Introduction: Cleft lip, palate and alveolar (CLPA) are congenital malformations of the face due to a defect in the fusion of embryonic buds during the first weeks of embryogenesis. These malformations affect the uppe...Introduction: Cleft lip, palate and alveolar (CLPA) are congenital malformations of the face due to a defect in the fusion of embryonic buds during the first weeks of embryogenesis. These malformations affect the upper lip, the alveolar bone and the palate. The incidence in Africa ranges from 1/2000 to 1/500 births. Their multidisciplinary management is long and costly. Thus, the help provided by humanitarian organisations during free care campaigns is welcome. Materials and Methods: This is a retrospective descriptive study conducted from August 2014 to July 2016 in the Maxillofacial Surgery and Stomatology Department of the Treichville University Hospital in Abidjan, Côte d’Ivoire. The objective was to describe the epidemiological, clinical and therapeutic aspects of CLPA during a humanitarian campaign for free care. Results: 51 cases of CLPA were operated on. Males were involved in 54.9% of the cases, i.e. a sex ratio of 1.2. The average age of the patients at the time of the operation was 3.44 years with extremes of 3 months and 52 years. Patients with low socioeconomic status represented 84.3% of the cases. Cleft lips (31.4%) and cleft palates (33.33%) predominated. For cleft lips, unilateral forms were the most frequent (73.5%) and the left side was most often affected (59.2%). The most common surgical techniques used were MILLARD cheiloplasty for cleft lips (79.36%) and Dorrance pushback for cleft palates (78.05%). The postoperative course was simple in the majority of cases (80.47%). Patients and/or parents were satisfied with the postoperative results in over 90% of cases. Discussion: Cleft lip and palate are common. Their management by humanitarian missions through mass campaigns allows us to receive a large number of patients affected by this pathology who are treated with a high satisfaction rate. Conclusion: The characteristics of cleft lip and palate in this study are in many respects identical to those described in the literature, but with some differences specific to Africa, notably the absence展开更多
<strong>Introduction: </strong>The management of nasolabial-palatal clefts in precarious environments is one of the topics most addressed by many humanitarian missions, especially in Africa and Asia. The a...<strong>Introduction: </strong>The management of nasolabial-palatal clefts in precarious environments is one of the topics most addressed by many humanitarian missions, especially in Africa and Asia. The aim of our study was to propose a humanitarian and not expensive care to the patients presenting with facial clefts during the fairgrounds in disadvantaged areas. <strong>Patients and</strong> <strong>Method:</strong> We carried out a prospective study on 32 patients who were operated with very limited means during the mobile clinics inside Togo during the year 2013. These patients were followed over a period of one year after their surgery. Included in our series were native patients with facial clefts, who had no means of managing their condition, and who therefore needed humanitarian support. We have reported the clinical history of some patients to illustrate our results. <strong>Results:</strong> Our study included 32 children, including 15 boys and 17 girls, with a sex ratio of around 1. The average age of patients was 5 years, with extremes of 6 months and 13 years. We performed 13 clefts (including 12 unilateral clefts and 1 bilateral cleft), 17 clefts palate (including 12 unilateral clefts and 5 bilateral clefts), and 2 velar clefts. We described the clinical history of a few patients in this humanitarian setting and showed the surgical results obtained.展开更多
Armed conflicts are increasing globally due to political unrest and the broader effects of climate change.Without resources to provide quality surgical care,it becomes nearly impossible to provide quality emergency su...Armed conflicts are increasing globally due to political unrest and the broader effects of climate change.Without resources to provide quality surgical care,it becomes nearly impossible to provide quality emergency surgery and trauma care similar to that in high-income countries.To understand and help aid organizations provide resources and address the surgical needs of populations facing armed conflict,a matrix to identify variables and help with interventions was envisioned.Apreviously published global surgery matrix based on the PIPES(Personnel,Infrastructure,Procedures,Equipment and Supplies)surgical capacity tool was adapted to this context.The novel matrix incorporates 108 variables.These variables are grossly divided into local and international agency components to address the issue of who is providing care.Using a time continuum of pre-conflict,conflict,and post-conflict allows organizations to concentrate on when during the conflict to target their intervention.In addition to the previously used personnel,infrastructure,procedures,equipment,and supplies categories,a sixth category called standards was included that addresses the issues such as information technology,data systems,quality improvement programs,and patient safety.Pilot testing of this matrix to obtain feedback from end users is the next step in development.Ultimately,peri-conflict preparedness should increase and improve surgical outcomes and reduce in death and disabilities around the world.展开更多
