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As more patients with large body surface area burns are surviving and requiring reconstructive surgery, there is a necessity for advances in the provision of bioengineered alternatives to autologous skin cover. The aims of this Thesis are to identify feasible source tissues of Endothelial Colony Forming Cells and Mesenchymal Stem/Stromal Cells for microvascular network formation in vitro with three-dimensional dermal substitute scaffolds. The working hypothesis is that pre-vascularised dermal scaffolds will result in better quality scarring when used with split thickness skin grafts. Human umbilical cord blood, peripheral blood and adipose tissue were collected and processed with ethical approval and informed consent. Samples were cultured to form endothelial outgrowth colonies and confluent Mesenchymal Stem/Stromal Cells, which were characterised using flow cytometry and expanded in vitro. Mesenchymal Stem/Stromal Cell multipotency was confirmed with tri-lineage mesenchymal differentiation. Primary cells were tested in a two-dimensional tubule formation co-culture assay and differences assessed using a proangiogenic antibody array. Tubule formation was tested in four different acellular dermal substitute scaffolds; Integra® Dermal Regeneration Template, Matriderm®, Neuskin-F® and De-cellularised Human Cadaveric Dermis. Umbilical cord blood was the most reliable source of Endothelial Colony Forming Cells, the yield of which could be predicted from placental weight. Microvasculature dissected free from adipose tissue was a reliable source of Mesenchymal Stem/Stromal Cells which supported significantly more tubule formation than Mesenchymal Stem/Stromal Cells from whole adipose tissue. Microvasculature Mesenchymal Stem/Stromal Cells secreted significantly higher levels of the proangiogenic hormone leptin, and addition of exogenous leptin to the tubule formation assay resulted in significantly increased tubule formation. Microvasculature was cultured in all four of the scaffolds tested, but depth of penetration was limited to 100µm. The artificial oxygen carrier perfluorocarbon was shown to increase two-dimensional tubule formation and may be useful in further three-dimensional scaffolds studies to improve microvascular penetration.

Improvements in the treatment of breast cancer have resulted in better survival rates and less breast cancer related morbidity. Nevertheless, a significant group of patients still experience a diminished quality of life as a result of lymphedema. In the early, often reversible, stage of lymphedema patients can experience subjective changes in the affected area. However, with the traditionally available tools the lymphedema often remains clinically undetectable and patients are denied essential care that can prevent worsening. Furthermore, most lymphedema assessment tools fail to support a clear unambiguous definition of lymphedema. This underlines the need for a sensitive objective measurement method that can assess lymphedema in a subclinical stage. In this study we demonstrated that measuring tissue dielectric constant (TDC) using the MoistureMeter-D is an effective method to detect tissue water changes and could potentially provide a cost-effective adequate tool to measure the early onset of breast cancer related lymphedema (BCRL). Secondarily, we established the correlation between the novel TDC method and the frequently used arm volume measurements and self-assessment questionnaires. A group of 20 female patients with clinically BCRL were included. TDC measurements in both arms and all quadrant of both breast were recorded along with volumetric measurements of both arms. All patients were asked to complete a self-report questionnaire. The novel TDC method detected significantly higher tissue water levels in the affected arm and breast compared to the control side. The TDC ratio between control and affected side showed significant correlation with self-reported pain and discomfort in both arm and breast. In the arm, the TDC method also showed correlation with the volume measurement method. The TDC value of the arm was correlated to age, but not to BMI. This study demonstrates that measuring TDC using the MMD is an effective method for quantifying lymphedema in arm and breast and is an important tool in detecting early TWC changes.

