Abstract
BackgroundIn this study, we share our experience of different operative techniques undertaken on 584 eumycetoma patients in the Gezira Mycetoma Center.MethodsThis 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.ResultsA 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.ConclusionThe 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.
Highlights
In this study, we share our experience of different operative techniques undertaken on 584 eumycetoma patients in the Gezira Mycetoma Center
The commonest surgical option is wide surgical excision which is recommended for small well-circumscribed lesions (≥ 5 cm) [6]
We share our experience of the different operative techniques used to treat our eumycetoma patients, looking at the factors that determine the choice of operation, at Gezira Mycetoma Center. Study design This is a retrospective, descriptive, hospital-based study, conducted during January 2013–December 2016 to review the surgical treatment of eumycetoma patients
Summary
We share our experience of different operative techniques undertaken on 584 eumycetoma patients in the Gezira Mycetoma Center. Mycetoma was recognized by the World Health Organization as a neglected tropical disease. It is defined as a chronic skin and subcutaneous swelling caused either by eumycetoma or actinomycetoma [1]. It has a worldwide distribution but is endemic in tropical and subtropical countries across the “mycetoma belt.”. Fahal et al conducted a review of their experience from the Mycetoma Research Center from 1991 to 2014 They reported that of the 2476 patients attending the center, 792 (31.9%) were from Gezira state [3]
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