Surgical complications and subsequent revision surgeries among noma cases treated in Ethiopia

埃塞俄比亚治疗的坏疽性口炎病例的手术并发症和后续翻修手术

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Abstract

INTRODUCTION: Noma, an overlooked infectious disease, inflicts severe facial tissue damage, posing substantial challenges in patient care. This study delves into surgical complications and subsequent revision surgeries among noma cases treated in Ethiopia. MATERIALS AND METHODS: The research employed a cross-sectional retrospective review of medical records treated between 2007 and 2019 retrieved from the Facing Africa database. RESULTS: The review encompasses 235 noma cases. Twenty-four cases (19 females and 5 males) experienced various complications, predominately major complications leading to subsequent revision surgeries. The identified complications included flap necrosis, abscess formation, tenderness, graft site infection, flap bulking, dental misalignment, corner of the mouth dehiscence, infected bone and plate, flap malpositioning, restricted mouth opening with ankylosis, neuropathic pain, recurrent flap infection, and offensive odor. Revision surgeries included wound cleansing, abscess drainage, skin graft removal, exploratory surgery, wound care, debulking, scar removal, debridement, trismus release, commisuroplasty, and flap repositioning. CONCLUSION: These findings illuminate the intricacies of noma surgery in Ethiopia, emphasizing the importance of understanding the nature and frequency of complications for optimizing treatment outcomes. Insights from this study can guide healthcare providers, especially novice surgeons, and policymakers, in refining surgical interventions and enhancing outcomes for noma patients. Improved knowledge in this realm is crucial for advancing patient care and developing targeted interventions. LEVEL OF EVIDENCE: 5.

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