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Surgical Site Infections in Trauma and Orthopaedics at Bouaké Teaching Hospital (Côte d’Ivoire)

Open Journal of Orthopedics 2024年第9期14卷 381-390页

作者： Loukou Blaise Yao Koffi Léopold Krah Aya Adelaïde Natacha Kouassi kouamé innocent m’bra kouamé Jean-Eric Kouassi michel Kodo Department of Trauma and Orthopaedics Bouak Teaching Hospital Bouak Cte dIvoire

Background: Surgical site infections are serious healthcare problems. The aim was to describe the epidemiological, diagnostic, therapeutic, and prognostic aspects of surgical site infections in Trauma and Orthopaedics at Bouaké Teaching Hospital. method: This retrospective, descriptive, and analytical study was conducted from January 2019 to December 31, 2021. The data studied included prevalence, initial lesions, type of surgical intervention, type of SSI, bacteria involved, treatment, and outcomes. Results: Forty-four (11%) of the 399 patients included in the study developed a surgical site infection. The mean age was 27 years, with 36 male and 8 female. Initial lesions were predominantly open fractures (n = 31;70%), with a mean delay of 48 hours for surgical management. Emergency interventions accounted for 70% (n = 31) of cases. The NNISS infection risk score was 1 in 80% (n = 35) of cases. Superficial infections (n = 34;77%) appeared early, on a mean 6 days postoperatively. Bacteriological analysis primarily identified Pseudomonas aeruginosa (n = 10;23%), sensitive to Imipenem and Chloramphenicol but resistant to Amoxicillin-clavulanic acid, Ceftriaxone, Gentamicin, and Ciprofloxacin. multidrug-resistant bacteria were found in 89% (n = 8) of cases, with all bacteria resistant to Ceftriaxone. Surgical revision was performed in 10 patients (23%), primarily involving debridement with hardware retention (n = 7;70%). Chloramphenicol was the most commonly used antibiotic post-antibiogram (61%). Outcomes were favourable in 98% of cases. Identified risk factors included the type of lesion according to NRC classification, the delay in managing open fractures, and the NNISS score. Conclusion: The prevalence of surgical site infection was 11%, favoured by the delayed operation of open fractures.

关键词： Surgical Site Infection Open Fractures Pseudomonas aeruginosa Ceftriaxone

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Predictive Factors of Functional Outcome of Open Fractures of the Foot at the Bouaké Hospital and University Center

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Open Journal of Orthopedics 2024年第11期14卷 510-523页

作者： kouamé innocent m’bra Achié Jean-Régis Akobe Aya Adélaide Natacha Kouassi Ibrahim Soumahoro Loukou Blaise Yao Bada Justin Léopold Niaoré Sery Koffi Léopold Krah michel Kodo Orthopaedics-Traumatology Department of the University Hospital of Bouak Ivoiry Coast (Alassane Ouattara University) Bouak Ivoiry Coast

The study evaluated functional outcomes of foot open fractures, finding satisfactory results in 89.6% of cases. It identified associated lesions, more than two fractures, and lack of rehabilitation as predictors of po... 详细信息

关键词： AOFAS-Open Fracture-Foot-Functional Outcome

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Peri-Operative morbidity and mortality of Elderly Patients in Traumatology-Orthopedics in Bouaké

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Open Journal of Orthopedics 2024年第11期14卷 524-534页

作者： Aya Adélaïde Natacha Kouassi Achié Jean-Régis Akobe Loukou Blaise Yao kouamé innocent m’bra Zolopégué marcel Soro Ibrahim Soumahoro Koffi Léopold Krah michel Kodo Department of Trauma and Orthopaedics Bouak Teaching Hospital Bouak Cte dIvoire Surgery Department Alassane OUATTARA University Bouak Cte dIvoire

Introduction: Elderly subjects have physiological and clinical characteristics that make surgical management more complex and have a major impact on their prognosis. The primary objective of this study was to assess peri-operative hospital morbidity and mortality in the elderly. Secondary objectives were to identify factors predictive of death. methods: This was a retrospective observational descriptive and analytical study carried out over 02 years, based on hospitalized patient records. It concerned patients aged 65 or over who had undergone surgery or for whom an indication for surgery had been given, all pathologies included. A total of 138 files were collected. The mean age was 74.15 years. Diabetes (n = 52;37.68%) and arterial hypertension (n = 38;27.54%) were the most common comorbidities. The reasons for hospitalization were mostly degenerative (n = 56;40.58%) and traumatic (n = 49;35.51%) pathologies. Preoperative delay, intraoperative and postoperative complications, hospital stay, evolution (mode of discharge), time of occurrence and presumed cause of death were studied. Univariate (p Results: The mean preoperative delay was 5.53 days (1 - 23). Intraoperative complications were mainly hemodynamic instability (n = 26, 18.8%). Postoperatively, the main complications were anemia (n = 62;48.44%) and glycemic imbalance (n = 28;21.86%). Average hospital stay was 13.4 days. Age (>75 years), the existence of comorbidities, degenerative pathologies, ASA score > 2, delay in treatment > 3 days, the occurrence of complications and the blood transfusion requirement were the independent predictors of the occurrence of death in the multifactorial analysis. Conclusion: Peri-operative morbidity in the elderly was influenced by age (>75 years), the existence of comorbidities, degenerative pathologies, ASA score > 2, time to treatment > 3 days, the occurrence of complications and the blood transfusion requirement.

