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Surgical management of Buruli ulcer disease: A four year experience from four endemic districts in Ghana
Abstract
replaced with chemotherapy.
Objective: To study the impact on surgery of prior treatment of MU disease with rifampicin and streptomycin.
Study Design: Retrospective, from September 2004
to September 2009.
Setting: Asunafo, Amansie West, Ahafo Ano and Amansie Central districts of Ghana.
Methods: Patients who have completed 8 weeks or a minimum of 4 weeks treatment with rifampicin and streptomycin but have unhealed lesions were selected for surgery.
Results: 132 patients had surgery for MU disease; 51 at Tepa (Ahafo Ano); 36 at Agroyesum (Amansie West); 16 from Jacobu (Amansie Central); 29 from Goaso (Asunafo) districts. Their ages ranged from 4
to 98 years, with mean age of 29.90 years, standard deviation of 20.74. Sites involved were: head and neck 1 (0.74%), upper limb 40 (29.63%), lower limb 92 (68.15%), trunk 2 (1.48%) (N=135). The clinical
forms were: papule 1 (0.74%), nodule 2 (1.48%), oedematous lesion 4 (2.96%), osteomyelitis 2 (1.48%), ulcers 124 (91.85%), contractures 2
(1.48%). 139 surgical procedures were performed: excision 25 (18.11), skin grafting 36 (26.1%), excision and skin grafting 54 (39.1%), debridem net 10 (7.2%), sequestrectomy 2 (1.4%), regrafting 10 (7.2%), release of contractures 2 (1.4%).
Conclusion: Treatment of MU disease with rifampicin and streptomycin improved the condition and minimised the extent of surgery. Combination of surgery and antibiotics is necessary to prevent the development
contractures.
