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July-December 2016 Volume 12 | Issue 2
Page Nos. 43-75
Online since Friday, March 17, 2017
Accessed 40,124 times.
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ORIGINAL ARTICLES |
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Initial experience in breast reconstruction with implants by general surgeons: A report of five cases |
p. 43 |
Oludolapo Ola Afuwape, Omobolaji O Ayandipo, Abdussemee I Abdurrazzaaq DOI:10.4103/0794-9316.202464 Context: This article presents a preliminary experience on implant breast reconstruction undertaken by the general surgeons in a tertiary hospital in Nigeria.
Aim: This article presents a preliminary experience on the implant breast reconstruction undertaken by the general surgeons in a tertiary hospital in Nigeria. It also discusses our challenges and limitations.
Patients and Methods: Five patients who consented to implant surgery in 5 years were reviewed retrospectively.
Results: Four of the five patients were satisfied with the outcome in the early postoperative period. There was one flap necrosis and one capsular contracture which developed a year after the procedure.
Conclusion: The practice of breast reconstruction in Nigeria is evolving, and demands will be made on general surgeons, especially in centers without reconstructive surgeons.
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Perception of healthcare professionals in University College Hospital, Ibadan toward wound care |
p. 47 |
Ayodele O Iyun, Samuel A Ademola, Afie Michael, Olayinka Olawoye, Odunayo Oluwatosin DOI:10.4103/0794-9316.202437 Background: A survey of perception of healthcare workers in a tertiary hospital [University College Hospital (UCH), Ibadan] was done with a view to determine the need to introduce a curriculum in wound care for healthcare workers.
Materials and Methods: A self-administered questionnaire was used to capture data related to knowledge and practices on wound care from healthcare workers in UCH, Ibadan. Descriptive analysis was done using the Statistical Package for the Social Sciences version 21 software (SPSS Inc., Chicago, IL, USA).
Results: One hundred and four healthcare professionals working in UCH, Ibadan, comprising doctors, nurses, and physiotherapist, with 61.1% over 10 years of experience in wound care were surveyed. Seventy-seven percent agree or strongly agree that healthcare professionals are knowledgeable about best practices in wound care. 50.5% agree or strongly agree that UCH operates best practices in wound care while 49% agree or strongly agree that wound assessment is standardized in the hospital. 96.2% agree or strongly agree that an interprofessional wound care course will be beneficial to healthcare professionals and that it will enable healthcare professionals speak the same language with regard to wounds.
Conclusion: Teamwork and definite wound care policy/protocol are essential for excellent outcomes in wound care. Introduction of this approach will enhance knowledge translation and encourage best practice in our health institutions. |
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Wound bed assessment in patients at a tertiary hospital in Nigeria—A preliminary report |
p. 50 |
Ayodele O Iyun, Samuel Ademola, Afie Michael, Olayinka Olawoye, Odunayo Oluwatosin DOI:10.4103/0794-9316.202438 Introduction: Wound assessment is fundamental for the management of wounds. It is the foundation in the care plan and helps in determining the effectiveness of interventions. Wound assessment also assists in making appropriate decisions regarding the type of wound dressing to be applied. Detailed wound assessment takes into account all aspects of the patient’s well-being and not just the wounds the patient has.
Objectives: The study assessed chronic wounds in the patients at a tertiary Nigerian hospital (University College Hospital, Ibadan) and utilized the information for preparing a standardized wound assessment format for health facilities in the subregion.
Materials and Methods: The study was conducted at the University College Hospital, Ibadan, South West Nigeria. Patients with chronic wounds from various causes were treated prospectively in the hospital for over a month and had detailed assessment of their wounds performed. The data obtained were entered into a predesigned form, and this was subsequently analyzed using Statistical Package for the Social Sciences version 21 software.
Results: Seventy-eight wounds were reviewed during the study period. The area of the wounds ranged from 1 to 1248 cm2 (median 24 cm2). The type of granulation tissue related to the wound type was not statistically significant. Assessment of the exudates of the wounds revealed that 44.9% of the wounds had seropurulent or purulent discharge, whereas 19.2% had serous discharge.
