait pour objectif de decrire les differentes pratiques en matiere de soins du site operatoire dans le service de traumatologie-orthopedie afin d’en ameliorer la qualite. Patients et methodes : C’etait une etude transversale descriptive ayant portee sur des patients operes dans le service de chirurgie traumatologique et orthopedique du CHU SO du 1er janvier au 30 juin 2013. Les variables analysees ont ete celles relatives aux donnees demographiques, aux antecedents des patients et aux parametres lies aux soins pre, per et postoperatoires. Resultats : L’etude a concerne 37 patients dont 27 etaient de sexe masculin soit une sexratio M/F de 2,7. Avant l’admission des patients en salle d’operation, le site a operer n’est pas prepare la veille. Au bloc operatoire, les osteosyntheses de femur avec 24,3% et du tibia, 13,5% ont ete les interventions les plus frequemment realisees et ont majoritairement dure au moins une heure trente minutes ; la ceftriaxone a raison ...

HEALTH SCIENCES AND DISEASES, 2020

The occurrence of electrical accidents in operating theaters exists mainly due to the growing num... more The occurrence of electrical accidents in operating theaters exists mainly due to the growing number of electronic equipment used. The electrosurgical unit remains the most used device. When it is defective or improperly placed on a reduced surface of the skin, the scalpel plate can be the cause of skin burn. This burn may be deep in a few cases and not heal spontaneously; in theses cases, a surgical gesture will be necessary. This event adds morbidity to the initial pathology and impacts negatively the patient, the surgeon and the hospital. Iatrogenic burn seems rare, due to a problem of definition and terminology. It is most often caused by scalpel plate when using the monopolar electrosurgical unit. We report these cases, due to the exceptional occurrence of this type of burn in the practice of the National Burn Center of the Ibn Rochd University Hospital of Casablanca. It is likely that these lesions are underestimated and / or underevaluated by operating theater practitioners, ...

Wound Healing Southern Africa, 2017

Purpose: Data about the epidemiological and clinical characteristics of leg ulcers in our country... more Purpose: Data about the epidemiological and clinical characteristics of leg ulcers in our country are still insufficiently documented. Material and methods: Charts of patients hospitalised for leg ulcers in the Department of General Surgery between 1 January 2009 and 31 December 2014 were retrospectively assessed for sociodemographic, clinical, therapeutic, and outcome characteristics. Results: In total, 582 charts reported leg ulcers thus representing 33% of all charts in the Department of Surgery during the study period. Among them, 144 charts contained enough information to be included in the study. The population of patients with leg ulcers was approximately balanced with respect to gender (1.15 men to women ratio). Median age was 53.07± 17.9 years old (yo), (range 18–90). Diabetes (27.8%), hypertension (11.8%) and alcohol consumption (8%) were the most prevalent of the reported medical history. Leg ulcers presented as infectious ulcers (necrotising fasciitis, superinfected trau...

Nigerian Journal of Plastic Surgery, 2017

Background: The management of lower limb soft tissue defects is still a challenge in our setting.... more Background: The management of lower limb soft tissue defects is still a challenge in our setting. Aims: This study aimed to review the clinical and socio-demographic characteristics of the patients with traumatic lower limbs defect and evaluate the results of surgical management in our setting. Settings and Design: Retrospective descriptive study. Materials and Methods: The charts of 30 adults patients treated surgically for lower limb soft tissue defects in the period from 1 January to 31 December 2014 were reviewed. Socio-demographic, clinical and therapeutic characteristics were documented. Statistical Analysis Used: The results were as general descriptive statistics, presented as medians, percentages and ranges. Results: The mean age was 34 years (range 18–60 years). The sex ratio was 3.28 for men. In 83% of the cases (20/30), injuries were due to collision between motorcycle and other vehicles. Soft tissue defects were type III B (50%, 15/30) and III A (47%, 14/30) of Gustilo-A...

