Surgical treatment of noma.

In the acute stage of noma the role of surgery is a minor one: wound care and, very occasionally, treatment of haemorrhage. However in patients who survive noma, and develop a mutilated and disabled face (trismus, leakage of saliva, impaired speech), reconstructive surgery may improve their fate significantly. Because of economic and educational reasons reconstructive surgery in noma patients should be performed preferably in their own country. Treatment consists of excision of all scar tissue, correction of the trismus and closure of the tissue defects with local, pedicled or free flaps. Because of the large variety of tissue defects and the many surgical options, systematization and subsequently standardization of the reconstructive surgical approach to patients with the sequelae of noma is needed.