Chronic Wounds at Aného Prefectural Hospital Centre (Togo): Epidemiological, Etiological and Therapeutic Aspects about 373 Cases

Abstract

Introduction: Chronic wounds represent a public health problem due to the high cost of their nursing and the deterioration of patients’ quality of life. Their nursing may be confronted with delays in consultation or lack of specialists in secondary hospitals. Aims: To determine the epidemiological, etiological and therapeutic aspects of chronic wounds in the general surgery department of the Aného Prefectural Hospital Centre. Materials and Methods : This was a restrospective and descriptive study over five years (2019-2024) including patients aged 15 years and over, admitted to hospital for a chronic wound with a minimum follow-up of four months. The frequency, age, sex, duration of evolution, topography and etiology of wounds; the type of surgical treatment and the evolution were studied. Results: A total of 373 cases of chronic wounds were collected from 4127 hospitalised patients, giving a frequency of 9.04%. The medium age of the patients was 58.65 ± 17.70 years [17; 98], the sex ratio W/M was 1.5. The wounds were located on the foot in 45.31% (n = 169); extended from the foot to the leg in 27.61% (n = 169). The average duration of evolution of the wounds before admission was 20.02 ± 16.54 weeks [3; 56]. Wounds of diabetic origin were noted in 43.70% (n = 163) followed by wounds coming from infections 34.58% (n = 129) then wounds of venous origin in 7.50% (n = 28). The treatment consisted of necrosectomy completed by skin graft in 37.26% (n = 139), and amputations were noted in 15.30% (n = 57). Crossectomies and stripping of the saphenous veins were associated with skin grafts in 5.63% (n = 21). The average duration of hospitalisation was 19.90 ±15 days [6; 98]. The mortality rate was zero, morbidity was linked to amputation and the long hospital stay of some patients. Conclusion: Chronic wounds are regular and serious at Aného Hospital. Raising awareness among the population and implementing health coverage for all will enable early nursing and reduce morbidity.