An ongoing objective in healthcare is the development of tools to improve patient decision-making and surgical outcomes for patients with breast cancer that have undergone or plan to undergo breast reconstruction. In keeping with the bioethical concept of autonomy, these decision models are patient-oriented and expansive, covering a range of different patient decision-makers. In pursuit of these goals, this dissertation contributes to the development of a prototype shared decision support system that will guide patients with breast cancer and their physicians in making decisions about breast reconstruction. This dissertation applies principles in decision analysis to breast reconstruction decision-making. In this dissertation, we examine three important areas of decision-making: (1) the options available to decision-makers, (2) the validity of probabilistic information assessed from reconstructive surgeons, and (3) the feasibility of applying multiattribute utility theory. In addition, it discusses the influences of breast aesthetics and proposes a measure for quantifying such influences. The dissertation concludes with a fictional case study that demonstrates the integration of the findings and application of decision analysis in patient-oriented shared breast reconstruction decision-making. Through the implementation of decision analysis principles, cognitive biases and emotion may be attenuated, clearing the decision-maker’s judgment, and ostensibly leading to good decisions. While good decisions cannot guarantee good outcomes at the individual level, they can be expected to improve outcomes for patients with breast cancer as a whole. And regardless of the outcome, good decisions yield clarity of action and grant the decision-maker a measure of peace in an otherwise uncertain world. / text

Enxertos livres de pele de espessura total são indicados para cobrir grandes defeitos de pele em superfícies flexoras ou em extremidades distais e sofrem lesão por isquemia e reperfusão pela própria natureza do procedimento cirúrgico. O objetivo deste trabalho foi testar a associação de células tronco mesenquimais de origem adiposa (ADSCs) heterólogas a enxertos cutâneos autólogos de espessura total em ratos Wistar. Enxertos de 12 mm de diâmetro foram executados no dorso de 30 ratos, em dois locais: cranial e caudal. Os ratos foram distribuídos em seis grupos (n=5): grupo ADSC_G recebeu, no enxerto, 1x106 ADSCs em 200 μL de Solução Salina 0,9% (SS); grupo ADSC_B recebeu 1x106 ADSCs em 200 μL de SS na borda do leito receptor; grupo ADSC_GB, metade da mesma suspensão na borda e outra metade no enxerto. Os grupos controle, SS_G e SS_B, receberam apenas SS no enxerto ou nas bordas respectivamente. No grupo S, o enxerto não recebeu nenhum tratamento durante as cirurgias. Curativos do tipo tie-over permaneceram até o 5º dia. Na cirurgia (d0), aos 5 (d5) e 14 (d14) dias de pós-operatório, os desenhos dos enxertos foram digitalizados e suas áreas mensuradas (software ImageJ). As avalições clínicas consideraram peso, presença de secreções e ocorrência de epidermólise. A planimetria demonstrou a taxa de pele normal, de pele avermelhada e de ulceração, assim como a contração dos enxertos entre os intervalos d0–d5, d5-d14 e d0-d14. As amostras dos enxertos foram obtidas em d14 para coloração com Hematoxilina e eosina e Tricrômico de Masson. A epiderme foi avaliada para espessamento, ceratose, acantose, degeneração hidrópica, infiltrado inflamatório. A derme foi avaliada quanto a rarefação pilosa, tecido de granulação, infiltrado inflamatório, deposição de colágeno. Os resultados foram expressos em média e desvio padrão, e a análise estatística utilizou as Equações de Estimações Generalizadas (GEE), com nível de significância de 5%. O grupo ADSC_G apresentou melhores aspectos macroscópicos, menos ocorrência de epidermólise e de rarefação pilosa e uma das menores médias de área de ulceração, juntamente com os outros grupos tratados com ADSCs. O grupo ADSC_G demonstrou as menores médias de alterações histopatológicas como: espessamento da epiderme, degeneração hidrópica, tecido de granulação. O mesmo grupo ficou entre as menores médias de acantose e infiltrado inflamatório na derme, ao mesmo tempo que apresentou as maiores médias de VEGF no subcutâneo e no tecido de