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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ftdoajarticles:oai:doaj.org/article:0c7f94c1112b4944ae36425ad9cdf8d0 2023-05-15T15:13:21+02:00 Surgical management of eumycetoma: experience from Gezira Mycetoma Center, Sudan Mohamed D. A. Gismalla Gamal M. A. Ahmed Mogahid M. MohamedAli Sami M. Taha Thouria A. Mohamed Ahmed E. Ahmed Lamia S. Hamed 2019-01-01T00:00:00Z https://doi.org/10.1186/s41182-018-0129-2 https://doaj.org/article/0c7f94c1112b4944ae36425ad9cdf8d0 EN eng BMC http://link.springer.com/article/10.1186/s41182-018-0129-2 https://doaj.org/toc/1349-4147 doi:10.1186/s41182-018-0129-2 1349-4147 https://doaj.org/article/0c7f94c1112b4944ae36425ad9cdf8d0 Tropical Medicine and Health, Vol 47, Iss 1, Pp 1-6 (2019) Amputations Eumycetoma Mycetoma Sudan Surgical excision Surgery Arctic medicine. Tropical medicine RC955-962 article 2019 ftdoajarticles https://doi.org/10.1186/s41182-018-0129-2 2022-12-30T21:04:21Z 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. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Tropical Medicine and Health 47 1 |
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Open Polar |
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Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
Amputations Eumycetoma Mycetoma Sudan Surgical excision Surgery Arctic medicine. Tropical medicine RC955-962 |
spellingShingle |
Amputations Eumycetoma Mycetoma Sudan Surgical excision Surgery Arctic medicine. Tropical medicine RC955-962 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 |
topic_facet |
Amputations Eumycetoma Mycetoma Sudan Surgical excision Surgery Arctic medicine. Tropical medicine RC955-962 |
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. |
format |
Article in Journal/Newspaper |
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 |
title |
Surgical management of eumycetoma: experience from Gezira Mycetoma Center, Sudan |
title_short |
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_sort |
surgical management of eumycetoma: experience from gezira mycetoma center, sudan |
publisher |
BMC |
publishDate |
2019 |
url |
https://doi.org/10.1186/s41182-018-0129-2 https://doaj.org/article/0c7f94c1112b4944ae36425ad9cdf8d0 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Tropical Medicine and Health, Vol 47, Iss 1, Pp 1-6 (2019) |
op_relation |
http://link.springer.com/article/10.1186/s41182-018-0129-2 https://doaj.org/toc/1349-4147 doi:10.1186/s41182-018-0129-2 1349-4147 https://doaj.org/article/0c7f94c1112b4944ae36425ad9cdf8d0 |
op_doi |
https://doi.org/10.1186/s41182-018-0129-2 |
container_title |
Tropical Medicine and Health |
container_volume |
47 |
container_issue |
1 |
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1766343915234918400 |