Ulcero-necrotic Wound and Its Socio-economic Impact: A Retrospective Study from Kayes, Mali

Wound care has always been an important issue in the practise of medicine. This is demonstrated by Ambroise Paré's decision to publish "La manière de traiter les Plaies" (The Way of Treating Wounds) in 1545. The purpose isto evaluate the therapeutic methods we practice and to describe the impact of the pathology on socio-economic and professional development.

this was a retrospective study was conducted at the Fousseyni Daou Hospital in Kayes from January 1, 2018, to December 31, 2020. We included all hospitalised patients with an ulcero-necrotic wound on immunocompetent terrain. Patients with ulcerative necrotic wounds caused by diabetes, HIV, or cancer were excluded. The following parameters were investigated: aetiologies, local care, sequelae, and socioeconomic and professional aspects. We collected 57 patients of whom 43 were men and 14 were women, i.e. a sex ratio of 3. The mean age was 40.7 years with a standard deviation of 8.4 with extremes (7 years and 80 years). The most represented socio-professional stratum was agropastoralism in 37 cases (65%). The predominant etiological factor was neglected traumatic wounds in 34 cases (59.6%). The site was the lower limb in 39 cases (68.5%). The germ found was Staphylococcus aureus in 21 cases (36.8%). The particularity during local care was the use of table sugar in 9 cases (15.7%) and maggot therapy in 2 cases (3.5%). Hyperthermia was the clinical sign of aggravation in 22 cases (38.6%) and we diagnosed 2 cases (3.5%) of tetanus. The mortality rate was 15.7% (9 cases) and 30 cases (52.7%) of sequelae after recovery. The average length of stay in the hospital was 38 days. In 35 cases (61.4%), the social welfare service provided hospital care. Nineteen (19) patients (39.5%) were unable to return to their previous socio-professional activity.

Ulcero-necrotic wounds are difficult to manage and can have a long-term impact on patients' socio-professional and economic activity.