granulação. Dessa forma, pode-se concluir que as ADSCs protegeram os enxertos dos efeitos deletérios da isquemia, assim como e sugerem-se novos estudos em fases iniciais da cicatrização para compreensão dos mecanismos envolvidos. / Evaluation of adipose derived stem cells (ADSC) effect on full-thickness skin graft (FTSG) as a wound healing model in ischemic conditions. Two 12 mm diameter FTSGs were harvested and placed onto dorsal recipient beds of twenty-four Wistar rats, in two anatomic regions: cranial and caudal. Rats were randomized into five groups. Before grafting, group E FTSGs received subfascial injection of 1X106 ADSCs diluted in 200 μL of physiologic saline. Group EC FTSGs received only physiologic saline. Group B received ADSCs in the recipient bed edges; group C received physiologic saline in the edges. Group ADSC_GB received the same ADSCs number and volume, half in the graft and half in the edges. Using planimetry, grafts were analyzed for graft´s contraction rate (d0, d5, d14), normal skin rate and occurrence of epidermolysis and failure rate (d14). FTSGs samples were obtained on the d14 to hematoxylin-eosin and Masson’s Trichrome staining for epidermal analysis (epidermal thickening, keratosis, acanthosis, hydropic degeneration, inflammatory infiltrate) and dermal analysis (hairless, granulation tissue, inflammatory infiltrate, collagen deposition). The obtained results were expressed by mean (n=5). Statistical significance (p<0,05) was calculated using Generalized Estimating Equations. The ADSC_G group had better macroscopic aspects, less occurrence of epidermolysis and hairless and one of the lowest averages of ulceration area, along with the other groups treated with ADSCs. The ADSC_G group showed the lowest mean on the histopathological changes measured such as thickening of the epidermis, hydropic degeneration, less granulation tissue. The same group was among the lowest acanthosis and inflammatory infiltrate averages in the dermis, while presented with the greatest of VEGF average in the subcutaneous and in the granulation tissue. Thus it can be concluded that the ADSCs may have protected the grafts from the deleterious effects of ischemia and suggest new studies in the early stages of healing to understand the mechanisms involved.

Conselho Nacional de Desenvolvimento Científico e Tecnológico / In the development of this research, 15 New Zealand rabbits were used, with the aim of storing platelet-rich plasma (PRP) during 30 days refrigerated at 4-6oC. There was a preparation of 30 samples of PRP which were sorted in three equal groups. Every three days a sample would be removed for evaluation, before and after storage, for the number of platelets, mean platelet volume (MPV), pH of the plasma, aggregation post addition of calcic thromboplastin and for the presence of bacterial and fungal contamination. In the variables of number of platelets, there was no linear relationship in function of time, when comparing the number of platelets before x after storage, a statistical difference was observed. The hemogram MPV variables, before and after storage also did not relate with time, however there was a statistical difference in the comparisons of MPV on blood count x MPV before storage and of MPV before storage x MPV post storage. On the evaluation of the pH there was no influence of time on the variables, but statistical differences were found in the samples after storage in between the periods of 30 and 6; 30 and 24; 30 and 27 days. Platelet aggregation occurred within twenty seconds in all samples independent of storage time. There was no growth of bacteria or yeast in any sample, however mold growth occurred in the samples 21 days of storage on group one and three. It can be concluded that platelet-rich plasma of rabbits can be stored under refrigeration of 4 to 6 °C for maintaining the number of platelets, without significant pH alteration and absence of bacterial or fungal contamination during 18 days. / Utilizou-se 15 coelhos da raça Nova Zelândia para o desenvolvimento da pesquisa, com o objetivo de armazenar plasma rico em plaquetas (PRP) durante 30 dias sob refrigeração de 4-6ºC. Preparou-se 30 amostras de PRP que foram divididas em três grupos iguais. A cada três dias uma amostra foi retirada para avaliação antes e após o