Journal of Surgical Oncology, 2021

BackgroundIn sub‐Saharan countries (SSAs), the advanced stage at diagnosis and the limited surgic... more BackgroundIn sub‐Saharan countries (SSAs), the advanced stage at diagnosis and the limited surgical interventions of female breast cancer (FBC) lead to poor outcomes. This study assessed current modalities of FBC surgeries.MethodsSix literature databases (Medline, Embase, African Journal Online, Google Scholar, Web of Science, Cochrane Library) were searched, plus a manual search, in 2011–2021. We included primary data studies with any setting and presurgeries or postsurgeries treatments, we excluded non‐English language studies, editorials, and grey literature.ResultsThe search yielded 21 observational studies (16 retrospective, 3 prospective, and 2 case reports). Of the total 6900 patients, 4121 (60%) patients underwent FBC surgical excision only, and 751/2779 (27%) conservative surgery (BCS) or therapy (BCT). All studies reported similar use of mastectomy (>60%), the FBC surgical excision/reconstruction studies displayed more neoadjuvant chemotherapy (536/2779, 19% vs. 215/412...

Journal of Pediatric Surgery Case Reports, 2021

Pan African Medical Journal, 2020

In the COVID-19's crisis, elective surgery and nonemergent cases were postponed; all other proced... more In the COVID-19's crisis, elective surgery and nonemergent cases were postponed; all other procedures have to be minimized. A 17-year male patient with severe crush and degloving injury over the thigh, gluteal, sacral, and perineum areas was admitted to our Department on the 16 th of March 2020. The patient presented soft tissue skin and muscle loss. A double Latissimus Dorsi and Anterolateral Thigh free flaps were indicated. However, due to the particular circumstance of the COVID-19 crisis, we applied domestic negative wound therapy (NPWT) using gauzes and wall

Journal of Surgery and Surgical Research, 2017

Purpose: The elbow bone traumas are very serious lesions that can compromise the function of this... more Purpose: The elbow bone traumas are very serious lesions that can compromise the function of this joint in the future. These lesions are most severe when there is a defect of bone which affects one component of the joint. Case report: We report a case of open trauma of the left elbow from a right-handed girl of 21 years, during an accident on the highway. On admission, the victim had a signifi cant defect of skin-muscle of the anterior medial aspect of the elbow. The exploration revealed a major loss of bone affecting the humeral trochlea which was completely absent. In emergency the patient has benefi ted from joint stabilization by an external fi xation, with a fi lling-in of the humeral-ulnar joint space with a cement spacer. The loss of muscle substance was fi lled with a latissimus dorsi fl ap followed by a skin graft made the days that followed. Conclusion: After a brief review of the literature, the authors emphasize on the need to preserve the joint space through the establishment of the spacer which is the only guarantee for maintaining the stability of the elbow, which also allows to consider arthroplasty surgery later.

Nigerian Journal of Plastic Surgery, 2018

Extravasation of cytotoxics is a dreaded complication of the intravenous route medication, especi... more Extravasation of cytotoxics is a dreaded complication of the intravenous route medication, especially in chemotherapy. The use of saline washout is insufficiently documented in the literature. Here, we report the excellent results of using saline washout in the management of these injuries. Three patients presenting extravasation of anthracycline, calcium gluconate, and radiologic contrast were treated in our department by saline washout. The technique was a use of saline to flush the extravasation area after liposuction of the body site injured. All patients were treated in an outpatient setting. No case of skin necrosis nor other complications related to the extravasation or to the surgical technique have been reported during the follow-up. Patients with extravasation should be referred to the plastic department at early stage. Saline washout is reliable technique to prevent skin and soft tissue necrosis caused by extravasation of cytotoxics.