关键词： Comorbidity Elderly Patient mortality Surgery

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Osteoarticular Lesions of the Shoulder Girdle by Hippopotamus Bite: Highly Septic Lesion

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Open Journal of Orthopedics 2024年第2期14卷 114-121页

作者： Jr Pierre Germain Ochou Achié Jean Régis Akobe Yao Aboh Ganyn Robert Arnaud Assere kouamé Jean-Eric Kouassi Adelaïde Aya Natacha Kouassi Ibrahim Soumahoro Zolopégué marcel Soro Sédi Loues De Randolphe Akpro Gbalé Yannick Blé kouamé innocent m’bra Loukou Blaise Yao Bada Juste Léopold NiaoréSery Koffi Léopold Krah michel Kodo Department of Orthopaedic and Traumatological Surgery Bouaké University Hospital Bouaké Ivory Coast Raoul Follereau Institute Manikro Centre Bouaké Ivory Coast

Hippopotamus bites are rare in medical consultations, despite several studies exposing their aggressive character. A case of a hippopotamus bite on the shoulder of a fisherman has been reported. In addition to the osteoarticular aspect representing a therapeutic problem, the infectious aspect was marked by sepsis, with a death in less than 48 hours. Based on this observation, a protocol for the initial management of large animal bites was submitted.

关键词： Bite Hippopotamus Septic Shock

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Honey Dressing of Cutaneous Wounds on Limbs in the Traumatology Orthopaedics Department of Bouaké University Hospital

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Open Journal of Orthopedics 2024年第9期14卷 411-420页

作者： Achié Jean-Régis Akobe Aya Adélaide Natacha Kouassi Ibrahim Soumahoro Zolopégué marcel Soro Sedy Louess De Randolphe Akpro Bakary Traoré Almamy Kamate Axel Fabrice Essehin Yao Aboh Ganyn Robert Arnaud Assere Lanciné Kaba kouamé innocent m’bra Loukou Blaise Yao Bada Justin Léopold Niaoré Sery Koffi Léopold Krah michel Kodo Orthopaedics-Traumatology Department of the University Hospital of Bouak Bouak Ivory Coast Plastic and Reconstructive Surgery Department of the University Hospital of Bouak Bouak Ivory Coast

The study evaluated the effectiveness of honey dressings in healing recent skin wounds with soft tissue loss on limbs. Conducted over a year with 60 patients, results showed a significant reduction in wound size and early healing, with complete recovery on average within 29 days. The study supports honey as a viable wound treatment.

关键词： Healing Honey Limbs Loss of Substances

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Treatment of Neglected Elbow Dislocations by Z-Lengthening of the Triceps brachii

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Open Journal of Orthopedics 2022年第4期12卷 142-152页

作者： m’bra kouamé innocent Kouassi kouamé Jean-Eric Yao Loukou Blaise AkobéJean Regis Achie Sery Bada Justin Léopold KouassiAya Adélaïde Natacha Krah Koffi Leopold michel Kodo Traumatology and Orthopedics Surgery of the University Hospital of Bouaké Bouaké C&ocirc te d’Ivoire

Introduction: Neglected elbow dislocations are much more common in developing and underdeveloped countries. The main reason for the delay in diagnosis is that patients initially seek treatment from traditional healers. These will immobilize the elbow in extension, which will lead to the retraction of the triceps muscle and collateral ligaments. Patients and method: We carried out a prospective study over five years (2014-2019). The study involved patients with unreduced elbow dislocation older than 21 days. All patients with a dislocated fracture and those whose x-ray showed joint fusion were not included in the study. We collected 26 patients, 20 men and 6 women with an average age of 27.5 years (17 and 45 years). The average consultation time was 8.9 months (3 - 13). The approach was posterior about 8 cm above the olecranon and 2 cm below the olecranon, the ulnar nerve was identified and isolated. The triceps tendon was cut in a Z from its myotendin junction to the beak of the olecranon, and then lengthened. Results: The patients were reviewed after a mean follow-up of 24 months (12 - 36). The mayo Clinic’s average elbow performance index was 77.1 (60 - 85), with 19 good and 6 average results. The mean flexion was 114°(100°- 135°) and the mean extension deficit was 31.15°(10°- 55°). The average range of motion was 82.5°(60°- 120°). We did not find a correlation between the duration of the lesion and functional recovery (p > 0.05). The Wilcoxon test showed that surgery significantly improved the overall range of motion of the elbow (p = 0.001). Discussion: Based on this study, open reduction with tendon lengthening should remain a treatment option regardless of the age and chronicity of the dislocation.