armazenamento quanto ao número de plaquetas, volume plaquetário médio (VPM), pH do plasma, agregação pós adição de tromboplastina cálcica e presença de contaminação bacteriana e fúngica. Nas variáveis número de plaquetas, não houve relação linear em função do tempo, na comparação do número de plaquetas pré x pós armazenamento, observou-se diferença estatística. As variáveis de VPM do hemograma, pré e pós armazenamento também não apresentaram relação com o tempo, porém obteve-se diferença estatística nas comparações VPM no hemograma x VPM pré armazenamento e VPM pré-armazenamento x VPM pós armazenamento. Na avaliação do pH não houve influência do tempo nas variáveis, mas houve diferença estatística nas amostras pós armazenamento entre os períodos 30 e 6; 30 e 24; 30 e 27 dias. A agregação plaquetária ocorreu dentro de vinte segundos em todas as amostras independente do tempo de estocagem. Não houve crescimento bacteriano e de leveduras em nenhuma amostra, porém ocorreu crescimento de bolores nas amostras 21 dias de armazenamento dos grupos um e três. Pode-se concluir que o plasma rico em plaquetas de coelhos pode ser armazenado sob refrigeração de 4 a 6ºC por manter o número de plaquetas, sem alteração significativa do pH e ausência de contaminação bacteriana e fúngica durante18 dias. / Mestre em Ciências Veterinárias

Enxertos livres de pele de espessura total são indicados para cobrir grandes defeitos de pele em superfícies flexoras ou em extremidades distais e sofrem lesão por isquemia e reperfusão pela própria natureza do procedimento cirúrgico. O objetivo deste trabalho foi testar a associação de células tronco mesenquimais de origem adiposa (ADSCs) heterólogas a enxertos cutâneos autólogos de espessura total em ratos Wistar. Enxertos de 12 mm de diâmetro foram executados no dorso de 30 ratos, em dois locais: cranial e caudal. Os ratos foram distribuídos em seis grupos (n=5): grupo ADSC_G recebeu, no enxerto, 1x106 ADSCs em 200 μL de Solução Salina 0,9% (SS); grupo ADSC_B recebeu 1x106 ADSCs em 200 μL de SS na borda do leito receptor; grupo ADSC_GB, metade da mesma suspensão na borda e outra metade no enxerto. Os grupos controle, SS_G e SS_B, receberam apenas SS no enxerto ou nas bordas respectivamente. No grupo S, o enxerto não recebeu nenhum tratamento durante as cirurgias. Curativos do tipo tie-over permaneceram até o 5º dia. Na cirurgia (d0), aos 5 (d5) e 14 (d14) dias de pós-operatório, os desenhos dos enxertos foram digitalizados e suas áreas mensuradas (software ImageJ). As avalições clínicas consideraram peso, presença de secreções e ocorrência de epidermólise. A planimetria demonstrou a taxa de pele normal, de pele avermelhada e de ulceração, assim como a contração dos enxertos entre os intervalos d0–d5, d5-d14 e d0-d14. As amostras dos enxertos foram obtidas em d14 para coloração com Hematoxilina e eosina e Tricrômico de Masson. A epiderme foi avaliada para espessamento, ceratose, acantose, degeneração hidrópica, infiltrado inflamatório. A derme foi avaliada quanto a rarefação pilosa, tecido de granulação, infiltrado inflamatório, deposição de colágeno. Os resultados foram expressos em média e desvio padrão, e a análise estatística utilizou as Equações de Estimações Generalizadas (GEE), com nível de significância de 5%. O grupo ADSC_G apresentou melhores aspectos macroscópicos, menos ocorrência de epidermólise e de rarefação pilosa e uma das menores médias de área de ulceração, juntamente com os outros grupos tratados com ADSCs. O grupo ADSC_G demonstrou as menores médias de alterações histopatológicas como: espessamento da epiderme, degeneração hidrópica, tecido de granulação. O mesmo grupo ficou entre as menores médias de acantose e infiltrado inflamatório na derme, ao mesmo tempo que apresentou as maiores médias de VEGF no subcutâneo e no tecido de granulação. Dessa forma, pode-se concluir que as ADSCs protegeram os enxertos dos efeitos deletérios da isquemia, assim como e sugerem-se novos estudos em fases iniciais da cicatrização para compreensão dos mecanismos envolvidos. / Evaluation of adipose derived stem cells (ADSC) effect on full-thickness skin graft (FTSG) as a wound healing model in ischemic conditions. Two 12 mm diameter FTSGs were harvested and placed onto dorsal recipient beds of twenty-four Wistar rats, in two anatomic