[Noma. Proposal for a surgical treatment].
The authors present their experience of surgical treatment of noma in situation of surgical camp. The strategy is focused on two objectives: treatment of tissue loss itself and treatment of the trismus. After having presented the means at disposal, going from local flaps, quickly exceeded, to distant flaps, they decided upon the indications by taking in account the NOILTULP classification. Thus, the authors present their experience of fascia temporalis skin grafted for oral lining in combination with the submental or Backamjian flap for external coverage. The treatment of the trismus is less codified requiring osteotomies in stages 3 and 4. They finally insist first on the prevention of this disease, very accessible to antibiotics at the initial stage of stomatitis and second on simple means very efficient to prevent the trismus which impairs heavily the functional outcome of the reconstructions.
Martin
D
D
Service de chirurgie plastique, université Victor-Segalen Bordeaux-II, CHU de Bordeaux, France.
Pinsolle
V
V
Pelissier
Ph
P
Barthelemy
I
I
Weis
C
C
Baudet
J
J
D002985:Clinical Protocols; D005602:France; D006801:Humans; D008493:Medical Missions / Q000458:organization & administration; D009549:Nigeria / Q000453:epidemiology; D009625:Noma / Q000145:classification / Q000453:epidemiology / Q000209:etiology / Q000601:surgery*; D010027:Osteotomy / Q000379:methods; D018579:Patient Selection; D011322:Primary Prevention / Q000379:methods; D019651:Plastic Surgery Procedures / Q000379:methods*; D012086:Reoperation / Q000379:methods; D013280:Stomatitis / Q000209:etiology; D013524:Surgical Flaps / Q000145:classification / Q000706:statistics & numerical data; D016896:Treatment Outcome; D014313:Trismus / Q000209:etiology