A prospective evaluation of lower extremity ulcers in a Zimbabwean population.

International Wound Journal
Martin SibandaKent Jönsson

Abstract

Aetiological factors and their frequencies, causes, level and impact of immunosuppression on outcome of lower extremity ulcers were prospectively recorded. A total of 100 patients were evaluated. Consent for HIV testing was given by 68 patients and 31 (46%) of these were HIV infected. Thirty patients were diabetic. CD 4+ T-lymphocyte count was assessed in 41 patients. Eleven were HIV infected with a mean CD 4+ count of 229 +/- 137 cells/microl. Six had non insulin-dependent diabetes mellitus (NIDDM) with a mean CD 4+ count 430 +/- 308 cells/microl. Five had both HIV infection and NIDDM with a mean CD 4+ count of 299 +/- 120 cells/microl. All three groups differed from the normal 707 +/- 285 cells/microl found in 17 non HIV-infected non diabetic patients (P < 0. 05). The main aetiologies were bacterial infection, arterial disease, trauma and neuropathy. Ulcer healing and limb salvage were noted in 71%. Mortality was 10%; seven in HIV-infected and three in non HIV-infected non diabetic patients (P = 0. 06). Amputation rate was 9%. Persisting ulcers were noted in 8% and 2% were lost to follow-up. Our evaluation shows that wound aetiologies in Zimbabwe differ from those in the West. Immunosuppression because of HIV infection and NI...Continue Reading

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Citations

Oct 10, 2013·International Wound Journal·David Muchuweti, Kent U G Jönsson

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