regions: cranial and caudal. Rats were randomized into five groups. Before grafting, group E FTSGs received subfascial injection of 1X106 ADSCs diluted in 200 μL of physiologic saline. Group EC FTSGs received only physiologic saline. Group B received ADSCs in the recipient bed edges; group C received physiologic saline in the edges. Group ADSC_GB received the same ADSCs number and volume, half in the graft and half in the edges. Using planimetry, grafts were analyzed for graft´s contraction rate (d0, d5, d14), normal skin rate and occurrence of epidermolysis and failure rate (d14). FTSGs samples were obtained on the d14 to hematoxylin-eosin and Masson’s Trichrome staining for epidermal analysis (epidermal thickening, keratosis, acanthosis, hydropic degeneration, inflammatory infiltrate) and dermal analysis (hairless, granulation tissue, inflammatory infiltrate, collagen deposition). The obtained results were expressed by mean (n=5). Statistical significance (p<0,05) was calculated using Generalized Estimating Equations. The ADSC_G group had better macroscopic aspects, less occurrence of epidermolysis and hairless and one of the lowest averages of ulceration area, along with the other groups treated with ADSCs. The ADSC_G group showed the lowest mean on the histopathological changes measured such as thickening of the epidermis, hydropic degeneration, less granulation tissue. The same group was among the lowest acanthosis and inflammatory infiltrate averages in the dermis, while presented with the greatest of VEGF average in the subcutaneous and in the granulation tissue. Thus it can be concluded that the ADSCs may have protected the grafts from the deleterious effects of ischemia and suggest new studies in the early stages of healing to understand the mechanisms involved.

Enxertos livres de pele de espessura total são indicados para cobrir grandes defeitos de pele em superfícies flexoras ou em extremidades distais e sofrem lesão por isquemia e reperfusão pela própria natureza do procedimento cirúrgico. O objetivo deste trabalho foi testar a associação de células tronco mesenquimais de origem adiposa (ADSCs) heterólogas a enxertos cutâneos autólogos de espessura total em ratos Wistar. Enxertos de 12 mm de diâmetro foram executados no dorso de 30 ratos, em dois locais: cranial e caudal. Os ratos foram distribuídos em seis grupos (n=5): grupo ADSC_G recebeu, no enxerto, 1x106 ADSCs em 200 μL de Solução Salina 0,9% (SS); grupo ADSC_B recebeu 1x106 ADSCs em 200 μL de SS na borda do leito receptor; grupo ADSC_GB, metade da mesma suspensão na borda e outra metade no enxerto. Os grupos controle, SS_G e SS_B, receberam apenas SS no enxerto ou nas bordas respectivamente. No grupo S, o enxerto não recebeu nenhum tratamento durante as cirurgias. Curativos do tipo tie-over permaneceram até o 5º dia. Na cirurgia (d0), aos 5 (d5) e 14 (d14) dias de pós-operatório, os desenhos dos enxertos foram digitalizados e suas áreas mensuradas (software ImageJ). As avalições clínicas consideraram peso, presença de secreções e ocorrência de epidermólise. A planimetria demonstrou a taxa de pele normal, de pele avermelhada e de ulceração, assim como a contração dos enxertos entre os intervalos d0–d5, d5-d14 e d0-d14. As amostras dos enxertos foram obtidas em d14 para coloração com Hematoxilina e eosina e Tricrômico de Masson. A epiderme foi avaliada para espessamento, ceratose, acantose, degeneração hidrópica, infiltrado inflamatório. A derme foi avaliada quanto a rarefação pilosa, tecido de granulação, infiltrado inflamatório, deposição de colágeno. Os resultados foram expressos em média e desvio padrão, e a análise estatística utilizou as Equações de Estimações Generalizadas (GEE), com nível de significância de 5%. O grupo ADSC_G apresentou melhores aspectos macroscópicos, menos ocorrência de epidermólise e de rarefação pilosa e uma das menores médias de área de ulceração, juntamente com os outros grupos tratados com ADSCs. O grupo ADSC_G demonstrou as menores médias de alterações histopatológicas como: espessamento da epiderme, degeneração hidrópica, tecido de granulação. O mesmo grupo ficou entre as menores médias de acantose e infiltrado inflamatório na derme, ao mesmo tempo que apresentou as maiores médias de VEGF no subcutâneo e no tecido de granulação. Dessa forma, pode-se