Introduction : L'objectif était de déterminer la fréquence, les aspects cliniques et thérapeutiques des infections du site opératoire (ISO) chez les césariennes itératives (utérus cicatriciels) versus césariennes systématiques (utérus sains). Matériel et méthode : Etude rétrospective et comparative du 1er janvier 2013 au 31 décembre 2017. Tous les cas de césariennes itératives et systématiques avec infections du site opératoire ont été inclus. L'analyse des données a été effectuée sur le logiciel SPSS. Le khi2 avec un seuil significatif de p < 0,05 a été utilisé. Résultats : Au total sur 10281 césariennes, 4318 étaient itératives et 5923 systématiques. Les infections du site opératoire ont été retrouvées chez 540(5,25%) dont 180 itératives et 360 systématiques (p=0,0000). L'âge moyen était de 26 ans. Conformément aux politiques, normes et procédures en vigueur au Mali, toutes les patientes césarisées ont été soumises à une antibioprophylaxie systématique à base d'Amoxicilline. La suppuration superficielle a été retrouvée chez 115(64%) utérus cicatriciels contre 192(53,33%) utérus sains (p=0,019). 170(94,44%) utérus cicatriciels et 304(84,44%) utérus sains étaient de la classe II de risque d'Altemeier avec p=0,000. 170(94,44%) utérus cicatriciels et 304(84,44%) utérus sains avaient le score zéro de NNISS. Staphylocoques sp et Escherichia coli ont été isolés respectivement dans 31,44%(77) et 16,94%(53). L'antibiothérapie était adaptée à l'antibiogramme. La durée moyenne d'hospitalisation était de 17,5 jours. Aucun décès maternel n'a été enregistré liés aux ISO. Conclusion : les ISO post césariennes restent élevées en commune V de Bamako.
Objectives: To evaluate the surgical activities of the surgical unit of the Fana Health Centre. This was a prospective and descriptive study carried out in the surgical unit of the Fana Health Centre over a period of 12 months (01 July 2020 to 30 June 2021). Results: 331 surgical consultations with 242 surgical pathologies operated on, i.e. 73.11%. Men were more affected than women with a sex ratio of 2.9 and a predominance of young adults aged 16-30 years with 28.51%. The main disease groups encountered were the digestive disease class with a rate of 82.23% in first place, followed by diseases of the urinary system with 19.83%. The average length of hospital stay was 5 days. We observed that of the 242 patients operated on, 10 died (6 from septic shock and 4 from pulmonary embolism). Conclusion: This work has enabled us to highlight the surgical activities of the surgical unit at the Fana Health Centre, to evaluate its performance and shortcomings.
Inguinal hernia is the spontaneous or progressive, temporary or permanent passage of viscera or part of viscera out of the cavity that normally contains it. This passage is made through an anatomically preformed area of weakness in the inguinal canal. The diagnosis of inguinal hernia is primarily clinical (inguinal swelling). Objectives: To study the epidemiological, diagnostic and therapeutic aspects of inguinal hernias in the general surgery unit of the Centre de Santé de Référence (CSRéf) in Fana. Results: 431 surgical interventions. 147 inguinal hernias including 12 cases of strangulation, The frequency of hernia was 34.11% in relation to surgical procedures, The 15-29 age group accounted for 32.7% of cases, The sex ratio was:35.75 in favour of men, In our study, farmers accounted for 53.06% of the total, Bilateral inguinal hernia which accounted for 57.14%, Patients who underwent para-rectal inguinotomy accounted for 88.4%, The Bassini technique was used in 70.75% of our patients, The operative follow-up was complicated in 19.73% of our patients, We recorded one case of death (0.7%). Conclusion: Inguinal hernia is a common surgical condition, preferentially affecting the male subjects and farmers, with a predominance of young people aged 15 to 25 years.
The aim is to study acute appendicitis in the surgery department of the Markala Reference Health Center. Patients and Methods: We conducted a retrospective study in the general surgery department of the reference health center which took place over a period of 35 months from October 1, 2019 to October 30, 2021. The retrospective period was from the month of October 2019 in October 2020 then follows the prospective period until October 2021. Inclusion criteria: Were included in our study; all patients with appendicitis or its complicated forms in the general surgery department of the Csréf in Markala. Non-inclusion criteria: Were not included in our study; cases of appendicitis outside the general surgery department of the Csréf. -Appendicitis accounted for 58.2% of hospitalizations or 31% of emergency surgeries performed during the study period. 85.4% of the patients were without medical-surgical ATCD, on the other hand the oldest of our patients was 61 years old; the average age was 29 years old and the youngest was 13 years old. Furthermore, we note that there was no age of onset of appendicitis. The treatment received by all of our patients was appendectomy (93 cases were operated on urgently and the 10 cases were first cooled and then operated on 3 months after the medical treatment). No major complication was noted in our patients, apart from three cases of infection of the surgical site related to the fact that it was an appendicular abscess. Conclusion: Acute appendicitis is one of the most common surgical emergencies in digestive surgery. Its diagnosis is essentially clinical, sometimes made difficult by the absence of anatomo-clinical parallelism linked to the polymorphism of the lesions and the variations in the position of the organ in the abdominal cavity. Untreated, it can progress to serious complications (generalized peritonitis). It is a condition with low morbidity and mortality subject to early diagnosis and surgical treatment.
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