Sickle cell leg ulcers in Ghana.
Twenty five (17 male, 8 Female) sickle cell disease patients with 30 leg ulcers were studied over a 3 year period (January 1985 to December 1987) to provide information on the pathogenesis, course and management. There were 23 patients with homozygous sickle cell and 2 patients with sickle cell haemoglobin C disease. The mean age was 28 years (range 15-44 years). An antecedent history of trauma was obtained in 40% of the patients and 96% had a previous history of leg ulcer. The major site affected (93%) was the skin around the malleoli. In 68% of the patients a single organism was isolated and the commonest bacteria were Pseudomonas species, Staphylococcus aureus, Proteus species and B haemolytic streptococci. The major complications encountered were equinovarus deformity (36%) and chronic periosteitis (32%). The main topical antimicrobial used was Eusol either alone (52%) or in combination with Metronidazole (32%) or honey (12%). Complete healing occurred in 40% of patients, partial healing with deterioration in 16% and no significant change in 44%. Admission and bed rest were the best determinants of complete healing of the chronic ulcers.
Ankra-Badu
G A
GA
Department of Haematology, University of Ghana Medical School, Accra.
D000293:Adolescent; D000328:Adult; D000755:Anemia, Sickle Cell / Q000150:complications*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001881:Borates / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D005869:Ghana / Q000453:epidemiology; D006722:Honey; D006784:Hospitals, Teaching; D006801:Humans; D007869:Leg Injuries / Q000150:complications; D007871:Leg Ulcer / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D008795:Metronidazole / Q000627:therapeutic use; D012307:Risk Factors; D012973:Sodium Hypochlorite / Q000627:therapeutic use; D014945:Wound Healing; D014946:Wound Infection / Q000453:epidemiology* / Q000209:etiology / Q000382:microbiology
D000900:Anti-Bacterial Agents; D001881:Borates; D008795:Metronidazole; C024611:Eusol; D012973:Sodium Hypochlorite