Although most patients are cooperative and willing to undergo an operation to correct their leprosy deformities, a small percentage of these patients will not. This may be because of cultural and societal attitudes towards the deformity and may have adapted to it for years. Or they may have too much fear of possible adverse side effects from the surgery. Whatever the reason, if you are considering surgery for leprosy, here are some things you should know.
There are two main types of lagophthalmos: surgical and medical. Medical treatment focuses on improving tear film and restoring eyelid function and coverage. Surgical treatment restores the eyes’ ocular structure. The choice of operation depends on the underlying etiology, patient factors, and expectations. Here are the details of these two types of surgery. Read on to learn more about the differences between surgical and medical lagophthalmos.
Although the success rate of this procedure is still low, it has made significant improvements in visual health. In one study, 29% of eyes still had a gap of five millimeters or more. However, the frequency of symptoms was high, and the results were not satisfactory for many patients. This finding demonstrates the need for more research and development to improve surgery and postoperative care. It also highlights the need for practical guidelines for leprosy control programmes. The guidelines should include a number of factors, including patient recognition and education.
Excision and grafting
Excision and grafting for leproses is a surgical procedure to repair the damaged tissues and prevent the disease from recurring. The goal of the surgical procedure is to reduce symptoms and improve function and sensation. Patients must undergo a comprehensive assessment of their disease and must be in complete remission from their multidrug therapy. Before surgery, patients must have had negative skin smears for a few months. Preoperative therapy should reduce stiffness in the fingers and hands.
There are two types of grafts: full-thickness graft and partial-thickness graft. The full-thickness graft involves removal of the entire dermis and epidermis of the donor site. The surgeon then takes healthy skin and closes the donor site in a straight line. This graft option is preferred when small wounds are present on highly visible parts of the body. It blends better with surrounding skin, making for a better cosmetic outcome.
A recent study published in the journal of ophthalmology revealed that fewer than half of leprosy patients underwent lagophthalmos surgery. While the procedure was effective, the results of the procedure were not perfect. Patients still had gaps of five millimeters or more, which was a concern. The frequency of symptoms was also high. Such limitations are a cause for concern, and practical guidelines are needed for leprosy control programs.
In this case study, a 35-year-old male patient with a history of 13 years’ inability to close his eyes normally was operated on. Physical examination revealed an infranuclear facial palsy and a mouth deviation to the right. His palpebral aperture widths were 3 mm and five mm, respectively, and he was missing eyelashes and eyebrows. He was diagnosed with lepromatous leprosy and Bell’s sign.
Nerve damage caused by leprosy
While drug therapy for leprosy has been effective for eradicating the disease, many people still suffer from the long-term effects of the disease, including damage to their nerves. In fact, research shows that leprosy can damage both peripheral nerves and the brain. Now, a new study suggests that nerve damage can affect both, making treatment and rehabilitation more challenging for those who have been affected by the disease.
Leprosy is caused by the Mycobacterium leprae bacteria, which multiply slowly and have an incubation period of two to three years. However, the symptoms can appear anywhere from six months to 40 years after infection. Because leprosy is not highly infectious, its spread is accelerated by close contact with an infected person. Although leprosy is rare, it is still stigmatized in some cultures, leading to the loss of self-esteem and prejudice. To reduce this stigma, research is needed to better understand the causes and cure of leprosy ulcers. In addition, research projects on leprosy skin changes and ulcers need improved methodological quality and standardized outcome measures.
Treatment with sulpha based drugs
Sulfa based drugs have a long history in the treatment of leprosy. Dapsone is a bacteriostatic sulphone that targets a key enzyme in bacteria. This drug has been used for decades as a standard treatment for leprosy. The irregular duration of treatment has resulted in secondary resistance. Dapsone is also used in the treatment of dermatitis herpetiformis and pneumonia, and is sometimes combined with pyrimethamine for malaria prophylaxis. The drug has a half-life of approximately 27 hours, but can cause a variety of adverse reactions, ranging from gastrointestinal discomfort to generalised allergic reactions.
The symptoms of leprosy vary widely. In severe cases, the condition may cause paralysis or crippling in the hands and feet. Without sensation, these digits are more prone to multiple injuries. Over time, the body can reabsorb the affected digits. The condition may also cause corneal ulcers, loss of eyebrows, and other physical symptoms. While these side effects may seem minor in the short term, they can be severe and even life-threatening.
Reconstructive surgery camps for leprosy
Reconstructive surgery camps for leproses are a low-cost alternative to tertiary hospitals. The surgeries also provide valuable practical training for surgical trainees. These camps could be a cost-effective solution to reduce waiting lists in public health sectors. Further, the patients treated at these camps would also benefit from a wider range of surgical procedures, including eyelid surgery. Moreover, a number of clinical trials have been undertaken to test the cost-effectiveness of reconstructive surgery in the camp setting.
Reconstructive surgery camps for leproses (RSCs) are medical programs that provide free plastic surgery expertise to leprosy patients with deformities. They help reduce the stigma of deformity in the community. Currently, there are 3 recognized reconstructive surgery camps in Gujarat. They are the civil hospital, the Sir Sayajirao General Hospital, and the New Civil Hospital. These centers run these surgical camps annually for leprosy patients with deformities.