Ulcero-Necrotic Wound: Socio-Economic Impact, Kayes, Mali

Abstract

The issue of wound care has always played an important role in the practice of medicine. This is evidenced by Ambroise Paré’s decision to publish his first work on this subject, “La manière de traiter les Plaies” (The Way of Treating Wounds) in 1545. Objective: To evaluate the therapeutic methods we practice and to describe the impact of the pathology on socio-economic and professional development. Patients and Method: This was a retrospective study carried out at the Fousseyni Daou Hospital in Kayes from January 1, 2018 , to December 31, 2020. We included all patients with an ulcero-necrotic wound on immunocompetent terrain hospitalized in the department. Patients with ulcerative necrotic wounds o f diabetes, HIV , or cancerous origin were not included. The parameters studied were: etiologies, local care, sequelae, and socio-economic and professional aspects. Results: We collected 57 patients of whom 43 were men and 14 were women, i.e. a sex ratio of 3. The mean age was 40.7 years with a standard deviation of 8.4 with extremes (7 years and 80 years). The average consultation time was 25.1 days. The most represented socio-professional stratum was agropastoralism in 37 cases (65%). The predominant etiological factor was neglected traumatic wounds in 34 cases (59.6%). The site was the lower limb in 39 cases (68.5%). The germ found was Staphylococcus aureus in 21 cases (36.8%). The particularity during local care was the use of table sugar in 9 cases (15.7%) and maggot therapy in 2 cases (3.5%). Hyperthermia was the clinical sign of aggravation in 22 cases (38.6%) and we diagnosed 2 cases (3.5%) of tetanus. The mortality rate was 15.7% (9 cases) and 30 cases (52.7%) of sequelae after recovery. The average length of hospitalization was 38 days. Hospital care was provided by the social welfare servi ce in 35 cases (61.4%). Nineteen (19) patients (39.5%) were unable to resume their socio-professional activity. Conclusion: Ulcero-necrotic wounds are complex to manage and can have a lifelong influence on the socio-pro fessional and economic activity of patients.