Surgical Treatment of Skin Substances Loss: Study of 40 Cases Followed Up at University Hospital of Bangassou in Central African Republic

Introduction: The aims of this study was to describe the results of the treatment of skin substance loss in a rural area  hospital in  Central African Republic and draw the resulting conclusions.Patients and Methods: This is a cross-sectional study carry out from January 2017 to December 2018 including patients of both sexes, regardless of age, treated for a loss of skin substance without tendency to scarring at the General Surgery Department of the Regional and University Hospital of Bangassou.Results: During the period 2500 patients were followed in the service.  The frequency of patients with a loss cutaneous substances was 1.6%. Male subjects made up 65% of the workforce. All age groups were represented. The average age was 35.5 years (Extremes: 8 months and 77 years). In 60% of cases, the patients came from remote areas of the urban center and most of them lived in precarious conditions (71.8%). The primary lesions were 2nd degree burns (22.5%) and 3rd degree (2.5%), open limb fractures (10%); ulcers (32.5%) and necrotizing fasciitis (32.5%). These lesions were found much more in the limbs (67.5%). In half of the cases, the lesions were in the budding phase. After a preparation phase, the procedures performed were mesh grafting (87.5%), lozenge grafting (10%) and the flap (2.5%). According to the evolution, scarring was obtained in 67.5% of cases 14 days after surgery. The average length of hospital stay was 14 days with extremes of 8 and 58 days.Conclusion: This study shows the advantage of using methods for recovering losses of skin substances to speed up the healing process of lesions. We recommend emphasizing the initial treatment of lesions which must be adapted to the stages of healing as well as the management of risk factors. In areas where there is a shortage of specialists, general practitioners must be trained in skin grafting techniques which are easy to perform.