文摘Introduction: Cleft lip, palate and alveolar (CLPA) are congenital malformations of the face due to a defect in the fusion of embryonic buds during the first weeks of embryogenesis. These malformations affect the upper lip, the alveolar bone and the palate. The incidence in Africa ranges from 1/2000 to 1/500 births. Their multidisciplinary management is long and costly. Thus, the help provided by humanitarian organisations during free care campaigns is welcome. Materials and Methods: This is a retrospective descriptive study conducted from August 2014 to July 2016 in the Maxillofacial Surgery and Stomatology Department of the Treichville University Hospital in Abidjan, Côte d’Ivoire. The objective was to describe the epidemiological, clinical and therapeutic aspects of CLPA during a humanitarian campaign for free care. Results: 51 cases of CLPA were operated on. Males were involved in 54.9% of the cases, i.e. a sex ratio of 1.2. The average age of the patients at the time of the operation was 3.44 years with extremes of 3 months and 52 years. Patients with low socioeconomic status represented 84.3% of the cases. Cleft lips (31.4%) and cleft palates (33.33%) predominated. For cleft lips, unilateral forms were the most frequent (73.5%) and the left side was most often affected (59.2%). The most common surgical techniques used were MILLARD cheiloplasty for cleft lips (79.36%) and Dorrance pushback for cleft palates (78.05%). The postoperative course was simple in the majority of cases (80.47%). Patients and/or parents were satisfied with the postoperative results in over 90% of cases. Discussion: Cleft lip and palate are common. Their management by humanitarian missions through mass campaigns allows us to receive a large number of patients affected by this pathology who are treated with a high satisfaction rate. Conclusion: The characteristics of cleft lip and palate in this study are in many respects identical to those described in the literature, but with some differences specific to Africa, notably the absence
文摘<strong>Introduction: </strong>The management of nasolabial-palatal clefts in precarious environments is one of the topics most addressed by many humanitarian missions, especially in Africa and Asia. The aim of our study was to propose a humanitarian and not expensive care to the patients presenting with facial clefts during the fairgrounds in disadvantaged areas. <strong>Patients and</strong> <strong>Method:</strong> We carried out a prospective study on 32 patients who were operated with very limited means during the mobile clinics inside Togo during the year 2013. These patients were followed over a period of one year after their surgery. Included in our series were native patients with facial clefts, who had no means of managing their condition, and who therefore needed humanitarian support. We have reported the clinical history of some patients to illustrate our results. <strong>Results:</strong> Our study included 32 children, including 15 boys and 17 girls, with a sex ratio of around 1. The average age of patients was 5 years, with extremes of 6 months and 13 years. We performed 13 clefts (including 12 unilateral clefts and 1 bilateral cleft), 17 clefts palate (including 12 unilateral clefts and 5 bilateral clefts), and 2 velar clefts. We described the clinical history of a few patients in this humanitarian setting and showed the surgical results obtained.
文摘Armed conflicts are increasing globally due to political unrest and the broader effects of climate change.Without resources to provide quality surgical care,it becomes nearly impossible to provide quality emergency surgery and trauma care similar to that in high-income countries.To understand and help aid organizations provide resources and address the surgical needs of populations facing armed conflict,a matrix to identify variables and help with interventions was envisioned.Apreviously published global surgery matrix based on the PIPES(Personnel,Infrastructure,Procedures,Equipment and Supplies)surgical capacity tool was adapted to this context.The novel matrix incorporates 108 variables.These variables are grossly divided into local and international agency components to address the issue of who is providing care.Using a time continuum of pre-conflict,conflict,and post-conflict allows organizations to concentrate on when during the conflict to target their intervention.In addition to the previously used personnel,infrastructure,procedures,equipment,and supplies categories,a sixth category called standards was included that addresses the issues such as information technology,data systems,quality improvement programs,and patient safety.Pilot testing of this matrix to obtain feedback from end users is the next step in development.Ultimately,peri-conflict preparedness should increase and improve surgical outcomes and reduce in death and disabilities around the world.
