BURULI ULCER-A devastating skin disease

1
BURULI ULCER-A devastating skin disease

• Enhancing early wound healing- Use of HYDROGEL
• Edwin Ampadu MD, MPH, FAPWCA

2
Introduction

• BU treatment developmental trend
• Why the further topical application
• Hence the topic of my presentation enhancing
  wound healing
• Preliminary observations made on the field
• Challenges to implementations
• Possible way forward

3
BU treatment development trend

• Treatment surgery with wide and extensive
  excision, wound dressing and Split Skin Graft

4
Challenges

• Program continues to record massive lesions Cat
  lll

5
Antibiotics treatment

• Recommendation WHO
• Results very encouraging
• However operational challenges
• geographically difficult to offer community
  treatment,
• cost implications,
• Battling with superstitions in the communities
  about the disease

6
After treatment
Before treatment
After 12 month follow-up
7
lesions with antibiotics only
8
Further improving case management

• Indication to use hydrogel
• Further reduce the wound healing time whiles
  continue treatment with antibiotics for 8 weeks
• Early healing than before

9
Why the further topical application

• Make treatment more acceptable/ friendly to
  client and communities - wound heal durationlt
  can be administered by patients, cost effective

10
Preliminary observations made on the field
11
Hydro gel application

• Trial parameters
• 2 endemic sites were selected
• Total patients affected- 15
• Male 3
• Female 12
• Children 7
• Adults 9

• Period of application 6 weeks
• Average days of change of dressing 3-5days

12
Observations

• Wound Healing catches on well with a whole
  community

13
Week 2
Initial
Week 4
14
(No Transcript)
15
Week 2
Initial
Week 4
16
Week 2
Initial
Week 6
Week 4
17
Initial
Week 2
Week 4
Week 6
18
Week 2
Initial
Week 6
Week 4
19
Week 2
Initial
Week 4
20
Week 1
Initial
Week 3
21
Week 2
Initial
Week 4
22
Week 2
Initial
Week 4
23
Implementation challenges

• Access to patients in communities
• Improve health education on the disease

• Picture of vehicle

• Late attending to patients
• night

24
Reaching patients in difficult areas
25
Other supports

• Ministry of health Dressings, transport,
  personnel
• WHO- educational materials, audio-visual tools
  for community education, transport

• Support with the Gel from McCard foundation

26
Way forward

• Strengthen support to reach patients in rural
  communities
• Gradual scale up of the application
• Improving knowledge to enhance wound healing in
  our challenging world

27
Thank you
28
Other challenging lesions
29
Week 2
Initial
Week 4
30
Week 1
Initial
Week 3
31
Week 1
Initial
Week 3
32
Week 2
Initial
Week 4
33
Week 2
Initial
Week 4