Reconstructive surgery including free flap transfers can be performed in low-resource settings: experiences from a wartime scenario.

BACKGROUND

Severe wartime injuries often require microsurgical reconstruction or pedicle flap transfer. The aim of the study is to explore if such reconstructive surgery can be performed under low-resource conditions in a rural area.

METHODS

A clinical intervention study was performed at rural hospital in a war scenario in the Balkans.

RESULTS

Thirty-four patients underwent microsurgical postinjury reconstructions for land mine or blast injuries. Five different types of flaps were used. Three patients developed postoperative complications and was reoperated (8.3%, 95% CI 1.8-22.5%).

CONCLUSIONS

The actual intervention demonstrates that skilled surgical teams can perform advanced reconstructive surgery in low-resource settings. The experience is not only relevant for wartime scenarios, but also in civilian trauma where decentralization of microsurgical service may be feasible.