Leg ulcers in tertiary public hospital in a sub-Saharan African country (Togo)

Abstract

Purpose: Data about the epidemiological and clinical characteristics of leg ulcers in our country are still insufficiently documented. Material and methods: Charts of patients hospitalised for leg ulcers in the Department of General Surgery between 1 January 2009 and 31 December 2014 were retrospectively assessed for sociodemographic, clinical, therapeutic, and outcome characteristics. Results: In total, 582 charts reported leg ulcers thus representing 33% of all charts in the Department of Surgery during the study period. Among them, 144 charts contained enough information to be included in the study. The population of patients with leg ulcers was approximately balanced with respect to gender (1.15 men to women ratio). Median age was 53.07± 17.9 years old (yo), (range 18–90). Diabetes (27.8%), hypertension (11.8%) and alcohol consumption (8%) were the most prevalent of the reported medical history. Leg ulcers presented as infectious ulcers (necrotising fasciitis, superinfected traumatic wounds) in 48 (33.3 %) patients, vascular ulcers (arterial, venous or mixed) in 25 (17.4 %) patients, and diabetic foot ulcers in 71 (49.3 %) patients, according to the major etiology factor accounted. Ten amputations (7%) at the level of leg or thigh were performed, all in diabetic patients. The median length of hospitalisation was 37.55 ± 51.45 days (range 1–380 days). Ninety-eight patients (68.1%) achieved complete healing, while 38 patients (26.4%) died. Conclusion: Leg ulcers occur in Togo as in other African countries at a young age, mostly caused by infections and complications of diabetes, with a high rate of amputations and mortality.