TY - JOUR
KW - Surgery
AU - Calonge WM
AU - Meredith P
AU - Kouakou-Adonis KA
AU - Yao CK
AU - N’da Assie KM
AU - Asse H
AB - Introduction
Infection by Mycobacterium ulcerans constitutes a neglected tropical disease whose prevalence seems to have overrun those of cutaneous tuberculosis and leprosy. Its aggressivity depends on a mycolactone toxin. Lesions may involve skin, tendon and bone with a large spectrum of manifestations: non-ulcerative (papules, nodules, plaques), ulcerative and oedematous presentations as well as osteomyelitis with muscular contraction and ankylosis. Upper limbs account for more than two thirds of the infection sites. Surgical treatment may involve tendon transpositions, partial and total skin grafts. Amputation is relegated to extreme cases.
Material and methods
Selected iconography from patients during the last 15 years is presented. At least 1500 cases had partial skin grafts (anterior thigh). Total skin grafts (inguinal region) were used in about 200 cases. Complex lesions involved 9 ilioinguinal flaps (5 boys, 4 girls, mean age 11.2 years, range 2–16 years), 5 tendon transfers (4 boys, one girl, mean age 15.4 years, range 12–19 years) and 3 resections of the first carpal row (2 girls, 1 boy, mean age 8 years, range 4–15 years).
Results and discussion
Out of 9 ilioinguinal flaps mild, marginal necrosis was the only complication in 2 patients without flap loss. Mean hospital stay was 26.44 days (range, 18–41 days), with return to full weight-bearing after a mean of 12 weeks (range 9–25 weeks) after discharge. Functional thumb opposition to allow pencil prehension was achieved in all three cases of resection of first carpal row resection without postoperative complications.
BT - Journal of Plastic Surgery and Hand Surgery
DO - 10.1080/2000656x.2021.1884083
LA - eng
N2 - Introduction
Infection by Mycobacterium ulcerans constitutes a neglected tropical disease whose prevalence seems to have overrun those of cutaneous tuberculosis and leprosy. Its aggressivity depends on a mycolactone toxin. Lesions may involve skin, tendon and bone with a large spectrum of manifestations: non-ulcerative (papules, nodules, plaques), ulcerative and oedematous presentations as well as osteomyelitis with muscular contraction and ankylosis. Upper limbs account for more than two thirds of the infection sites. Surgical treatment may involve tendon transpositions, partial and total skin grafts. Amputation is relegated to extreme cases.
Material and methods
Selected iconography from patients during the last 15 years is presented. At least 1500 cases had partial skin grafts (anterior thigh). Total skin grafts (inguinal region) were used in about 200 cases. Complex lesions involved 9 ilioinguinal flaps (5 boys, 4 girls, mean age 11.2 years, range 2–16 years), 5 tendon transfers (4 boys, one girl, mean age 15.4 years, range 12–19 years) and 3 resections of the first carpal row (2 girls, 1 boy, mean age 8 years, range 4–15 years).
Results and discussion
Out of 9 ilioinguinal flaps mild, marginal necrosis was the only complication in 2 patients without flap loss. Mean hospital stay was 26.44 days (range, 18–41 days), with return to full weight-bearing after a mean of 12 weeks (range 9–25 weeks) after discharge. Functional thumb opposition to allow pencil prehension was achieved in all three cases of resection of first carpal row resection without postoperative complications.
PB - Informa UK Limited
PY - 2021
SP - 1
EP - 6
T2 - Journal of Plastic Surgery and Hand Surgery
TI - Reconstructive surgery for sequellae of Mycobacterium ulcerans infection (Buruli ulcer) of the upper limb
UR - https://www.tandfonline.com/doi/pdf/10.1080/2000656X.2021.1884083?needAccess=true
SN - 2000-656X, 2000-6764
ER -