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Increased Malaria-Morbidity of Long-Term Travellers Due to Inappropriate Chemoprophylaxis Recommendations

easy through partly avulsed and inflamed tissues, and the aesthetic result was satisfactory. There was necrotic material, bone chips, grass leaves and debris in the depth of the wounds. A generous debridement of the injured soft tissue and freshening of the edges provided an uneventful healing. In view of the extensive injury, the reconstruction was gratifying. All bear inflicted injuries should be considered serious. Injured soft tissues should be explored and generously debrided of debris and foreign bodies that usually enter deep into wound, so preventing contamination and infection during transit. The wounds should then be loosely sutured to prevent retraction and the injuries documented in detail. All patients should be administered anti-rabies vaccine. Under cover of a broad-spectrum antibiotic, they should then be referred to an advanced medical centre with plastic, ophthalmic, orthodontic and neurosurgical facilities. At the definitive healthcare centre the injuries in the high-risk mid-facial area should be given priority. An exploration, debridement and primary reconstruction as much as possible, should be undertaken as teamwork by the specialties involved. An early reconstruction of bony and soft tissue injuries in our series had been aesthetically and functionally gratifying except for those who had lost a bone segment. Facial fractures are usually comminuted and stabilization by implants is preferable to simple reduction of these fractures. Eyes with perforating injury should be given priority. All such injuries in our series required enucleation to prevent sympathetic ophthalmitis in the other eye.