关键词： Elbow Dislocation Neglected Triceps Plasty Posterior Approach

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Ankle Arthrodesis in the Treatment of Neglected Ankle Fractures

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Open Journal of Orthopedics 2022年第4期12卷 123-130页

作者： m’bra kouamé innocent Krah Koffi Leopold Kouassi kouamé Jean-Eric Yao Loukou Blaise Akobé Jean Regis Achie Ochou Pierre Germain Jr Sery Bada Justin Léopold Kouassi Aya Adélaïde michel Kodo Traumatology and Orthopedics Surgery of the University Hospital of Bouaké Bouaké C&ocirc te d’Ivoire

Introduction: Neglected ankle fractures are common in our regions. Patients first consult traditional healers and it is when the signs persist that they consult the surgeon for a swollen and painful ankle. Initially we always performed anatomical repairs with osteosynthesis, but the majority of patients still complained of pain and disability. We wondered whether a primary arthrodesis would not be indicated in old ankle fractures to avoid disabling pain for patients. We therefore performed a series of arthrodesis on neglected post-traumatic ankles. The objective of our study was to describe the results of arthrodesis on an old post-traumatic ankle and to propose a therapeutic indication in the face of any neglected ankle fracture. material and method: This was a prospective study over 8 years between December 2012 and November 2020, involving 36 cases of neglected ankle fractures treated by arthrodesis using meary’s technique. We used AOFAS (American Orthopedic Foot and Ankle Score) preoperatively and postoperatively for an objective assessment. Results: The average follow-up was 4.2 years and our results were satisfactory (94.4%) with an average AOFAS score ranging from 27.8 preoperatively to 76.7 postoperatively. The fusion rate was 97.2%. Discussion: Arthrodesis appears here as an important alternative in the treatment of neglected ankle fractures with significant trophic disorders.

关键词： Arthrodesis Ankle Neglected Fracture Osteosynthesis Traditional Healers

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major Limb Amputation Secondary to Locally Advanced Cutaneous Squamous Cell Carcinoma in Tropical Environments: Determinants

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Open Journal of Orthopedics 2018年第4期8卷 139-147页

作者： Kouassi kouamé Jean Eric Yao Loukou Blaise Sery Bada Justin Leopold Niaoré m’bra kouamé innocent Krah Koffi Léopold Kouassi Aya Adelaide Nathacha Assere Yao Aboh Ganyn Robert Arnaud Kodo michel Trauma and Orthopedics Department Bouake Teaching Hospital Bouake Ivory Coast

Objective: To identify the determinants of secondary limb amputation in advanced squamous cell carcinoma. material and methods: This was a retrospective study carried out in the Orthopedic Traumatology Department of the Bouaké University Hospital in Côte d’Ivoire from January 2013 to December 2016. It involved ten patients with locally advanced skin squamous cell carcinoma, confirmed by histology and having amputated limbs. The parameters studied were: demographic data (gender, age), socio-economic conditions (occupation, place of residence), the risk factors involved, the use of topical self-medication and the use of traditional medicine, antecedents and comorbidities factors, lifestyle, clinical aspects (seat, size), extension assessment (X-ray), anatomo-pathological examination data, duration of evolution of squamous cell carcinoma, the function of the affected limb, the treatment performed, the evolutionary modalities and the equipment. Results: Between 2013 and 2016, ten patients underwent either upper or lower limb amputations following locally advanced squamous cell carcinoma. The average age was 34.1 years (19 - 64 years). There were 7 men (70%) and 3 women (30%) and all our patients were black (sub-Saharan Africa). The majority of our patients were farmers (70%). The risk factors for squamous cell carcinoma were neglected chronic wounds. All our patients recognized during the interrogation a large use of the topicals of traditional medicine for the treatment of the initial cutaneous lesions. In terms of lifestyle, five (50%) were smokers and alcoholics. The mean time to progression of squamous cell carcinoma was 5.9 years. Lesions were localized preferentially to the pelvic limbs six (60%) cases and four (40%) to the limbs chest. The lesion was diagnosed late in all our patients. The size of the tumor in all our patients was greater than 5 cm and had a deep invasion (nerves, vessels and bone). The proximal ipsilateral ganglionic invasion was constant.

