A Survey of Wound Care Knowledge in South Africa

Chronic wounds afflict millions worldwide; incurring significant health care costs and chronic suffering. Clinicians are often unsure about treatment; resulting in poor outcomes. Objective. To determine the scope of knowledge possessed by fifth-year medical students; general practitioners (GPs) and surgical registrars; concerning chronic wound management. Design. Cross-sectional study.Methods. Deans of eight South African medical schools received letters requesting information regarding time devoted to wound-care training. Knowledge-based questionnaires were distributed to final-year students at two universities; surgical registrars at four universities and GPs attending refresher courses. Results. Four medical schools replied; of whom only two offered formal teaching. 162 medical students; 45 GPs and 47 surgical registrars completed questionnaires. The overall median (25th - 75th percentiles) knowledge scores for registrars; GPs and students were 65(55 - 70); 55(45 - 65) and 45(35 - 50) respectively. Whereas the scores of registrars and GPs did not differ; the student scores were significantly less. Only 32of registrars and 18of GPs attained scores of 70or more. 96considered training to be inadequate. Interest in wound care was only mild to moderate; with more GPs than registrars requesting literature. Conclusions. Very little; if any; training on chronic wounds is offered in South Africa. The levels of knowledge cannot be considered adequate for successful treatment; nor for teaching to undergraduates. This preliminary study cannot reflect the attitudes and knowledge throughout the country. However; it is clear that there is a need for improved education about these conditions that have huge clinical and economic consequences

Les complications uro-génitales des traumatismes du bassin: a propos de 41 cas

Objectifs Analyser les donnees epidemiologiques; diagnostiques et therapeutiques des complications uro-genitales de 41 cas de traumatismes du bassin. Patients et methode Il s'agit d'une etude retrospective effectuee a partir de 41 cas de traumatismes du bassin avec complication urinaire et/ou genitale colliges dans le service d'urologie du CHU de Treichville sur une periode de cinq ans. L'age moyen des patients est de 27;8 ans (extremes: 14 a 48 ans); avec un sexe ratio de 9;25 hommes pour une femme. Resultats Les accidents de la voie publique sont les plus grands pourvoyeurs de traumatisme representant 75;6des cas. Les fractures de l'arc anterieur sont les plus incriminees (26;9). Les signes cliniques les plus evocateurs sont : la retention aigue d'urines (16;7); l'uretrorragie (10;4) et l'hematurie (29;1). Nous avons observe 50de lesions uretrales; 38;5de lesions vesicales; 9;6d'atteintes des organes genitaux externes et 1;9de lesions prostatiques. Nous avons opte pour une reparation a distance du traumatisme causal (3 mois) pour les ruptures de l'uretre membraneux en faisant une large part a la resection-anastomose avec spatulation (51;16). Nous avons obtenu 66de bons resultats sur le plan urinaire et 73de conservation d'une fonction erectile satisfaisante tandis qu'une mortalite de 4;9assombrit le pronostic. Conclusion Le pronostic peut etre ameliore par la celerite du diagnostic et la prise en charge des lesions qui sont squelettiques et souvent poly-viscerales chez les patients presentant des lesions uro-genitales consecutifs aux traumatismes du bassin; c'est a dire la necessite d'une prise en charge specialisee pluridisciplinaire