Prise En Charge Des Dermo-Hypodermites Nécrosantes Au Centre Hospitalier Régional De Diffa, Niger

Introduction: Necrotizing dermo-hypodermatitis (NHD) is a dreaded condition, responsible for a significant morbi-mortality constituting a real public health problem in the region of Diffa. The objective of this study is to describe the management of NHD in the surgical department of the Regional Hospital Center (CHR) of Diffa. Patients and methods: This was a descriptive retrospective study, conducted in the surgery department of the CHR of Diffa, and including the records of NHD cases, taken in charge from January 2017 to December 2018. Results: 132 cases were recorded. The median age was 25 years (extremes: 10 days and 87 years). All patients received antibiotic therapy and in 91.8% of cases surgical treatment was required. The number of visits to the operating theatre ranged from 2 to 36. A skin graft was performed in 25.7% of cases. The limb amputation rate was 9.1%. The average length of hospital stay was 32.3 days (extremes: 17 days and 189 days). Intra-hospital mortality was 3.8% (n=5). Conclusion: Necrotizing dermo-hypodermatitis is a serious condition, frequent in the region of Diffa, with a poor prognosis and heavy medical and surgical management. Emphasis should be placed on etiological research and control of predisposing and aggravating factors of the disease. br /> Introduction : la dermo-hypodermite necrosante (DHN) est une affection redoutable, responsable d’une morbi-mortalite importante constituant un veritable probleme de sante publique dans la region de Diffa. L’objectif de cette etude est decrire la prise en charge des DHN dans le service de chirurgie du Centre Hospitalier Regional (CHR) de Diffa. Patients et methodes : Il s’est agi d’une etude retrospective descriptive, menee dans le service de chirurgie du CHR de Diffa, et incluant les dossiers des cas de DHN, pris en charge de Janvier 2017 a Decembre 2018. Resultats : 132 cas ont ete enregistres. L’âge median etait de 25 ans (extremes : 10 jours et 87 ans). Tous les patients ont beneficie d’une antibiotherapie et dans 91,8% un traitement chirurgical etait necessaire. Le nombre de passage au bloc operatoire etait compris entre 2 et 36. Une greffe de peau a ete realisee dans 25,7% des cas. Le taux d’amputation de membre etait de 9,1%. La duree moyenne de sejour hospitalier etait de 32,3 jours (extremes : 17 jours et 189 jours). La mortalite intra hospitaliere etait de 3,8% (n=5). Conclusion: la dermo-hypodermite necrosante est une affection grave, frequente dans la region de Diffa dont la prise en charge medico-chirurgicale est lourde, grevee d’un mauvais pronostic. Un accent devrait etre mis sur la recherche etiologique et le controle des facteurs predisposant et aggravant de la maladie.