The Journal of Foot and Ankle Surgery, 2009

Chronic Achilles tendon ruptures are often challenging to repair because of muscle and tendon atr... more Chronic Achilles tendon ruptures are often challenging to repair because of muscle and tendon atrophy, retraction, and short distal stumps. We undertook a retrospective investigation of 14 patients who were treated with the Ligament Advanced Reinforcement System (LARS) ligament for the treatment of chronic, neglected rupture of the Achilles tendon. The patients pursued a course of early functional rehabilitation, and postoperative outcome scores were obtained at 3, 6, and 12 months, based on the American Orthopaedic Foot and Ankle Society (AOFAS) ankle and hindfoot scoring system, and the Tegner Activity score. The minimum duration of follow-up was 36 months. After a minimum of 28 months postoperative, and up to 41 months postoperative, there was no observed incidence of rerupture or recurrent pain. The mean time to return to full activity was 18.

Introduction: La prise en charge des pertes de substances cutanees etendues, parait difficile en ... more Introduction: La prise en charge des pertes de substances cutanees etendues, parait difficile en milieu rural faute de plateau technique adequat. L’objectif de notre travail etait de rappeler le recours a la technique de greffe en pastilles en milieu rural, a travers les bons resultats que nous avons obtenus a partir de 03 cas a l’hopital Bethesda d’Agou-Nyogbo. Materiels et methode: Il s’est agi d’une etude prospective allant de Fevrier en Decembre 2015, soit 10 mois menee dans le service de chirurgie de l’Hopital Bethesda d’Agou- Nyogbo. Elle a porte sur 03 patients ayant presente des plaies de profondeur et etendue variables localisees aux jambes et aux pieds. La couverture de ces pertes de substances cutanees a ete faite par des greffes en pastilles. Resultats: La duree moyenne de cicatrisation complete apres les greffes en pastilles etait de 59,33jours. Les plaies ont cicatrise sans complication majeure en dehors de la dyschromie et une necrose partielle tres limitee chez un pa...

Defects located on the lower leg and the foot represents a challenging task for the reconstructiv... more Defects located on the lower leg and the foot represents a challenging task for the reconstructive surgeon, especially in high voltage electric burned patients. We admitted a 29-year-old male patient for forefeet defects following high voltage electric burns in our national burn and plastic surgery center. There was an exposition of metatarsal bones on both forefeet. We performed the distally-based superficial artery fasciocutaneous sural flap in a one-stage surgery separately for each side; the fascio subcutaneous pedicles were 5 cm wide buried under skin tunnels. We noticed suture dehiscence on the right foot and tip necrosis on the left foot. The bones were still covered. We used a V-Y advancement flap and split-thickness skin graft to complete the reconstruction. The wounds healed without any infectious complication. The ambulation was normal. The patient was satisfied with the flaps and did not complain about the donor sites.

Journal de la Recherche Scientifique de l’Université de Lomé, 2019

French Title: Le syndrome De Beckwick-Wiedemann neglige revele par une macroglossie severe The Be... more French Title: Le syndrome De Beckwick-Wiedemann neglige revele par une macroglossie severe The Beckwick-Wiedemann is a congenital syndrome (BWS) characterised by macroglossia, and other symptoms as abdominal wall congenital defect or hemihypertrophy. Some of the hallmark symptoms can appear lately after birth rending the diagnosis difficult. We present a case of macroglossia revealing a BWS in a 12-year-old girl, the social implications and the early surgical outcome. After a history of abdominal wall repair in early childhood, the girl was admitted to our Plastic and Reconstructive surgery department for dysarthria caused by the overgrowth tongue. The severe macroglossia, the congenital laparoschisis, and a hemi-body overgrowth lead to the BWS diagnosis. The surgical glossectomy using a keyhole technique provided good cosmetic results. The girl was lost in the follow-up screening. The frequency of congenital abnormalities is still underestimated in Africa especially in remote areas. The presence of a macroglossia might urge clinical examination seeking other BWS symptoms. Keywords: Macroglossia, Beckwith-Wiedemann syndrome, congenital abnormality, glossectomy, Africa.

