Chronic leg ulcers in hospitalized patients in Lomé, Togo: 125cases.

Abstract

The aim of this study was to document the profile and causes of chronic leg ulcers (CLU) in patients hospitalized in Lomé, Togo. This retrospective study reviewed records from the dermatology departments (CHU Sylvanus Olympio and Campus, and the dermatology center of Gbossimé) from 2000 to 2017 and from the general surgery department of CHU Sylvanus Olympio from 2013 to 2017 to identify cases. In all, 125cases of CLU were identified during the study period. The patients' mean age was 56.6years and the sex ratio (M/F) was 0.89. The average time from CLU onset to consultation was 10.9weeks (range: 7 weeks to 4 years). They were mainly associated with a history of diabetes (32cases), arterial hypertension (16cases), varicose veins (14cases), and malnutrition (14cases). The main causes were: ulcers of infectious origin in 49.6% of cases (including 38 with phagedenic ulcers), ulcers of vascular origin in 36% (including 21cases with a venous ulcer) and diabetic ulcers in 8.8% of cases. The ulcer was unilateral in 122patients (67 on the right and 55 on the left) and bilateral in 3patients. The locations were the foot in 56cases, the leg in 37cases, and leg and foot in 32cases. In addition to dressings, surgical debridement was performed in 23patients, followed by skin autografts for 16. Amputation was performed for 31patients. Sixteen (12.8%) of the 125patients died. Our study observed a high rate of phagedenic ulcers among CLU in Togo. It also pointed to a problem explaining the very high mortality rate: delayed consultation by patients who arrive only after the onset of complications.