BURULI ULCER-A devastating skin disease

Enhancing early wound healing- Use of

HYDROGEL

Edwin Ampadu; MD, MPH, FAPWCA

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

BU treatment development trend

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

Challenges

• Program continues to record massive lesions Cat lll

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

Before treatment After treatment

After 12 month follow-up

lesions with antibiotics only

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

Why the further topical application

Make treatment more acceptable/ friendly to client and communities -[ wound heal

duration<; can be administered by patients, cost effective

Preliminary observations made on the field

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

• Wound Healing catches on well with a whole communityWound Healing catches on well with a whole communityObservations

Initial

Week 2

Week 4

Initial

Week 2

Week 4

InitialWeek 2

Week 4Week 6

Week 4

Initial

Week 6

Week 2

Initial Week 2

Week 4 Week 6

Initial

Week 2

Week 4

Initial

Week 1

Week 3

Initial

Week 2

Week 4

Initial

Week 2

Week 4

Implementation challenges

• Access to patients in communities

• Improve health education on the disease

• Picture of vehicle

• Late attending to patients• night

Reaching patients in difficult areas Reaching patients in difficult areas

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

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

Thank you Thank you

Other challenging lesions

Initial

Week 2

Week 4

Initial

Week 1

Week 3

Initial

Week 1

Week 3

Initial

Week 2

Week 4

Initial

Week 2

Week 4