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Year : 2014  |  Volume : 4  |  Issue : 3  |  Page : 141-145

Chronic leg ulcers in sickle cell disease patients in Zaria, Nigeria

1 Department of Haematology, Ahmadu Bello University Teaching Hospital, Shika, Zaria, Nigeria
2 Department of Surgery, Ahmadu Bello University Teaching Hospital, Shika, Zaria, Nigeria
3 Department of Orthopaedics, Ahmadu Bello University Teaching Hospital, Shika, Nigeria

Correspondence Address:
Dr. Abdulaziz Hassan
Department of Haematology, ABUTH PMB 06, Shika - 810 001 Zaria
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2278-9596.146405

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Background: Chronic Leg Ulcers (CLU) are common cutaneous manifestation of sickle cell disease (SCD) and a major cause of debility. CLU results from vaso-occlusion, poor venous pressure, hypercoagulabilty and trauma. The incidence of CLU is variable based on geographical region. Treatment modalities include debridement and skin grafting. The aim of this study was to determine the prevalence, incidence, hematological parameters and treatment modalities of CLU among SCD patients in Ahmadu Bello University Teaching Hospital (ABUTH) Zaria. Patients and Methods: It was a retrospective study of adult SCD patients between January-December 2012 at ABUTH Zaria. Case notes of SCD patients were retrieved and data on socio-demographics, hematological parameters and CLU were extracted and analyzed using Epi Info. Data was analysed using descriptive analysis and comparisom of mean by student's t-test. Results: Of the 446 SCD patients attended to during the study period 14 had CLU. The incidence of CLU was 0.45% among the SCD patients studied. The male to female ratio was (M: F = 1.3:1). CLU occurs commonly around the malleoli in 78.6% whereas other sites constituted 21.4%. In 77.8% of CLU low steady state PCV was seen, 76.9% had reticulocytosis whereas 81.8% had high platelet count > 477 × 109/l. Recurrence rate was 78.5% with osteomyelitis (16.7%) and limitation of movement (16.7%) as a frequent complications of CLU. Wound debridement and dressing was the commonest surgical management option but with a high recurrence rate. Conclusion: Prevalence of CLU is low in SCD patients in Zaria; occurring commonly in patients with low steady state PCV, reticulocytosis and thrombocytosis. Debridement and skin grafting has good cure rate and lower recurrence of CLU.

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