concluir que as ADSCs protegeram os enxertos dos efeitos deletérios da isquemia, assim como e sugerem-se novos estudos em fases iniciais da cicatrização para compreensão dos mecanismos envolvidos. / Evaluation of adipose derived stem cells (ADSC) effect on full-thickness skin graft (FTSG) as a wound healing model in ischemic conditions. Two 12 mm diameter FTSGs were harvested and placed onto dorsal recipient beds of twenty-four Wistar rats, in two anatomic regions: cranial and caudal. Rats were randomized into five groups. Before grafting, group E FTSGs received subfascial injection of 1X106 ADSCs diluted in 200 μL of physiologic saline. Group EC FTSGs received only physiologic saline. Group B received ADSCs in the recipient bed edges; group C received physiologic saline in the edges. Group ADSC_GB received the same ADSCs number and volume, half in the graft and half in the edges. Using planimetry, grafts were analyzed for graft´s contraction rate (d0, d5, d14), normal skin rate and occurrence of epidermolysis and failure rate (d14). FTSGs samples were obtained on the d14 to hematoxylin-eosin and Masson’s Trichrome staining for epidermal analysis (epidermal thickening, keratosis, acanthosis, hydropic degeneration, inflammatory infiltrate) and dermal analysis (hairless, granulation tissue, inflammatory infiltrate, collagen deposition). The obtained results were expressed by mean (n=5). Statistical significance (p<0,05) was calculated using Generalized Estimating Equations. The ADSC_G group had better macroscopic aspects, less occurrence of epidermolysis and hairless and one of the lowest averages of ulceration area, along with the other groups treated with ADSCs. The ADSC_G group showed the lowest mean on the histopathological changes measured such as thickening of the epidermis, hydropic degeneration, less granulation tissue. The same group was among the lowest acanthosis and inflammatory infiltrate averages in the dermis, while presented with the greatest of VEGF average in the subcutaneous and in the granulation tissue. Thus it can be concluded that the ADSCs may have protected the grafts from the deleterious effects of ischemia and suggest new studies in the early stages of healing to understand the mechanisms involved.

Doctor Educationis / This study was a cephalometric and dental investigation of the treatment outcomes of UCLP children treated at the Red Cross Children's Hospital (RCCH) with respect to craniofacial morphology and dental arch relationship. The quality of the outcome for the RCCH group was compared with the outcomes reported for the Six-Centre International Study (Melsted et al., 1992; Mars et al., 1992). The sample consisted of 20 (11 females, 9 males) consecutively treated UCLP children who had cephalometric and dental records taken between the ages of8 to 11years (mean 10.13 ± 1.2 years). The cephalometric analysis described by Melsted et al. (1992) was used to evaluate the skeletal and soft tissue morphology. The quality of the dental arch relationship was measured according to the Gosion Yardstick (Mars et al., 1987). The treatment outcome of children treated at the RCCH was evaluated with respect to craniofacial form and dental arch relationship. When comparing the mean cephalometric skeletal parameters of the RCCH to the six centres in the Eurocleft study, a significant difference was found between the RCCH group and centre D for most of the variables. A significant increase in the upper incisor inclination and maxillary inclination was found in the RCCH patients compared to the European centres. The difference in the soft tissue parameters was limited to the relative protrusion of the nose and the sagittal soft tissue variable sss-ns-pgs. The analysis of the Goslon scores showed a significant difference between the RCCH group and centres C, D, and F. According to the Goslon score, 85% of the RCCH patients had good to satisfactory dental arch relationship, which was comparable to that recorded for centres A(92%), B(89%) and C(94). In conclusion, the results of the cephalometric analysis and the Goslon Yardstick showed a significant difference between the RCCH group and centre D. The GosIon score indicated good quality of the dental arch relationship, which faired favourably with the better centres in the Six Centre Study.

