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

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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

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

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

Study of the Akouedo Landfill (Abidjan) Using the Electrical Resistivity Method: Implications for the Risk of Contamination of the Continental Terminal Water Table

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Journal of Geoscience and Environment Protection 2023年第11期11卷 103-115页

作者： Ehui Beh Jean Constantin Aka loukou nicolas kouame Kouassi Eric Germain Kouakou Department Earth Sciences and Mineral Resources Félix Houphou&#235t-Boigny University Abidjan C&#244te d’Ivoire Department of Biological Sciences Peleforo Gon Coulibaly University Korhogo C&#244te d’Ivoire

An electrical resistivity survey was carried out on the household and industrial waste disposal site (landfill) of Akouédo (Central Abidjan) with a view to searching for a possible layer of clay in the stratification which could constitute a protective screen of the aquifer of the Continental Terminal of Abidjan against the migration of leachate. Electrical surveys (SE) carried out according to the Schlumberger configuration showed that the stratigraphy of the area is composed of three to four geoelectric layers depending on the SE positions. The correlation with the lithology of two piezometric boreholes carried out indicates that the lithology of the study area is dominated by clayey sand, sand, sandy clay and clay. The average thickness of accumulated waste varies between 30 and 40 m. The virtual absence of a continuous layer of clay under the waste exposes the Continental Terminal aquifer to contamination by leachate from waste accumulated over several decades in the Akouedo area.

关键词： Landfill Continental Terminal Aquifer Electrical Sounding Akouédo Abidjan

3D Modeling and Estimation of the Tonnage of the Granite Quarry of Linguésso (North-West of Côte d’Ivoire) by Electrical Methods

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Journal of Geoscience and Environment Protection 2023年第3期11卷 138-154页

作者： Yapo Assi Martial kouame loukou nicolas Aka Ehui Beh Jean Constantin Sombo Boko Celestin Laboratory of Geology Mineral and Energy Resources UFR-STRM University Félix Houphouët-Boigny Abidjan Ivory Coast

A survey and evaluation was carried out on a potential granitoid quarry site in the locality of Linguésso (North West of Ivory Coast) with the aim of identifying and estimating the quantity of exploitable granite based on the electrical resistivity methods. The combination of electrical trailing, sounding and tomography techniques allowed the determination of the characteristics of the rock deposit, namely the electrical signature (between 19,259 Ωm and 86,316 Ωm), the extension (N90°), the rooting (between 0 and 45 m) and the fracturing (between N14° and N160°) of the granitic formation sought. The modeling resulted in an estimated mineable rock volume of 2,936,250 m3 providing a production quantity of 7,927,875 tonnes.

关键词： Eelectric Resistivity 3D geoelectric Model Granitic Quarry Linguésso Ivory Coast

Assessment of the Quality of Sediments and Agricultural Soils: Case of the Ity-Floleu Area in the Prefecture of Zouan-Hounien, Western Côte d’Ivoire

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Journal of Geoscience and Environment Protection 2020年第12期8卷 255-275页

作者： Konan Kouakou Séraphin Gbamélé Kouassi Serge Doffou Richard Jean Olive Brou loukou Alexis Kouassi Kouakou Lazare Dongui Bini kouamé Laboratory of Geosciences and Environment University Jean Lorougnon Guede Daloa C&ocirc te d’Ivoire Departement of Geology University Jean Lorougnon Guede Daloa C&ocirc te d’Ivoire

The objective of this study is to assess the level of metal contamination of sediments and agricultural soils in the Ity-Floleu zone. The concentrations of trace elements (Fe, Mn, As, Cd, Cr, Cu, Hg, Ni, Pb and Zn) were measured in different seasons over two successive years. The sediment pollution index made it possible to note that the sediments and agricultural soils of the various stations studied are highly polluted in all seasons. The calculation of the geoaccumulation index indicates that surface water sediments most often experience extreme or moderate pollution in As, Cd, Cu, Hg and Zn in the dry or rainy season except in Pb in some cases. We observed that the sediments of the Cavally river present a serious pollution due to extreme anthropic activities carried out along the river. Over the entire region, the results of the potential ecological risk index (RI) indicate that all the sediments and agricultural soils analysed present a moderate ecological risk in terms of Pb and Zn in certain cases and an ecological risk is observed low bound to other metals in all seasons. This metallic pollution generated by human activities in this region can have consequences for the environment and biodiversity.

关键词： Anthropogenic Activities Cavally River Contamination Factors Contamination Indices Metallic Trace Elements Sediments and Agricultural Soils

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

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

Occurrence of Enterobacter sakazakii(Cronobacter)and Other Enterobacteriaceae in Commercial Powdered Infant Formula in Abidjan,Ivory Coast

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Food and Nutrition Sciences 2012年第6期3卷 822-826页

作者： Kouadio Yao Nanga Yessé Zinzendorf Guichard Bohoua Kra Athanase Kouassi Amian Koua Luc Kouakou Kouadio Patrice kouamé Guillaume Yao loukou Department of Sciences and Food Technology University of Abobo-AdjaméAbidjanCote d’Ivoire Department of Microbiology National Laboratory of Public HealthAbidjanCote d’Ivoire Department of Bacteriology and Virology University of CocodyAbidjanCote d’Ivoire Deprtment of Hydrology and Public Health University of CocodyAbidjanCôte d’Ivoire Laboratory of Biology National Institut of Public HealthAbidjanCote d’Ivoire

To determine the occurrence of Enterobacter sakazakii and other Enerobateriaceae in commercial powdered infant formula (PIF), 185 packages of PIF from different manufacturers, supermarkets and drug-stores in Abidjan were analyzed. Ten g of sample was homogenized in 90 ml of buffered peptone water (PBW, Biorad, Paris) for further studies. Enterobacteriaceae (coliforms) were enumerated according to French Association of Standardization methods. E. sakazakii was detected according to Kandhai’s method. Bacteria were identified using API20 system. Thirty-eight samples (20.5%) were positive for Enterobacteriaceae. Twenty-four samples (13%) yielded Enterobacter sakazakii. Other Enterobacteriaceae isolated included Pantoea spp. 21 (11.5%), Klebsiella pneumoniae subsp. Pneumonia 8 (4.3%), Citrobacter diversus 1 (0.5%), Citrobacter freundii 1 (0.5%), Enterobacter cloacae 1 (0.5%), Salmonella reading 1 (0.5%), Serratia ficara 1 (0.5%) Serratia odorifera 1 (0.5%). This study is the first report to describe the contamination of PIF from Abidjan with E. sakazakii and several other Enterobacteriaceae that could be opportunistic pathogens. Therefore, well-controlled studies need to be conducted to assess the extent of risk associated with contaminated PIF for infants in Abidjan.

关键词： Enterobacteriaceae Enterobacter sakazakii Powedered Infant Formulat