Surgical treatment of noma

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