Clinical Pattern and Management of Keloids in Black Poplulation

Objective: To present the clinical pattern, treatment approach and outcome of keloid care in our clinical practice.Design: A retrospective study.Setting: Obafemi Awolowo University Teaching Hospital, Ile-Ife, Southwestern Nigeria.Subjects: All patients presenting with keloids during the study periodIntervention: The pattern of presentation, modalities of treatment and outcome of care as well as complications and recurrences were documented.Results: Seventy – six patients were studied. Equal male to female ratio. Their ages ranged from 1-75 years with a modal age of 24 years. Lesions presented for treatment were most commonly located in the head and neck region. Itching was the most common symptom. Combination therapy by surgical resection, intralesional triamcinolone injection and superficial radiotherapy was the most common modality of treatment and gave the least rate of recurrence.Conclusions: Combination therapy gave the best outcome in our practice

Adolescent and adult cleft lip and palate, in Ile-Ife, Nigeria

Introduction: Congenital cleft lip and palate (CLP) defects usually present in childhood, especially in places with available and affordable care. In Nigeria, their incidence is low but late presentation in Adult life have been reported. This article aims at reviewing adolescent and adult CLP patients in our center, with the advent of free and available care, and to documentthe patterns and management outcomes of these patients as an addition to existing literature on the subject of adult CLP. Materials and Methods: A retrospective review of adolescent and adult CLP patients managed from May 2006 to April 2010. Demographic data as well as clinical information were retrieved from the hospital records and include the type of cleft deformity, surgical intervention prior to presentation, the type of surgery performed and postoperative outcomes. Some pertinent clinical photos were also reviewed. Results: Adolescent and adults constituted 24% of the 137 patients, their age ranged from 13 to 76 years, with a mean, median and modal age of 28, 22 and 20 years respectively. Unilateral cleft of primary palate was commonest with female preponderance. Most never had surgery, others desired revision surgery or secondary procedures. Theoutcomes were satisfactory in the 37 procedures performed on 33 patients.Conclusion: A relatively high ratio of adolescent and adult clefts is observed. Most of them have never had surgical intervention. Some had failed surgical intervention prior to presentation. Satisfactory outcomes were achieved despite late intervention but failed initial intervention was associated with poorer outcomes

Symptomatology Of Keloids In Africans

The symptoms of keloids need to be well highlighted especially among African blacks. To outline the symptoms of keloids in Southwest Nigeria with a view to offering adequate treatment to patients by relieving these symptoms. A prospective study of 121 consecutive keloid patients managed in two teaching hospitals in Nigeria was done to assess the symptoms of keloids. Their demographics, site(s) of keloids; and symptoms associated with lesions associated with the lesions were documented. The commonest symptom among the 121 patients was cosmesis, (100.0%) followed by itching, in 35 (28.9%), and then pain in 32 (26.4%) patients, foul smell in 4 (3.3%), heaviness, 6 (5.0%), peppery sensation, 8(6.6%), discharge, 7 (13.5%), tenderness (experienced when keloids are touched intentionally or accidentally), 10 (19.3%), and burning sensation, 10 (19.3%). The chest has the most symptomatic lesions with 15 (28.8%) and 9 (17.3%) patients having painful and itching lesions respectively. Attention needs to be paid to treatment of keloid symptoms which may make life unbearable to patients in addition to overall treatments of these patients. This is in view of the fact that cure is difficult in these lesions.Key words: Keloids, Symptomatology, Black African, Treatment

Retroperitoneal and Genital Lymphangioma Therapeutic Challenges in a Developing Country

Background: Lymphangiomas occur most commonly in the head and neck region, while other sites are rarely affected. A combination of retroperitoneal and genital lymphangioma is very rare indeed. Though congenital, it may persist into adulthood due to missed diagnosis and inadequate or total lack of treatment. Materials and methods: A report of a 22-year-old male student who presented with recurrent multiloculated genital, thigh, groin and retroperitneal lymphangioma. He underwent surgical excision and adjuvant sclerotherapy using ethylene-diamine tetra acetic acid. Results and Conclusions: There was an initial recurrence after surgery which responded satisfactorily to sclerotherapy. Complete surgical excision of lymphangioma may be precluded by vital structures but sclerotherapy produces satisfactory resolution. The difficulties in management with limited facilities for diagnosis and treatment are highlighted

Single versus two layer suturing for wound closure after inguinal hernia repair

No Abstract

Incisional Hernia in Women: Predisposing Factors and Management Where Mesh is not Readily Available

Background / Aim: Incisional hernia is still relatively common in our practice. The aim of the study was to identify risk factors associated with incisional hernia in our region. The setting is the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria during a period when prosthetic mesh was not readily available. Patients and Methods: All the women who presented with incisional hernia between 1996 and 2005 were prospectively studied using a standard form to obtain information on pre-hernia (index) operations and possible predisposing factors. They all had open surgical repair and were followed up for 18–60 months. Results: Forty-four women were treated during study period. The index surgeries leading to the hernias were emergency caesarian section 26/44 (59.1%), emergency exploratory laparotomy 6/44 (13.6%), and elective surgeries 12/44 (27.3%). Major associated risk factors were the use of wrong suture materials for fascia repair, midline incisions, wound sepsis, and overweight. Conclusion: For elective surgeries, reduction of weight should be encouraged when appropriate, and transverse incisions are preferred. Absorbable sutures, especially chromic catgut, should be avoided in fascia closure. Antibiotics should be used for complicated obstetric cases

Laryngeal carcinoma: Experience in Ile-Ife, Nigeria

No Abstract

The use of large bilobed flap in the management of cheek defect: a case report

Introduction: bilobed flaps are versatile reconstructive tools which have been used extensively in the management of nasal, shoulder and neck defects. Although its use in the cheek has been reported, it is uncommonly utilized.Case report: This is a case report of a 22yr old lady with traumatic left cheek defect managed with the use of a large bilobed flap.Result: The Post-operative outcome was satisfactoryConclusion: Large bilobed flaps should be considered when reconstructing cheek defects.Key Words: Bilobed flap, cheek defect

Isolated bileteral upper lid coloboma a case report

No Abstract. Nigerian Journal of Medicine Vol. 14(2) 2005: 224-22

Lip reconstruction after major tissue loss

Background: Major defects of the lips are challenging to the reconstructive surgeon. The goals in treating total or near total lip defects are reconstruction of the skin, the muscle, the mucosal lining, maintenance of oral competence and an acceptable cosmetic appearance. Six patients with major lip defects from various causes as seen in our practice were successfully managed are discussed. Case reports: Two patients had major lower lip loss following gunshot injuries, one patient had major upper lip defect following blast injury. Two other patients had post excision defects for lip malignancy while the lasthad a congenital midline defect of the upper lip and primary palate. All patients had lip reconstruction using local flaps, no flap loss was recorded and the postoperative appearance was acceptable to them. Conclusion: Functional and aesthetic outcomes appear acceptable when local flaps are employed in lip reconstruction in this black population even with major lip defects.Key words: lip reconstruction, major lip defect