Surgery
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Item Ambulatory cleft lip surgery in a developing country(2015) Olawoye O.A; Olusanya A.A; Ademola S.A; Iyun A.O; Michael A.I; Akinmoladun V.I.Background: Ambulatory cleft lip surgery has been practiced extensively in many developed countries, however cleft lip repair in most developing countries involve patient hospitalization of varying duration. Driven bythe recent acute shortage of pediatric bed space in our hospital, an increasing number of cleft lip surgeries are being performed on out-patient basis. The aim of this study was to report our experience with ambulatory cleft lip surgery at the University College Hospital, Ibadan. Methods: A retrospective review of Cleft lip Surgeries performed between February 2007 and January 2010 was done. Data of patients who had cleft lip surgery was retrieved from our Smile Train data base, the operating room surgery records and the Nurses' admission/discharge records on ail the wards on which the patients were either received or admitted. Information obtained included the demographic characteristics of the patients, complications reported, length of stay (LOS) for in-patients and the need for re-admission before the first follow-up clinic appointment among the two groups. Results: Eighty three patients were identified but complete data was obtained for forty patients. (Retrieval rate of 48%) The ambulatory group comprised of 15 patients while- the in-patient group had 25 patients. The mean patient age was 5.7years in the ambulatory and 9.7 years in the in-patient group. Both groups were homogenous for other parameters. None of the patients in the ambulatory group was re-admitted for any post-operative complication while only one patient in the in-patient group had a post-operative complication necessitating prolonged hospitalization. Conclusion: Ambulatory cleft lip surgery was found to be safe in our practice with comparable patient outcome to the in-patient group. It is anticipated that this may assume increasing prominence in the scope of cleft lip management in many more centers in the developing world.Item Distribution and morphological pattern of clefts in the craniofacial region seen in a sub-saharan tertiary hospital(2015) Olusanya A.A; Michael A.I; Olawoye O.A; Akinmoladun V.I; Ademola S.A; Iyun A.O; Oluwatosin O.M.Aim: Clefts in the craniofacial region are one of the commonest congenital anomalies recorded in literature. The incidence varies globally with racial differences observed. In Nigeria, the evaluation of the absolute incidence of oral clefts is a challenge as births and deaths are not adequately registered. Especially lacking is the relative prevalence of rare craniofacial clefts to the more common cleft lip and palate anomaly. This study aims to document the pattern of distribution of craniofacial clefts, including cleft lip and palate anomaly, rare craniofacial clefts, unusual presentation of some of these anomalies, as well as other abnormalities noted in affected cleft patients seen at our centre. Material and methods: Information on age, gender, weight at presentation, type of cleft anomaly, other abnormalities, as well as affected relatives were extracted from the clinic records of the Cleft Clinic of the University College Hospital, Ibadan, Oyo, Nigeria, from April 2010 to September 2012. Results: One hundred and forty-two cases were seen within the 30-month period, consisting of 58 men and 84 women with a mean age of 43.54 months and a median of 2.0 months. Eighty-eight per cent of the cases were cleft lip and palate anomalies, while 12.0% were craniofacial clefts. Thirteen per cent had other abnormalities, while 3.5% were considered to be unusual cleft anomalies. Conclusion: The pattern of distribution of clefts in the craniofacial region in our centre has been documented. Cleft of the primary palate was the commonest while rare craniofacial clefts constituted about one-eighth of all the craniofacial clefts.Item Demographic characteristics and prognostic indicators of childhood burn in a developing country(2014) Olawoye O.A; Iyun A.O; Ademola S.A; Michael A.I; Oluwatosin O.M.Children constitute a significant proportion of burn victims in most studies from the developing countries. While there has been a progressive improvement in the outcome from childhood burn in many developed nations, the morbidity and mortality remains high in many low and middle income countries. The aim of our study is to evaluate the demographic characteristics and prognostic indicators of childhood burn in a major referral teaching hospital in a developing country. A review of the records of 638 patients with acute burns managed over a 10-year period from January 2001 to December 2010 at the University College Hospital, Ibadan Nigeria was done. The clinical and epidemiological data were retrieved from computerized data base using the ISBI proforma. Information obtained includes Biodata, Etiology, location, TBSA, presence of Inhalation injury and the treatment outcome. Data of patients aged 16 years and below were analyzed using the SPSS version 16. The main outcome measure was the patient’s survival. 289 children representing 45.3% of the total number of burn patients were managed over the period. The M:F ratio was 1.1:1. The median age of the cohort was 4.0 years while the median TBSA was 21.0%. Nonintentional causes were responsible for 89.6% cases. Most of the injuries (88.6%) occurred at home. Eighty-three patients had inhalation injury out of which 57 (68.7%) deaths were recorded. The overall mortality rate in the cohort was 39.5% with an LA50 of burn size of 45%. The TBSA was also found to be a determinant of outcome. Majority of childhood burns are from preventable causes with attendant dismal mortality figures. Effective burn prevention strategies and improved quality of care remain pivotal in reducing childhood burn morbidity and mortality in the developing countries.Item Awareness and attitude of doctors and nurses at a crossmark teaching hospital to skin donation and banking(2014) Michael A.I; Ademola S.A; Olawoye O.A; Iyun A.O; Oluwatosin O.M.Introduction: This study sought to determine the awareness and attitude of doctors and nurses in a teaching hospital to skin donation and banking, and to identify needs for personnel educational programmes. Methods: A cross sectional survey on doctors and nurses was carried out using a 44-item questionnaire that included a Likert scale on attitudes. Predictors of favourable attitudes were determined. Results: Eighty (49.7%) doctors and 81 (50.3%) nurses participated in the study. Many participants, 126 (78.3%), knew that skin could be donated, but only 96 (59.6%) participants were aware of skin banking. The main source of information was during professional training (17.4%). Only 41 (25.5%) participants were willing to donate skin after death. Body disfigurement was the major reason (20.5%) against skin donation. Participants who were doctors, were aware of skin banking, and who were previous blood donors had higher attitudes scores (p < 0.001, p = 0.004, p = 0.007 respectively). Being a doctor and having heard of skin banking were predictors of favourable attitudes to skin donation and banking. Conclusion: Knowledge transfer during health professional training on the usefulness of banked skin in patients with major burns may lead to improved attitude of health professionals and acceptance of this modality of burn management.