Introduction: There has been a significant improvement in the outcome of treatment of large surface area burns in developed countries. A major contributory factor is an early excision and skin grafting of burn wounds. The initial coverage of large surface area deep burn wounds requires the use of temporary skin substitutes such as allografts due to limited skin autografts. Cadaveric skin allografts are the commonest source of skin allografts in use; however, there may be religious, cultural, cost, or other factors mitigating its availability and routine use in low- and middle-income countries (LMICs). Human skin allografts may be used fresh or stored in tissue banks to ensure its ready availability. The purpose of this review is to promote glycerolised skin allografts as a means of skin preservation in low-resource countries above other modalities cryopreservation due to its cost advantages and relative ease of operation. Materials and Methods: A literature search for articles related to human skin allograft use in burn care, skin banks, and glycerolised skin allografts in LMICs was done using PubMed, EMBASE, and Web of Science databases. The key words used were ‘allograft’ and ‘burn’ with a filter in the search for human studies. The relevant references in the articles obtained were also searched for and included in the review Results: Sixty-three journal articles were reviewed for contents in line with the objectives of this study. Conclusion: Glycerolised skin graft is a viable option for coverage of extensive burns in LMICs.
Background: Hundreds of international projects are implemented all over the world. Sustainability of such projects is always questioned. The objective of this study was to analyze landmarks of successful collaboration in global surgical issues between Ukrainian and Canadian institutions from 2006 to 2013. Methods: We completed a descriptive analyses of 3 international projects. Results: In collaboration with Ukrainian obstetrics and gynaecology associations and the Society of Obstetricians and Gynecologists of Canada, an initiative seeking to improve emergency obstetrical care using the Advances in Labour and Risk Management International Program (AIP) was conducted in Ukraine. From 2006 to 2009, 912 providers participated in 18 AIP trainings. Since project termination, 10 AIP training with 435 participants were conducted by a national team. Training is now institutionalized into the Donetsk National Medical University (DNMU) curricula. Since 2010 in collaboration between the University of Toronto, and the DNMU, the Donetsk Telesimulation Satellite Center was established. A telesimulation program has been applied to introduce the Fundamentals of Laparoscopic Surgery course, with the objective to standardize the technical skills of Ukrainian professionals. In total, 137 participants from 11 sites have completed the course. Since 2011, a collaboration between the McGill University and the DNMU to improve disaster management and trauma care has been established. A risk assessment tool geared speci fically toward the European Football Championship Euro 2012 was developed. Trauma training has been conducted and the creation of a database of injury epidemiology. Conclusion: Sustainable partnerships is important to ensure long-term interest in an initiative either funded or not. Capacity building based on bottom-up approaches with the initiative coming from national professionals to ensure national ownership and leadership with long-term commitment is essential. 2. COSECSA, achievements and challenges in improving global surgery. P.G. Jani.
Introduction: The management of patients with cutaneous wounds entails both inpatient and outpatient care. There is scarcity of dedicated community wound clinics in Nigeria to guarantee appropriate management of especially difficult-to-heal wounds on outpatient basis. The aim of the study was to describe the pattern of presentation of patients with wounds at a community outpatient wound clinic (COWC). Materials and Methods: Consecutive patients with wounds who presented to a COWC in the city of Ibadan from October 2015 to December 2021 were included. Descriptive analysis was done using IBM ® SPSS ® Statistics 21. Results: Two hundred and forty-four patients with wounds presented at the wound clinic. There was a slight female preponderance of 52%. Almost one-tenth of the patients were 80 years old and above. Post-traumatic wounds were the commonest type of wounds accounting for 15.3% of the patients seen. This was followed by diabetic wounds (14.9%) and haemoglobinopathic (sickle cell) wounds (13.2%). In patients with leg wounds who presented during the period, diabetic wounds (24.4%) was the commonest aetiology, haemoglobinopathic leg wounds accounted for 23% of patients, and post-traumatic leg wounds were seen in 20% of the patients. Conclusion: COWC is an option to managing complex wounds from various aetiology. Best practices in wound care will result in more favourable outcome in difficult-to- heal wounds and early referrals from wound clinics for limb salvaging procedures are additional benefits.
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