School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, 852-8523, Japan
National Buruli Ulcer Control Program, Abidjan, Côte d’Ivoire
Eur J Dermatol. 2022 Apr 1;32(2):227-236. doi: 10.1684/ejd.2022.4225.
Buruli ulcer (BU) is a neglected tropical disease caused by Mycobacterium ulcerans which manifests as deep ulceration of the skin. Wounds from any cause heal slowly if individuals are malnourished.
To assess the impact of nutritional status on wound healing, we carried out a nutritional assessment of 11 patients diagnosed with BU in rural Côte d’Ivoire, and followed them longitudinally through the wound healing process.
MATERIALS & METHODS: We conducted patient interviews to collect data on their socioeconomic characteristics, food intake and perception of nutrition. We then prospectively carried out clinical observations to assess their wound healing until complete healing or the end of the study period (median follow-up period: 19 weeks).
The age of the patients ranged from 6 to 66 years (median: 24; interquartile range: 20.5-52). Nine patients had normal nutritional status, one had mild malnutrition and one had moderate malnutrition as assessed by their body mass index and/or mid-upper arm circumference. Three (60%) of the five patients with adequate caloric intake, but only 1/6 (17%) of the patients with an inadequate caloric intake achieved complete healing during follow-up. Low food intake from appetite loss primarily due to wound pain and odour was reported by seven patients after developing wounds.
Our study is the first of its kind, and the findings highlight the importance of integrating nutritional interventions into wound management protocols, and properly assessing and controlling wound pain in patients with BU.
溃疡分枝杆菌引起的皮肤深层溃疡是一种被忽视的热带病，称为溃疡分枝杆菌溃疡（BU）。如果个体营养不良，任何原因导致的伤口愈合都会很慢。
为了评估营养状况对伤口愈合的影响，我们对科特迪瓦农村地区的 11 名确诊为 BU 的患者进行了营养评估，并通过纵向观察伤口愈合过程对他们进行了随访。
我们对患者进行了访谈，以收集其社会经济特征、食物摄入和营养感知的数据。然后，我们前瞻性地进行了临床观察，以评估他们的伤口愈合情况，直到完全愈合或研究期结束（中位随访期：19 周）。
患者年龄为 6 至 66 岁（中位数：24；四分位距：20.5-52）。9 名患者的营养状况正常，1 名患者存在轻度营养不良，1 名患者存在中度营养不良，根据其体重指数和/或中上臂围评估。5 名热量摄入充足的患者中，有 3 名（60%）患者在随访期间完全愈合，而热量摄入不足的 6 名患者中，只有 1 名（17%）患者完全愈合。7 名患者在伤口形成后报告称，由于伤口疼痛和气味，食欲下降导致食物摄入量低。
我们的研究是首例此类研究，研究结果强调了将营养干预措施纳入伤口管理方案的重要性，以及在 BU 患者中正确评估和控制伤口疼痛的重要性。
