[Plastic surgery treatment of Buruli ulcer sequelaes. A retrospective study of 16 patients]

Thirteen percents of the patients suffering from Buruli ulcer in Ivory Coast show sequels at a result of their spontaneous healing. The purpose of our study is to report and estimate the first series of the sequel treatment of Buruli ulcer, with standard reconstructive procedures used in plastic surgery.

Sixteen patients totalizing 18 sequels were classified into 2 groups:13 patients showed functional sequels in connection with cicaticial retractions about level with joints;3 patients showed aesthetic sequels with no repercussion on the functional aspect. The surgical treatment included for the functional sequels, the excision of the retractile scar, the restoration of the underlying structures followed by the coverage of the defect with skin grafts or muscle or musculo cutaneous flaps and for aesthetic sequels, the excision of the scar tissues and the coverage with full-thickness skin grafts.

The results were considered good because the patients found an acceptable physical activity again that enable some of them to resume a professional activity and others a school activity. Motherless, a certain number of complications are to be deplored:1 case of distal necrosis of a skin flap autonomized which required excision and conducted healing but without repercussions on the functional result;1 residual edema about level with the fingers at the time of the covering of a hand with a groin flap;1 haematoma at the donar site of a full-thickness skin graft.

Distance flaps are more advisable for hand sequels in Buruli ulcer considering the regional character of the disease and the necessity to preserve the main vascular axes about level with the hand. On the lower limb, autonomized skin flaps enable provide important tissue and preserve the major vascular axes of the lower limb.