Saka B, Abilogoun-Chokki A E, Akakpo S, Teclessou J, Soga G W, Mahamadou G, Gnassingbe W, Mouhari-Toure A, Kombate K, Dosseh E D, Pitche V P
CHU Sylvanus Olympio, 30785 Lomé, Togo.
CHU Campus, Lomé, Togo.
Med Sante Trop. 2018 Aug 1;28(3):257-260. doi: 10.1684/mst.2018.0804.
The aim of this study was to document the profile and causes of chronic leg ulcers (CLU) in patients hospitalized in Lomé, Togo. This retrospective study reviewed records from the dermatology departments (CHU Sylvanus Olympio and Campus, and the dermatology center of Gbossimé) from 2000 to 2017 and from the general surgery department of CHU Sylvanus Olympio from 2013 to 2017 to identify cases. In all, 125 cases of CLU were identified during the study period. The patients' mean age was 56.6 years and the sex ratio (M/F) was 0.89. The average time from CLU onset to consultation was 10.9 weeks (range : 7 weeks to 4 years). They were mainly associated with a history of diabetes (32 cases), arterial hypertension (16 cases), varicose veins (14 cases), and malnutrition (14 cases). The main causes were : ulcers of infectious origin in 49.6% of cases (including 38 with phagedenic ulcers), ulcers of vascular origin in 36% (including 21 cases with a venous ulcer) and diabetic ulcers in 8.8% of cases. The ulcer was unilateral in 122 patients (67 on the right and 55 on the left) and bilateral in 3 patients. The locations were the foot in 56 cases, the leg in 37 cases, and leg and foot in 32 cases. In addition to dressings, surgical debridement was performed in 23 patients, followed by skin autografts for 16. Amputation was performed for 31 patients. Sixteen (12.8%) of the 125 patients died. Our study observed a high rate of phagedenic ulcers among CLU in Togo. It also pointed to a problem explaining the very high mortality rate: delayed consultation by patients who arrive only after the onset of complications.
本研究的目的是记录多哥洛美住院患者慢性腿部溃疡（CLU）的概况和病因。这项回顾性研究查阅了2000年至2017年皮肤病科（西尔瓦努斯·奥林匹奥大学医院和校区以及戈西米皮肤科中心）以及2013年至2017年西尔瓦努斯·奥林匹奥大学医院普通外科的记录以确定病例。在研究期间共确定了125例CLU病例。患者的平均年龄为56.6岁，性别比（男/女）为0.89。从CLU发病到就诊的平均时间为10.9周（范围：7周至4年）。它们主要与糖尿病史（32例）、动脉高血压（16例）、静脉曲张（14例）和营养不良（14例）有关。主要病因如下：49.6%的病例为感染性溃疡（包括38例蚕食性溃疡），36%为血管性溃疡（包括21例静脉溃疡），8.8%为糖尿病溃疡。122例患者的溃疡为单侧（右侧67例，左侧55例），3例为双侧。溃疡部位为足部56例，腿部37例，腿部和足部32例。除敷料外，23例患者进行了手术清创，随后16例进行了自体皮肤移植。31例患者进行了截肢。125例患者中有16例（12.8%）死亡。我们的研究观察到多哥CLU中蚕食性溃疡的发生率很高。它还指出了一个解释极高死亡率的问题：患者仅在并发症出现后才就诊，导致就诊延迟。
