article · Ghana Medical Journal
Mycobacterium ulcerans disease, also known as Buruli ulcer, causes severe tissue destruction that has traditionally required extensive surgical excision. A retrospective study across four endemic districts in Ghana reviewed 132 patients who received surgery between 2004 and 2009 after undergoing at least four to eight weeks of antibiotic therapy with rifampicin and streptomycin. Patients ranged from four to 98 years old, with the majority of lesions affecting the lower limbs and presenting predominantly as open ulcers. Healthcare teams conducted 139 procedures, with skin grafting and excision accounting for most interventions. The findings demonstrate that pre-treating patients with antibiotics improves the state of the disease and minimises the scope of surgery required. Combining chemotherapy with targeted surgical procedures is essential for healing persistent lesions and preventing disabling joint contractures.
Buruli ulcer causes destructive skin lesions that can lead to permanent deformities and physical disability. Demonstrating that initial antibiotic therapy reduces the extent of required surgery provides healthcare workers with an evidence-based clinical approach. This dual strategy helps preserve tissue, supports functional healing, and reduces the risk of severe contractures in affected individuals living in endemic regions.
This research provides applied clinical evidence relevant to public health programmes, hospitals, and surgical practitioners managing neglected tropical diseases. The findings support the standardisation of combined therapeutic protocols in healthcare facilities rather than pointing to a proprietary commercial product. Beyond informing clinical treatment guidelines and medical training programmes, the abstract does not indicate a commercialisation pathway.
AI-generated from the published abstract. Always read the original work before citing.
BACKGROUND: Mycobacterium ulcerans (MU) disease causes extensive destruction of tissues leaving large ulcers on the body. Management which consisted of surgical excision of the lesions is gradually being replaced with chemotherapy. OBJECTIVE: To study the impact on surgery of prior treatment of MU disease with rifampicin and streptomycin. STUDY DESIGN: Retrospective, from September 2004 to September 2009. SETTING: Asunafo, Amansie West, Ahafo Ano and Amansie Central districts of Ghana. METHODS: Patients who have completed 8 weeks or a minimum of 4 weeks treatment with rifampicin and streptomycin but have unhealed lesions were selected for surgery. RESULTS: 132 patients had surgery for MU disease; 51 at Tepa (Ahafo Ano); 36 at Agroyesum (Amansie West); 16 from Jacobu (Amansie Central); 29 from Goaso (Asunafo) districts. Their ages ranged from 4 to 98 years, with mean age of 29.90 years, standard deviation of 20.74. Sites involved were: head and neck 1 (0.74%), upper limb 40 (29.63%), lower limb 92 (68.15%), trunk 2 (1.48%) (N=135). The clinical forms were: papule 1 (0.74%), nodule 2 (1.48%), oedematous lesion 4 (2.96%), osteomyelitis 2 (1.48%), ulcers 124 (91.85%), contractures 2 (1.48%). 139 surgical procedures were performed: excision 25 (18.11), skin grafting 36 (26.1%), excision and skin grafting 54 (39.1%), debridem net 10 (7.2%), sequestrectomy 2 (1.4%), regrafting 10 (7.2%), release of contractures 2 (1.4%). CONCLUSION: Treatment of MU disease with rifampicin and streptomycin improved the condition and minimised the extent of surgery. Combination of surgery and antibiotics is necessary to prevent the development contractures.
This page summarises published work. The authoritative version sits with the publisher.
DOI: 10.4314/gmj.v45i1.68914
Is something wrong with this record? Report it or request removal.
Discussion
Have you built on this work, tried to replicate it, or seen it applied in practice? Share what you know. Verified researchers and MARATTO™ domain experts can open a discussion, and any member can reply. Contributions are reviewed before they appear.
No discussion yet. Open the first thread.
New to MARATTO™? Create a free account.