PubMed, Dec 31, 2018

Burn in pregnancy represents a threat to the mother and the fetus. Burn care in pregnant women is... more Burn in pregnancy represents a threat to the mother and the fetus. Burn care in pregnant women is not well codified. An aggressive treatment including oxygen supplementation, smart fluid resuscitation and early excision has been reported. Nevertheless, auto-transplantation of amnion-chorion membrane in a pregnant woman with burns has not been reported to date. We present our first case of auto-transplantation of fresh amnion-chorion membrane in a pregnant woman admitted to our department with 14% TBSA deep and superficial burns associated with inhalation injury. The chorion-amnion membrane harvested after caesarean section was used to cover the excised and autograft sites. Outcome was good and all wounds healed. The child was healthy also.

Nigerian Journal of Plastic Surgery, 2017

Negative pressure wound therapy (NPWT) has become a popular tool for wound healing. The use of do... more Negative pressure wound therapy (NPWT) has become a popular tool for wound healing. The use of domestic material has been reported, but it is still not completely documented. We present the use of a domestic NPWT on traumatic wounds to achieve a final minimal reconstructive surgery. We treated three patients presenting with traumatic skin loss of the abdomen, lower leg, and foot with domestic NPWT. A wall suction was used as the source of negative pressure and gauzes as interface over the wounds. We documented the size of wounds, the anatomic structure exposed, the number and the length of cycles of NPWT, and the final reconstructive procedure. The cycles of NPWT ranged 3–5 days. A good granulating tissue appeared in range 17–21 days. Exposed urinary bladder, fractured metatarsal, and fractured lateral malleolus were covered by a good granulating tissue. There was no infectious complication. All the wounds healed with a split thickness skin graft. The cost of the procedure per patient ranged from 65 to 85 US Dollars. Domestic material for negative pressure has been a reliable technique in the management of traumatic wounds and helped pass down the reconstructive ladder.

Journal of cancer policy, Sep 1, 2018

Despite the emerging incidence of cancer, sub-Saharan African countries (SSAs) show the lowest ca... more Despite the emerging incidence of cancer, sub-Saharan African countries (SSAs) show the lowest cancer survival among the low-middle income countries while the access to cancer care is still unbalanced and unbearable compared with high-income countries. The aim of this literature review is to highlight the possible role, critical issues, and challenges linked to the implementation of teleoncology projects in SSAs. Methods: Screened studies with primary data, literature and systematic reviews reported in peer-reviewed publications were retrieved through two databases (PubMed and Google Scholar) and manual search. Results: Reported teleoncology projects were mainly related to cervical and breast cancers, and lymphoproliferative disorders performed in a small number of SSAs, using different digital tools, equipment, and information technology platforms. Although the teleoncology experiences were limited and scattered, the results are promising. A list of key success factors such as suitable telepathology and tele-radiotherapy supports and several recommendations have been identified. Beyond technical shortcomings of bandwidth, network coverage, power supply, training of healthcare professionals and financial sustain human obstacles may hinder the development of teleoncology programs. Conclusions: Teleoncology experiences in SSAs suggest the importance of identifying best practices for each local setting. Tailored teleoncology projects should be integrated into whole oncological services to amplify screening, diagnosis, therapies, and palliative care.

Objective: To describe “Sourire de l’Espoir” humanitarian missions in _X_ on cleft lip and palate... more Objective: To describe “Sourire de l’Espoir” humanitarian missions in _X_ on cleft lip and palate (CLP) repair and how it shaped the future of CLP repair in _X_. Design: Retrospective. Patients: Clinical files of patients operated for CLP during humanitarian missions from October 2008 to May 2013 in _Y_, the capital of _X_, were reviewed in a nine-month postoperative assessment from June to December 2020. Demographics, clinical, and therapeutic patterns were assessed. We also assessed the Zwisch method used for the training of local surgeons during the missions. Statistical analysis was performed with Epi Info (CDC version 7.1.3.3-2013). Results: CLP repair was performed in 201 patients during 10 missions. Patients’ mean age was 7.05 (SD 9.22) years (range: 3 months-50 years); the sex ratio was 1.05. Distribution of cases was as follows: Cleft lip (CL) 109/201 (54.23%); cleft palate (CP) 53/201 (26.23%), and CLP 39/201 (19.40%). The Tennison-Borde-Bedouelle-Malek technique was used ...

