Surgical management of eumycetoma: experience from Gezira Mycetoma Center, Sudan
Abstract Background In this study, we share our experience of different operative techniques undertaken on 584 eumycetoma patients in the Gezira Mycetoma Center. Methods This is a retrospective, descriptive, hospital-based study, conducted to review the surgical treatment of eumycetoma patients. We...
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| Format: | Article |
| Language: | English |
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BMC
2019-01-01
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| Series: | Tropical Medicine and Health |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s41182-018-0129-2 |
| _version_ | 1811206628359274496 |
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| author | Mohamed D. A. Gismalla Gamal M. A. Ahmed Mogahid M. MohamedAli Sami M. Taha Thouria A. Mohamed Ahmed E. Ahmed Lamia S. Hamed |
| author_facet | Mohamed D. A. Gismalla Gamal M. A. Ahmed Mogahid M. MohamedAli Sami M. Taha Thouria A. Mohamed Ahmed E. Ahmed Lamia S. Hamed |
| author_sort | Mohamed D. A. Gismalla |
| collection | DOAJ |
| description | Abstract Background In this study, we share our experience of different operative techniques undertaken on 584 eumycetoma patients in the Gezira Mycetoma Center. Methods This is a retrospective, descriptive, hospital-based study, conducted to review the surgical treatment of eumycetoma patients. We included all patients diagnosed with eumycetoma who underwent a surgical operation in the center during January 2013–December 2016. Results A total number of 1654 patients were seen during the study period, and their records were revised, while 584 (35.3%) of them underwent an operation and included in the study. There was a male predominance 446 (76.4%). Surgical excision of mycetoma was the commonest operation performed among 513 (87.8%) patients in comparison with amputation 71 (12.2%). Below-knee amputation and toe amputation are the commonest types of amputation in 36 (6.1%) and 14 (2.3%) patients, respectively. Clinical features determining the type of operation performed included the size of the lesion, whether or not a bone was involved, and the feasibility of primary closure. A wide surgical excision (WSE) is performed mainly when the bone is not involved and when moderate or primary closure is possible or reconstruction is feasible. Amputations will typically follow identifying bone involvement, secondary infection, and an already disabled patient. Conclusion The commonest procedure in our series was WSE and primary skin closure undertaken when the lesion was small (< 5 cm); there was no bone involvement, and the skin closure was achievable. Larger lesions (> 10 cm) without bone involvement were treated with excision and flap/graft. Bone involvement and large primary lesions were more likely to be managed by amputation. Recurrent and relapse of mycetoma were observed in patients with bone involvements or presented with recurrent mycetoma for the second time. |
| first_indexed | 2024-04-12T03:50:22Z |
| format | Article |
| id | doaj.art-0c7f94c1112b4944ae36425ad9cdf8d0 |
| institution | Directory Open Access Journal |
| issn | 1349-4147 |
| language | English |
| last_indexed | 2024-04-12T03:50:22Z |
| publishDate | 2019-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Tropical Medicine and Health |
| spelling | doaj.art-0c7f94c1112b4944ae36425ad9cdf8d02022-12-22T03:48:59ZengBMCTropical Medicine and Health1349-41472019-01-014711610.1186/s41182-018-0129-2Surgical management of eumycetoma: experience from Gezira Mycetoma Center, SudanMohamed D. A. Gismalla0Gamal M. A. Ahmed1Mogahid M. MohamedAli2Sami M. Taha3Thouria A. Mohamed4Ahmed E. Ahmed5Lamia S. Hamed6Department of surgery, Faculty of Surgery, Gezira UniversityDepartment of surgery, Faculty of Surgery, Gezira UniversityDepartment of surgery, Faculty of Surgery, Gezira UniversityDepartment of surgery, Faculty of Surgery, Gezira UniversityGezira Mycetoma Center, Ministry of HealthGezira Mycetoma Center, Ministry of HealthGezira Mycetoma Center, Ministry of HealthAbstract Background In this study, we share our experience of different operative techniques undertaken on 584 eumycetoma patients in the Gezira Mycetoma Center. Methods This is a retrospective, descriptive, hospital-based study, conducted to review the surgical treatment of eumycetoma patients. We included all patients diagnosed with eumycetoma who underwent a surgical operation in the center during January 2013–December 2016. Results A total number of 1654 patients were seen during the study period, and their records were revised, while 584 (35.3%) of them underwent an operation and included in the study. There was a male predominance 446 (76.4%). Surgical excision of mycetoma was the commonest operation performed among 513 (87.8%) patients in comparison with amputation 71 (12.2%). Below-knee amputation and toe amputation are the commonest types of amputation in 36 (6.1%) and 14 (2.3%) patients, respectively. Clinical features determining the type of operation performed included the size of the lesion, whether or not a bone was involved, and the feasibility of primary closure. A wide surgical excision (WSE) is performed mainly when the bone is not involved and when moderate or primary closure is possible or reconstruction is feasible. Amputations will typically follow identifying bone involvement, secondary infection, and an already disabled patient. Conclusion The commonest procedure in our series was WSE and primary skin closure undertaken when the lesion was small (< 5 cm); there was no bone involvement, and the skin closure was achievable. Larger lesions (> 10 cm) without bone involvement were treated with excision and flap/graft. Bone involvement and large primary lesions were more likely to be managed by amputation. Recurrent and relapse of mycetoma were observed in patients with bone involvements or presented with recurrent mycetoma for the second time.http://link.springer.com/article/10.1186/s41182-018-0129-2AmputationsEumycetomaMycetomaSudanSurgical excisionSurgery |
| spellingShingle | Mohamed D. A. Gismalla Gamal M. A. Ahmed Mogahid M. MohamedAli Sami M. Taha Thouria A. Mohamed Ahmed E. Ahmed Lamia S. Hamed Surgical management of eumycetoma: experience from Gezira Mycetoma Center, Sudan Tropical Medicine and Health Amputations Eumycetoma Mycetoma Sudan Surgical excision Surgery |
| title | Surgical management of eumycetoma: experience from Gezira Mycetoma Center, Sudan |
| title_full | Surgical management of eumycetoma: experience from Gezira Mycetoma Center, Sudan |
| title_fullStr | Surgical management of eumycetoma: experience from Gezira Mycetoma Center, Sudan |
| title_full_unstemmed | Surgical management of eumycetoma: experience from Gezira Mycetoma Center, Sudan |
| title_short | Surgical management of eumycetoma: experience from Gezira Mycetoma Center, Sudan |
| title_sort | surgical management of eumycetoma experience from gezira mycetoma center sudan |
| topic | Amputations Eumycetoma Mycetoma Sudan Surgical excision Surgery |
| url | http://link.springer.com/article/10.1186/s41182-018-0129-2 |
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