关键词： Amputation Squamous Cell Carcinoma Cutaneous Histology

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Team experience of nasopharyngeal samples reception,decontamination,and sorting during the COVID-19 pandemic(2020)at Institut Pasteur Côte d’Ivoire

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Journal of Biosafety and Biosecurity 2021年第2期3卷 120-124页

作者： kouaméinnocent Kolia KipréBertin Guédé Kan Stéphane Kouassi Koby Albert Obro Kpadraux Danielle Odegue Sylvie mireil Sina-kouaméle Banga Victor Yepri mireille Dosso molecular Biology Platform/Institut Pasteur Côte d’Ivoire Central Laboratory/University Hospital Center of Yopougon(Côte d’Ivoire)Cote d’Ivoire Bacteriology and Virology Department National Reference Center for Antibiotics/Institut Pasteur Côte d’IvoireCôte d’Ivoire molecular Biology Platform/Institut Pasteur Côte d’Ivoire Côte d’Ivoire Cell Biology Unit/Institut Pasteur Côte d’Ivoire Côte d’Ivoire Transport and packaging unit/Institut Pasteur Côte d’Ivoire Côte d’Ivoire Institut Pasteur Côte d’Ivoire Côte d’Ivoire

molecular testing sensitivity,which allows for early diagnosis of the 2019 coronavirus disease(COVID-19),could be affected by sample quality,storage,and transportation timeframe to the laboratory,along with bias related to the pre-analytic *** present study reports the selection and decontamination of nasopharyngeal samples during COVID-19 management at the Institut Pasteur Côte d’*** objective of this work was to organize sample reception management and report a complete picture of sample selection and decontamination in the context of diagnosis activity *** administrative note creating the selection and decontamination unit of nasopharyngeal samples initiated activities in may *** required human resources and necessary materials were identified and put in *** activity consisted of receiving,sorting,decontaminating,and sending nasopharyngeal samples to different diagnostic *** were recorded *** a six-month period of activities,from a total amount of 11,401 containers received and decontaminated,174,085 samples were selected.A proportion of 92.0%of these specimens met the diagnostic standards,while 7.0%that were found acceptable showed minor ***,a rate of 1.0%of samples with major abnormalities could not be used for COVID-19 testing and,therefore,were ***,the non-conformity rate was reduced by 2.4%after the first term *** and decontamination of nasopharyngeal samples are crucial steps in biosafety optimization for the technical staff and quality improvement of sample care.

关键词： Sorting and decontamination Nasopharyngeal sample COVID-19 Côte d’Ivoire

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Using Water Quality Index for Assessing of Physicochemical Quality of Quaternary Groundwater in the Southern Part of Abidjan District (Côte d’Ivoire)

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Journal of Water Resource and Protection 2019年第10期11卷 1278-1291页

作者： Aristide Gountô h Douagui innocent Kouassi kouamé Jules mangoua Oi mangoua Auguste kouamé Kouassi Issiaka Savané Laboratoire Géosciences et Environnement Unité de Formation et de Recherches des Sciences et Gestion de l’Environnement Université Nangui Abrogoua Abidjan Côte d’Ivoire Unité de Formation et de Recherches Environnement Université Lorougnon Guédé Daloa Côte d’Ivoire

In this study, fourteen physicochemical parameters were monitored at 61 groundwater sampling points located in the southern part of Abidjan District. Each water sampling location was sampled in march and July 2007, representing respectively the long dry season and the long wet season. Groundwater evaluation index and statistical methods were used to assess Quaternary groundwater physicochemical quality in term of drinking and irrigation purposes. The groundwater samples irrespective of seasons fell in mixed K-Na-HCO3 and K-Na-Cl types. Groundwater quality index values varied from 14.01 to 593.44 and from 20.88 to 567.44, in dry and rainy seasons, respectively. In both seasons, 9.83% exhibited poor water quality and 3.27% indicated unsuitable water for drinking purposes. The studied water wells were heavily contaminated with nitrate, nitrite and ammonium in the strongly urbanized areas at Treichville, Koumassi, marcory, Port-Bou?t and Grand-Bassam. The degree of correlation between physicochemical parameters suggested that groundwater quality was mainly related to geogenic (rock–water interaction) and anthropogenic sources (domestic sewage), and intrusion of marine and lagoon waters in the study area. Sodium adsorption ratio was generally low during study period, indicating most groundwater sampled was suitable for irrigation purposes.

关键词： Hydrochemistry Groundwater Quality Chemical Pollution Abidjan District

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