Nigerian Journal of Plastic Surgery, 2019

In Togo, reconstructive management has been based on local and regional flaps. In some severe cas... more In Togo, reconstructive management has been based on local and regional flaps. In some severe cases and in cases of failure, only a cross leg flap (if possible) or an amputation would save the patient. It has become vital to move forward in the reconstructive ladder in our setting. We report our first case of free gracilis muscle flap for the reconstruction of a foot defect in a 21-year-old male patient who was presented with a foot laceration due to a road traffic accident. The plastic surgeon had training in microsurgery. For other members of the operative team, this was the first microsurgery procedure. The gracilis muscle was harvested from the contralateral thigh and inset in the defect by microsurgical vascular anastomosis. The flap’s monitoring was done clinically. The post-operative course was uneventful. The muscle flap was resurfaced on day 5 using a split thickness skin graft. The patient was discharged on day 12. Total healing was seen on day 21. The patient was very satisfied with the procedure. The success of this first case represents an optimal motivation to build up a microsurgery team and the debut of microsurgery procedures for patients with difficult defects in Togo.

Annals of burns and fire disasters, 2020

Eyebrows have a critical functional and aesthetic role on the face. Alopecia on the eyebrows has ... more Eyebrows have a critical functional and aesthetic role on the face. Alopecia on the eyebrows has multiple origins, including scars formed after deep burns on the head and neck region. Reconstruction of the eyebrows represents a challenge for plastic surgeons due to their particular anatomical structure and variations inside of genders. Follicular Unit Transplantation (FUT) is believed to be the gold standard for the treatment of all sorts of alopecia, including that located on the eyebrows. However, FUT is technically demanding and requires skills, extensive anatomical knowledge, and equipment. In settings where FUT is still not feasible, flaps such as the superficial temporal artery island scalp flap remain reliable options. A 32-year-old male patient presented at the National Burn and Plastic Surgery Center, Casablanca (Morocco), with right eyebrow alopecia caused by fire burn on the face. We reconstructed the alopecia using a superficial temporal artery island scalp flap. The res...

Objectif : cette etude avait pour objectif de decrire les differentes pratiques en matiere de soi... more Objectif : cette etude avait pour objectif de decrire les differentes pratiques en matiere de soins du site operatoire dans le service de traumatologie-orthopedie afin d’en ameliorer la qualite. Patients et methodes : C’etait une etude transversale descriptive ayant portee sur des patients operes dans le service de chirurgie traumatologique et orthopedique du CHU SO du 1er janvier au 30 juin 2013. Les variables analysees ont ete celles relatives aux donnees demographiques, aux antecedents des patients et aux parametres lies aux soins pre, per et postoperatoires. Resultats : L’etude a concerne 37 patients dont 27 etaient de sexe masculin soit une sexratio M/F de 2,7. Avant l’admission des patients en salle d’operation, le site a operer n’est pas prepare la veille. Au bloc operatoire, les osteosyntheses de femur avec 24,3% et du tibia, 13,5% ont ete les interventions les plus frequemment realisees et ont majoritairement dure au moins une heure trente minutes ; la ceftriaxone a raison ...

HEALTH SCIENCES AND DISEASES, 2020

The occurrence of electrical accidents in operating theaters exists mainly due to the growing num... more The occurrence of electrical accidents in operating theaters exists mainly due to the growing number of electronic equipment used. The electrosurgical unit remains the most used device. When it is defective or improperly placed on a reduced surface of the skin, the scalpel plate can be the cause of skin burn. This burn may be deep in a few cases and not heal spontaneously; in theses cases, a surgical gesture will be necessary. This event adds morbidity to the initial pathology and impacts negatively the patient, the surgeon and the hospital. Iatrogenic burn seems rare, due to a problem of definition and terminology. It is most often caused by scalpel plate when using the monopolar electrosurgical unit. We report these cases, due to the exceptional occurrence of this type of burn in the practice of the National Burn Center of the Ibn Rochd University Hospital of Casablanca. It is likely that these lesions are underestimated and / or underevaluated by operating theater practitioners, ...

