The operating site infections constitute the major postoperative issue in surgery. Our objectives were to determine the hospital frequency, the risk factors, the involved germs as well as the cost generated by the operating site infections. Method: Our three months prospective survey run from September the 1st to November the 30th 2013 has included all department patients being operated on and hospitalized. The criteria have been set by CDC d'Atlanta. Results: 374 files were involved, among them 229 (61.2%) were emergencies and 145 (38.8%) were scheduled. The average age was 41 (extremes 7 and 95 standard deviation 17.46), the sex ratio 1.67. The infective risk according to Altmeier has found 17.5% type 1, 25.1% type 2, 11.2% type 3 and 46.3% type 4; according to NNISS, 96 (25.7) were NNISS 0; 94 (51.9%) NNISS 1; 80 (21.4%) NNISS 2; and 4 (1.1%) NNISS. In the Altmeier class I have not got antibiotic before infection signs appearances. Our overall rate of operating site infections was 7.9% (29 cases), with 24 (82.8%) emergency cases. According to Altmeier's class of infective risk, the rate of operating site infections was 1.54% making 1 out of 65 type I patients; 4.3% making 4 out of 93 type II patients; 11.9% making 5 out of 42 type III patients; 10.9% making 19 out of 174 type IV patients. According to NNISS, the infective risk has been assessed and was 2.08% for score 0, we have got 8.25% score 1, and 12.5% for score 2, and 25% for score 3. The bacteriology has been dominated by Escherichia coli (51.7), Proteus mirabilis (13.8), and Klebsiella pneumoniae (10.34). The germs have been resistant to the combination Amoxicillin-clavulanic Acid between 50% and 87% of cases. The most active antibiotics on the germs have been Cephalosporin, Polypeptides, and aminoglycosides. The hospital stay has been B. T. Dembélé et al. 60 delayed to 12 days on average by operating site infections, making 2.5 times greater than those uninfected. The infection has increased the cost of management around 600 Euro.
Objectives: To evaluate the quality of the information provided to patients for their consent to be operated laparoscopically in the "A" surgery service of Point "G" University Hospital in Bamako (Mali). Methodology: The study was transversal, descriptive and prospective from November 1, 2016 to December 31, 2017 (14 months). It was performed at the general and laparoscopic surgery department of the Point "G" University Hospital in Bamako. Laparoscopically operated patients in scheduled or emergency programm whom consented the study and answered the questions before and after the surgical procedure were included. Results: One hundred patients were retained. The sex ratio was 4.2 for women. The surgery was scheduled in 93% (programmed surgery) of cases versus 7% (urgent surgery). Gynecological and obstetric surgery was performed in 54%, digestive surgery in 43% and laparoscopic exploration in 3%. The information was provided by surgeons, anesthetists, fellowship and students in respectively 63%, 6%, 11% and 9%. The reflection period before consenting to the act was greater or equal to 3 days in 90%. The media used were found to be suitable in 62%. The information was considered satisfactory preoperatively in 54% and postoperatively in 88%. Patients wanted additional information on post-surgery outcomes in 21%. Conclusion: The establishment of an information system and a free and informed consent form is a prerequisite for the quality of care in laparoscopic surgery.
The simultaneous double volvulus of the transverse colon and sigmoid in the same patient is a rare cause of intestinal occlusion. Two cases were observed in general surgery in Kati. Its clinical symptomatology does not differ from other occlusions as well as simple radiological images. It is an extreme surgical emergency, the diagnosis is generally intraoperative. Extensive left hemicolectomy with terminoterminal rectal anastomosis was performed. The surgical follow-up was simple.
Introduction: Voluntary assault and injuries are acts that damage the physical and psychological integrity of a human being. WHO in its global report on violence and health estimates that in 2000, 1.6 million people worldwide died as a result of self-harm, interpersonal or collective violence, resulting in an overall rate adjusted by age of 28.8 per 100,000 population. Because of the seriousness of this phenomenon and the heavy socioeconomic and health consequences that they generate, it seemed important to us to undertake this study, which aimed to study the deliberate injuries in the emergency unite of the Gabriel Touré Teaching Hospital in Bamako. Material and methods: This was a descriptive and cross-sectional study with a prospective study from September 1st, 2016 to August 31st, 12 months, covering 295 patients, including any patient received for voluntary injury consultation with a workable medical record and/or a full investigation record with or without requisition. Our data were collected on individual survey cards and subsequently analyzed with Word, Excel, IBM SPSS Statistics 22 software. Results: The majority of victims of assault and bodily injury were male with 83.1%; with a sex ratio of 4.9, the 18 to 28 age group was the most concerned with 163 cases of the 295 cases in our study, 55.2%. The extremes were 6 and 100 years old with an ectype at 11.08. The most affected ethnic group was Bambara with
Objectives: To determine hospital frequency and to write the diagnostic and therapeutic aspects of appendicular abscess in adults in the General Surgery Department of teaching Hospital Gabriel Touré from 2005 to 2017. Material and Methods: This was a retrospective study conducted from January 1, 2005 to December 31, 2017 in the General Surgery Department of Gabriel Touré University Hospital in all patients with appendicular abscess. Results: In 13 years, 1420 cases of acute appendicitis have been reported, including 105 cases of appendicular abscess (7.4%). Mean age of the patients was 32 years with extremes of 16 years and 70 years. Abdominal pain and fever were present in all patients. Pain sat in the right iliac fossa in 73.3% and was epigastric in 11.4%. In almost all cases abdominal defense was present (97.1%). There was generalized abdominal contracture in 2.8% of cases. Average duration of evolution was 27 days with extremes of 1 day and 60 days. Ultrasonography was performed in 42.6% of cases and found peri-appendicular effusion in 29 cases (27.6%). 90 incisions were made by incision of Mac Burney, 8 by median umbilical, 7 by midline above and below umbilical. The amount of fluid aspirated was greater than 100 cc in 47 patients. We performed an appendectomy with appendicular stump burying followed by washing plus drainage of the abdominal cavity in 65 patients. Morbidity rate was 14.3%. No deaths were recorded. Average duration of hospitalization was 6.5 days with extremes of 2 days and 26 days.
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