Conclusion: Wound care management can be improved with appropriate wound assessments, which form the foundation in the care plan. Wound assessment will enhance objective measurement of the status of the wound and helps in choosing appropriate wound care dressing to promote wound healing. |
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Clinico-pathological characteristics of Skin Cancers at Benue State University Teaching Hospital, Makurdi, North Central Nigeria |
p. 56 |
Chukwukadibia N Ahachi, Priscilla Denen Akaa, Itodo C Elachi, Daniel D Mue, Joseph A Ngbea, Ikenna N Anakebe, Eunice O Onuh DOI:10.4103/0794-9316.202465 Objective: To document the clinico-pathological characteristics of skin malignancies seen at Benue State University Teaching Hospital, Makurdi.
Materials and Methods: A 3-year retrospective study of patients with histologically-confirmed skin cancers presenting to our institution from April 1, 2012 to March 31, 2015 was done. Relevant data was extracted from the patients' records and subjected to statistical analysis.
Results: Records were available for 43 patients with a mean age of 46 ± 18 years. There were 21 males and 22 females with a male:female ratio of approximately 1:1. Squamous cell carcinomas were the most common histologic type seen (44.2%) followed by melanoma and Kaposi's sarcoma (25.6% each) while basal cell carcinomas accounted for 4.7%. Farmers (37.2%) and artisans (23.3%) were the most common occupations seen. Human immunodeficiency virus (HIV)-positive patients accounted for 27.9% of the total and albinos 18.6%. Majority of the patients (60.4%) had history of prolonged exposure to sunlight with little regard for protective measures. The average duration of symptoms before presentation was 28 ± 33 months.
Conclusion: The study suggested an association between skin cancer and prolonged, unprotected exposure to sunlight on one hand and HIV infection on the other. It highlights the need to promote basic preventive measures.
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CASE REPORTS |
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Cleft hands and monodactylous feet: A rare variant of ectrodactyly |
p. 62 |
Emmanuel J.K. Adu, Peter Konadu DOI:10.4103/0794-9316.202439 A 2-year-old male child presented with bilateral asymmetric cleft hands, a right monodactylous foot (diastatic type), posteriorly dislocated at the ankle joint, and a left monodactylous foot (Type VI, Blauth and Borisch) posteriorly dislocated at the ankle joint. Surgical management has enabled weight bearing and walking. Psychological problems, especially with the hands, are anticipated. Further multidisciplinary management by surgeons, physical therapists, clinical psychologists, child psychologists, and occupational therapists is advocated. |
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Florid pseudoepitheliomatous transformation in a chronic pressure ulcer |
p. 66 |
Dafiewhare O Rex DOI:10.4103/0794-9316.202441 The case is reported of a florid manifestation of pseudoepitheliomatous hyperplasia in a chronic recurrent right ischial pressure ulcer of 26 years duration in a 60-year-old man with post-traumatic parapereisis. The peculiar characteristics seen were an incidental finding at surgery. Associated left ischial and sacral ulcers did not have these changes. Histological diagnosis of a benign lesion was at variance with a high clinical suspicion of malignant transformation based on the morphological appearance and chronicity. He had ulcer excision and primary flap cover. He was carefully followed up for 4 years and has been without recurrence or disease progression after excision and primary flap cover.
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Ulnar nerve compression by accessory abductor digiti minimi muscle |
p. 69 |
Jagannathan Mohan, Bellam Alagirisamy Ramesh DOI:10.4103/0794-9316.202440 We report two cases of accessory abductor digiti minimi muscle causing ulnar nerve compression at the Guyon’s canal. One case had venous malformations on the palm with gangrenous left little finger terminal phalanx. Excision of the abnormal muscle relieved patient symptoms. Though the abnormal muscle is reported in literature, the number of symptomatic clinical cases due to muscle compression is rare. The diagnosis itself might be missed because of lack of awareness.
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Vulvar necrotizing soft tissue infection in a child: Review of a multi-disciplinary surgical emergency and management in the modern era |
p. 72 |
Rahul K Patil, Harshal K Patil, Prashant Varkey DOI:10.4103/0794-9316.202463 A case of necrotizing infection of the vulva in a 15-month-old female child has been presented. The case presented multiple problems, from delayed presentation to involvement of critical area and associated issues. The patient sailed through a series of interventions before she could be rehabilitated to her routine but still awaits further reconstructive procedure. Early detection and appropriate intervention of this fulminant disease would help reducing the morbidity.
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