Protocol for managing acute cancrum oris in children: an experience in five cases.Afr J Paediatr Surg. 2009 Jul-Dec; 6(2):77-81.AJ
Acute cancrum oris (NOMA) is a major health concern in most parts of northern Nigeria, affecting children aged 2-9 years. The management of the acute phase/condition poses a great clinical challenge. We present our protocol for the management of acute NOMA in a referral health facility in northern Nigeria.
MATERIALS AND METHODS
The management of five consecutive children with acute NOMA managed at the maxillo-facial department of Ahamdu Bello University Teaching Hospital, Kaduna, is presented. The initial management is conservative, followed later by multiple reconstructions.
NOMA thrives in children with poor nutritional status and/or compromised immune status. Aggressive wound debridement, antibiotic therapy and nutritional rehabilitation limited the spread of the orofacial tissue destruction and produced rapid wound healing.
The management of acute NOMA should be nonoperative; surgery is only indicated to debride the ulcer. Efforts to boost patient's immune and nutritional status limit further tissue destruction and produced satisfactory wound healing.