Prevalence and Factors Associated With Surgical Site Infections in the University Clinics of Traumatology and Urology of the National University Hospital Centre Hubert Koutoukou Maga in Cotonou.

Objectives: Study the prevalence and factors associated with the occurrence of surgical site infections in University Clinics of Trauma-Orthopedics, Reconstructive Surgery and Urology in a developing country. Methods: This was a retrospective descriptive and analytical study of 384 people operated on during the period of 2019. Logistic regression was used to study the factors associated with surgical site infections. The associations between the dependent variable and the other variables were assessed by the odds ratio (OR) followed by their 95% confidence interval. Results: The prevalence of surgical site infections was 7.81% CI 95% = (5.12-10.51). The factors linked to the surgical site infections in the studied population were the patient's admission method [OR = 2.74; 95% CI = (1.08-6.95)] and the length of the postoperative stay [OR = 8.75; 95% CI = (2.83-26.98)]. The interview and direct observation identified health care system dysfunctions, medical errors, patient monitoring and financial unavailability as factors that could favor the onset of surgical site infections. Conclusion: Interventions should be focused on the factors identified for the effective management of operated patients.

[Medico-Surgical treatment of mycetoma in the Somine Dolo hospital of Mopti (Mali)]. / Prise en charge médico-chirurgicale des mycétomes à l'hôpital Somine Dolo de Mopti (Mali).

Objective: The objective of this study was to describe the epidemiological and clinical aspects as well as the therapeutic methods of mycetomical lesions. Material and Methods: This was a longitudinal retrospective study, which included all patients treated for mycetoma from January 2016 to December 2018 including two years of recruitment and one year of monitoring (2019). The study concerned 19 patients who were hospitalized and treated in the department of surgery. Results: Patients represented 2.3% of hospitalizations and consisted of 11 males and 8 females with an average age of 38 years with extremes of 15 - 70 years, and an average time between the onset of symptoms and presentation to the hospital of 10 years (range 1 - 40 years). Eight livestock breeders and seven farmers were concerned, 14 of whom have started the disease after trauma. The foot was involved in 13 patients. Twelve suffered from osteoarticular lesions. Black grains were present in 16 cases attributed to Madurella sp. We performed 12 amputations, six carcinological ablation to which specific local treatments were added (thin skin graft in two patients, fasciocutaneous flap in one patient and directed healing in the others) and local treatment in the last case. Conclusion: Mycetoma should be discussed and diagnosed at an early stage in predisposed patients particularly in farmers and breeders. Prevention is necessary; it is based on wound disinfection and wearing safety shoes.

Traitement par fixateur externe des fractures ouvertes des membres type III de Gustilo-Anderson

Introduction : Les fractures ouvertes des membres type III de Gustilo et Anderson relèvent d'un traumatisme à haute énergie. Ces fractures sont stabilisées par un fixateur externe. Le but de cette étude rétrospective était de préciser les caractéristiques épidémio-cliniques des patients et d'évaluer les résultats du traitement. Patients et Méthodes : Cette étude était basée sur 20 patients totalisant 20 fractures ouvertes des membres traitées par fixateur externe entre janvier 2015 et décembre 2017. L'évaluation des résultats tenait compte de la consolidation, le résultat fonctionnel et les complications. Résultats : Il y avait 15 hommes et cinq femmes avec un âge moyen de 26 ans. Le délai moyen de prise en charge était de 21 heures. Les lésions siégeaient au membre inférieur (n=17) et au membre supérieur (n=3). Selon la classification de Gustilo et Anderson les fractures étaient de type IIIa (n= 11), type IIIb (n= 8) et type IIIc(n=1). Il a été réalisé des greffes de peau (n=16) et des lambeaux n=3). Les types de fixateur étaient le Fixateur Externe du Service de Santé des Armées (n=7), le Hoffman (n=7), et l'Orthofix (n=6). La cicatrisation des plaies a été obtenue dans un délai moyen de 31 jours. La consolidation était acquise chez 17 patients dans un délai moyen de 9 mois. Après un recul moyen de 9 mois, le résultat fonctionnel a été jugé excellent (n= 12), bon (n= 5) et mauvais (n=3). Les complications étaient l'infection postopératoire (n=12), le cal vicieux (n= 4), et la pseudarthrose (n=2). Conclusion : Le fixateur externe a été utilisé comme moyen de contention. La cicatrisation dirigée associée à une greffe cutanée a été réalisée dans la majorité des cas. La consolidation a été acquise chez 17 patients avec des résultats fonctionnels excellents et bons

Traumatic hip dislocation in Cotonou.

PURPOSE: Traumatic hip dislocation is an emergency. We studied their epidemiological, and therapeutic characteristics at Cotonou. METHODS: This was a retrospective study from 2006 to 2014 including all inpatient for traumatic hip dislocation, whose minimum follow-up was 12 months. RESULTS: Twenty-three cases in which 19 males were selected. The mean age was 39.6 years. It was mainly fracture-dislocations (17 cases). Sixteen dislocations were posterior. Reduction average delay was 41.0 h. The treatment was mainly orthopedic (16 cases). Few complications were noted: two osteoarthritis, one death. The functional results were excellent (8 cases), very good (4 cases) and good (8 cases). CONCLUSION: Traumatic hip dislocations require early reduction to avoid complications.

Prevention of venous thromboembolism among inpatients at Cotonou teaching hospital, Benin.

AIM: The aim of this retrospective study was to evaluate the use and appropriateness of preventive measures for venous thrombosis among adult inpatients in a Benin teaching hospital. PATIENTS AND METHODS: All patients were systematically enrolled. The risk of venous thrombosis was estimated according to international guidelines. Thromboembolic events were diagnosed using the Wells score and, when possible, by paraclinical investigations. The following variables were studied: the risk of venous thrombosis, the use and appropriateness of preventive measures, and the frequency of thromboembolic events. The data were analyzed with Epiinfo 6.04.fr and SPSS software, and significance was assumed at p=0.05. RESULTS: The study population consisted of 487 patients recruited in four surgical wards, four general wards and one obstetric-gynecology ward. Mean age was 38.7+/-11.3 years and the sex ratio 0.51. The risk of thrombosis was considered low in 15% of patients, moderate in 60.8%, high in 21.1% and very high in 3.1%. Prophylactic measures were prescribed to 33.9% of the patients overall, 53.6% in the obstetric gynecology ward, 28.5% in the surgical wards and 12.9% in the general wards. The frequency of preventive measures rose with the level of risk (p<0.0001). Preventive measures consisted of passive mobilization, aspirin, enoxaparin and acenocoumarol. The prescriptions were appropriate in only 6% of cases. Among 198 patients who were monitored for two months after hospital discharge, 8% had a venous thromboembolic event. Such events were more frequent in the absence of prophylaxis (12% vs 3.3%, p=0.02). CONCLUSION: The risk of venous thromboembolic is recognized but poorly managed in this Bénin teaching hospital.