4 research outputs found
Marjolin's ulcers at a university teaching hospital in Northwestern Tanzania: a retrospective review of 56 cases
Marjolin's ulcer is a rare but highly aggressive squamous cell cancer that is most often associated with chronic burn wounds. Although many individual case reports exist, no comprehensive evaluation of Marjolin's ulcer patients has been conducted in our setting. This study was conducted to describe the clinicopathological presentation and treatment outcome of this condition in our local setting and to identify predictors of outcome. This was a retrospective study of histologically confirmed cases of Marjolin's ulcer seen at Bugando Medical Centre over a period of 10-years between January 2001 and December 2010. Data were retrieved from patients' files and analyzed using SPSS computer software version 15.0 A total of 56 patients were studied. Male to female ratio was 2.1:1. Burn scars (89.3%) were the most common causative lesions of Marjolin's ulcer. The mean latent period between original injury and diagnosis of Marjolin's ulcer was 11.34 ± 6.14 years. Only 12.0% of the reported cases were grafted at the time of injury (P < 0.00). Most patients (48.2%) presented between one and five years of onset of illness. The lower limb (42.9%) was the most frequent site for Marjolin's ulcers. The median tumor size at presentation was 8 cm and the vast majority of patients (85.7%) presented with large tumors of ℠5 cm in diameter. Lymph node metastasis at the time of diagnosis was recorded in 32.1% of cases and distant metastasis accounted for 26.9% of cases. Squamous cell carcinoma (91.1%) was the most common histopathological type. Wide local excision was the most common surgical procedure performed in 80.8% of cases. Post-operative complication rate was 32.1% of which surgical site infection was the most common complication in 38.9% of patients. Local recurrence was noted in 33.3% of cases who were treated surgically. The mean length of hospital stay for in-patients was 7.9 ± 2.3 days. Mortality rate was 7.1%. According to multivariate logistic regression analysis, stage and grade of the tumor and presence of local recurrence were the main predictors of death (P < 0.001). Marjolin's ulcers are not rare in our environment and commonly occur in burn scars that were not skin grafted and were left to heal secondarily. A high index of suspicion is required in the management of chronic non-healing ulcers and all suspected lesions should be biopsed. Early recognition and aggressive treatment of Marjolin's ulcers and close follow-up are urgently needed to improve outcomes in our environment
Profil epidemiologique des brulures d'enfants admis au Centre National des Brules, Maroc
Ce travail rétrospectif analyse les particularités épidémiologiques de 543 cas de brûlures d'enfants, représentant 45,7% des admissions de notre centre, en vue de déterminer les éléments pouvant contribuer à renforcer la prévention, qui reste le traitement de choix de cette pathologie. La moyenne d'ùge est de 4,25 ans avec une prédilection pour la tranche d'ùge d'un à cinq ans, avec 42,5% des cas. Une atteinte masculine est retrouvée dans 63,5% des cas. La brûlure survient à domicile dans 85,1% et accidentellement dans 95% des cas. Les brûlures thermiques représentent 96,5% des causes dominées par les liquides dans 69,3% des cas. La surface cutanée brûlée est ℠20% dans 52,3%. La brûlure intéresse essentiellement les membres supérieurs (79,1%). 56,8% des enfants sont transférés par d'autres hÎpitaux et le délai de prise en charge hospitaliÚre est supérieur à 6 heures dans 65,5%. Le taux de mortalité a été de 13,2%
Profil épidémiologique des brûlés à Marrakech: à propos de 152 cas
Cet article concerne une Ă©tude Ă©pidĂ©miologique rĂ©trospective portant sur 152 patients brĂ»lĂ©s hospitalisĂ©s entre 2006 et 2008. Les brĂ»lĂ©s avaient moins de 20 ans dans 65% des cas. Le sex ratio (m/f) Ă©tait de 1,18/1. Lâorigine thermique est incriminĂ©e dans 84% des cas. Lâatteinte par flammes reprĂ©sente 56% des cas. La surface corporelle brĂ»lĂ©e moyenne chez nos patients Ă©tait de 28%, et les brĂ»lures de deuxiĂšme degrĂ© Ă©taient de loin les plus frĂ©quentes. Dans notre sĂ©rie, le visage et le cou Ă©taient le siĂšge le plus frĂ©quemment touchĂ©. La prĂ©vention reste la meilleure arme pour lutter contre ce flĂ©au, et pour cela plusieurs mesures sont proposĂ©es pour amĂ©liorer lâĂ©tat actuel des choses