Wound Healing Southern Africa, 2017

Purpose: Data about the epidemiological and clinical characteristics of leg ulcers in our country... more Purpose: Data about the epidemiological and clinical characteristics of leg ulcers in our country are still insufficiently documented. Material and methods: Charts of patients hospitalised for leg ulcers in the Department of General Surgery between 1 January 2009 and 31 December 2014 were retrospectively assessed for sociodemographic, clinical, therapeutic, and outcome characteristics. Results: In total, 582 charts reported leg ulcers thus representing 33% of all charts in the Department of Surgery during the study period. Among them, 144 charts contained enough information to be included in the study. The population of patients with leg ulcers was approximately balanced with respect to gender (1.15 men to women ratio). Median age was 53.07± 17.9 years old (yo), (range 18–90). Diabetes (27.8%), hypertension (11.8%) and alcohol consumption (8%) were the most prevalent of the reported medical history. Leg ulcers presented as infectious ulcers (necrotising fasciitis, superinfected trau...

Nigerian Journal of Plastic Surgery, 2017

Background: The management of lower limb soft tissue defects is still a challenge in our setting.... more Background: The management of lower limb soft tissue defects is still a challenge in our setting. Aims: This study aimed to review the clinical and socio-demographic characteristics of the patients with traumatic lower limbs defect and evaluate the results of surgical management in our setting. Settings and Design: Retrospective descriptive study. Materials and Methods: The charts of 30 adults patients treated surgically for lower limb soft tissue defects in the period from 1 January to 31 December 2014 were reviewed. Socio-demographic, clinical and therapeutic characteristics were documented. Statistical Analysis Used: The results were as general descriptive statistics, presented as medians, percentages and ranges. Results: The mean age was 34 years (range 18–60 years). The sex ratio was 3.28 for men. In 83% of the cases (20/30), injuries were due to collision between motorcycle and other vehicles. Soft tissue defects were type III B (50%, 15/30) and III A (47%, 14/30) of Gustilo-A...

Journal of Surgical Oncology, 2021

BackgroundIn sub‐Saharan countries (SSAs), the advanced stage at diagnosis and the limited surgic... more BackgroundIn sub‐Saharan countries (SSAs), the advanced stage at diagnosis and the limited surgical interventions of female breast cancer (FBC) lead to poor outcomes. This study assessed current modalities of FBC surgeries.MethodsSix literature databases (Medline, Embase, African Journal Online, Google Scholar, Web of Science, Cochrane Library) were searched, plus a manual search, in 2011–2021. We included primary data studies with any setting and presurgeries or postsurgeries treatments, we excluded non‐English language studies, editorials, and grey literature.ResultsThe search yielded 21 observational studies (16 retrospective, 3 prospective, and 2 case reports). Of the total 6900 patients, 4121 (60%) patients underwent FBC surgical excision only, and 751/2779 (27%) conservative surgery (BCS) or therapy (BCT). All studies reported similar use of mastectomy (>60%), the FBC surgical excision/reconstruction studies displayed more neoadjuvant chemotherapy (536/2779, 19% vs. 215/412...

Journal of Pediatric Surgery Case Reports, 2021

Pan African Medical Journal, 2020

In the COVID-19's crisis, elective surgery and nonemergent cases were postponed; all other proced... more In the COVID-19's crisis, elective surgery and nonemergent cases were postponed; all other procedures have to be minimized. A 17-year male patient with severe crush and degloving injury over the thigh, gluteal, sacral, and perineum areas was admitted to our Department on the 16 th of March 2020. The patient presented soft tissue skin and muscle loss. A double Latissimus Dorsi and Anterolateral Thigh free flaps were indicated. However, due to the particular circumstance of the COVID-19 crisis, we applied domestic negative wound therapy (NPWT) using gauzes and wall