Contexte : Les mutilations génitales féminines (MGF) se réfèrent à toute intervention non thérapeutique aboutissant à une lésion ou ablation des organes génitaux externes des femmes. Peu de données existent sur l’organisation, la continuité et la coordination dans la prise en charge des femmes vivant avec une MGF dans les pays où elles sont encore pratiquées – notamment en Afrique subsaharienne. Objectif : L’objectif de la recherche est de décrire l’offre de soins proposée aux femmes vivant avec une MGF au Burkina Faso dans le cadre d’une campagne de chirurgie réparatrice, analyser la continuité et la coordination dans cette offre de soins. Méthodologie : Le devis de recherche retenu est l’étude de cas unique selon l’approche de Stake. Le cas unique est la campagne annuelle de chirurgie réparatrice offerte à des femmes vivant avec une MGF, organisée par le Centre hospitalier universitaire de Bogodogo, au Burkina Faso. Quatorze entrevues individuelles ont été réalisées du 3 au 18 mai 2022 au Burkina Faso avec les membres du personnel impliqué dans cette campagne. Les données ont été organisées en suivant les sept étapes de l’approche Framework. Les verbatims ont été transcrits et codés à l’aide du logiciel QDA Miner. Le Modèle d’analyse de la performance (MAP) a permis une analyse thématique des données à partir des composantes des dimensions de la continuité et de la coordination. Résultats : Selon le point de vue des participants de l’étude, la continuité et la coordination semblent satisfaisantes; l’implication d’autres professionnels (sexologue, psychologue) permettrait d’améliorer l’offre de soins; la mise en place d’un cadre approprié permettrait aux femmes de s’exprimer sur les enjeux liés à leur bien-être sexuel. Conclusion : Notre étude a permis d’apporter des connaissances sur l’offre de soins pour les femmes vivant avec une MGF dans un contexte ouest-africain, sur la continuité et la coordination dans cette offre de soins et aussi de combler un manque dans la littérature sur ce type d’offre de soins. D’autres recherches impliquant les femmes et abordant d’autres aspects organisationnels de cette offre de soins seraient complémentaires au présent travail et sont donc fortement encouragées. / Context : Female genital mutilation (FGM) refers to any non-therapeutic intervention resulting in damage or removal of the external genitalia of women. Little data exists on the organization, continuity and coordination in the care of women living with FGM in countries where it is still practiced – particularly in sub-Saharan Africa. Objective: The objective of the research is to describe the care offered to women living with FGM in Burkina Faso as part of a reconstructive surgery campaign, and to analyze the continuity and coordination in this care offer. Methodology: The research design selected is a single case study using the Stake approach. The unique case is the annual reconstructive surgery campaign offered to women living with FGM, organized by the Bogodogo University Hospital Center, in Burkina Faso. Fourteen individual interviews were conducted from May 3 to 18, 2022 in Burkina Faso with staff members involved in this campaign. The data was organized following the seven steps of the Framework approach. The verbatims were transcribed and coded using QDA Miner software. The Performance Analysis Model (MAP) allowed a thematic analysis of the data based on the components of the dimensions of continuity and coordination. Results: According to the point of view of the study participants, continuity and coordination seem satisfactory; the involvement of other professionals (sexologist, psychologist) would make it possible to improve the provision of care; establishing an appropriate framework would allow women to express themselves on issues related to their sexual well-being. Conclusion: Our study provided knowledge on the provision of care for women living with FGM in a West African context, on the continuity and coordination in this provision of care and also to fill a gap in the literature on this type of care provision. Other research involving women and addressing other organizational aspects of this care provision would be complementary to this work and is therefore strongly encouraged.