Objective: To determine the magnitude, socio-demographic and epidemiological characteristics of injury at a Provincial referral hospital. Methods: This review was conducted on all trauma patients admitted at the Mthatha Hospital Complex and Nelson Mandela Academic Hospital from the 1 st January 1997 to the 31 st December 2000. Results: The incident rate of injuries was 3.2% (n=2460/75,833 total admissions). Injured patients were mostly black (80%) and males (ratio: 5 men: 1 woman). Only 8.1% of injured patients were transported to hospital by ambulances. The leading causes of injuries were inter-personal violence accounting for 60% of cases, and motor vehicle accidents accounting for 19%; of them 38% were due to poor visibility, over speeding, and fatigue. The overall mortality was 33% (n=821) independently predicted by poverty (OR=8.2 95%CI 6-11.1; P<0.0001) and age>40 years(OR=7.8 95%CI 7.7-12.1;P<0.0001). Conclusion:The burden of injury is a mass issue that warrants regional attention with quality of care and training.

Urgent prevention strategies of burns and evidence-based practice with early nutritional supplementation are needed to reduce high rates of malnutrition and mortality.

No abstract

Preservation of viable tissue is important in wound management. It is achieved by small, incremental removal of devitalised, necrotic and infected tissues. Maggot debridement therapy (MDT) is used in septic necrotic wounds that fail to respond to conventional modalities. MDT has relied on Lucilia sericata, which consumes only necrotic tissues, as opposed to Lucilia cuprina, which devours both flesh and necrotic tissues. Recent findings have shown that L. cuprina consumes mainly necrotic and very small amounts of viable tissues and may be used in MDT where L. sericata is very rare or absent. Here we describe wound healing in a patient from rural South Africa with cutaneous myiasis. Our findings agree with workers who indicated that L. cuprina could be used in MDT.

No abstract