Journal of Surgery and Surgical Research, 2017

Purpose: The elbow bone traumas are very serious lesions that can compromise the function of this... more Purpose: The elbow bone traumas are very serious lesions that can compromise the function of this joint in the future. These lesions are most severe when there is a defect of bone which affects one component of the joint. Case report: We report a case of open trauma of the left elbow from a right-handed girl of 21 years, during an accident on the highway. On admission, the victim had a signifi cant defect of skin-muscle of the anterior medial aspect of the elbow. The exploration revealed a major loss of bone affecting the humeral trochlea which was completely absent. In emergency the patient has benefi ted from joint stabilization by an external fi xation, with a fi lling-in of the humeral-ulnar joint space with a cement spacer. The loss of muscle substance was fi lled with a latissimus dorsi fl ap followed by a skin graft made the days that followed. Conclusion: After a brief review of the literature, the authors emphasize on the need to preserve the joint space through the establishment of the spacer which is the only guarantee for maintaining the stability of the elbow, which also allows to consider arthroplasty surgery later.

Nigerian Journal of Plastic Surgery, 2018

Extravasation of cytotoxics is a dreaded complication of the intravenous route medication, especi... more Extravasation of cytotoxics is a dreaded complication of the intravenous route medication, especially in chemotherapy. The use of saline washout is insufficiently documented in the literature. Here, we report the excellent results of using saline washout in the management of these injuries. Three patients presenting extravasation of anthracycline, calcium gluconate, and radiologic contrast were treated in our department by saline washout. The technique was a use of saline to flush the extravasation area after liposuction of the body site injured. All patients were treated in an outpatient setting. No case of skin necrosis nor other complications related to the extravasation or to the surgical technique have been reported during the follow-up. Patients with extravasation should be referred to the plastic department at early stage. Saline washout is reliable technique to prevent skin and soft tissue necrosis caused by extravasation of cytotoxics.

The Journal of Foot and Ankle Surgery, 2009

Chronic Achilles tendon ruptures are often challenging to repair because of muscle and tendon atr... more Chronic Achilles tendon ruptures are often challenging to repair because of muscle and tendon atrophy, retraction, and short distal stumps. We undertook a retrospective investigation of 14 patients who were treated with the Ligament Advanced Reinforcement System (LARS) ligament for the treatment of chronic, neglected rupture of the Achilles tendon. The patients pursued a course of early functional rehabilitation, and postoperative outcome scores were obtained at 3, 6, and 12 months, based on the American Orthopaedic Foot and Ankle Society (AOFAS) ankle and hindfoot scoring system, and the Tegner Activity score. The minimum duration of follow-up was 36 months. After a minimum of 28 months postoperative, and up to 41 months postoperative, there was no observed incidence of rerupture or recurrent pain. The mean time to return to full activity was 18.

Introduction: La prise en charge des pertes de substances cutanees etendues, parait difficile en ... more Introduction: La prise en charge des pertes de substances cutanees etendues, parait difficile en milieu rural faute de plateau technique adequat. L’objectif de notre travail etait de rappeler le recours a la technique de greffe en pastilles en milieu rural, a travers les bons resultats que nous avons obtenus a partir de 03 cas a l’hopital Bethesda d’Agou-Nyogbo. Materiels et methode: Il s’est agi d’une etude prospective allant de Fevrier en Decembre 2015, soit 10 mois menee dans le service de chirurgie de l’Hopital Bethesda d’Agou- Nyogbo. Elle a porte sur 03 patients ayant presente des plaies de profondeur et etendue variables localisees aux jambes et aux pieds. La couverture de ces pertes de substances cutanees a ete faite par des greffes en pastilles. Resultats: La duree moyenne de cicatrisation complete apres les greffes en pastilles etait de 59,33jours. Les plaies ont cicatrise sans complication majeure en dehors de la dyschromie et une necrose partielle tres limitee chez un pa...