From the Hansjörg Wyss Department of Plastic Surgery, New York University Langone Health; the Global Smile Foundation; and Otolaryngology, Tufts University School of Medicine.
Plast Reconstr Surg. 2019 Apr;143(4):1165-1178. doi: 10.1097/PRS.0000000000005416.
Cleft deformities of the lip and palate affect nearly one in 500 to 700 births, and lead to increased morbidity and mortality if untreated. Nevertheless, significant global disparities in access to timely and appropriate care still exist. The relatively basic infrastructure required to surgically correct these deformities and large unmet disease burden have resulted in a significant number of foundation-based cleft care initiatives focused on developing countries. In this study, the authors evaluate the peer-reviewed literature generated by these foundations in an attempt to assess their clinical, scientific, educational, and economic impact.
A comprehensive review of the literature was performed using key search terms, and the level of evidence of identified articles was determined. Data were then analyzed to determine the different models of foundation-based cleft care in developing countries, and their clinical, scientific, educational, and economic impact.
A total of 244 articles were identified through the authors' search and reviewed. Foundation-based cleft care initiatives in developing countries have significantly contributed to a better understanding of disease epidemiology, barriers to care, safety considerations, complications and outcomes, and international and local cleft surgery education. The cleft care center model is more cost-effective than the surgical mission model and provides more sustainable care.
Foundation-based cleft care prevents significant morbidity in developing countries and has provided valuable resources for capacity building. The surgical mission model should be considered as a transitory conduit for establishing the more effective and sustainable cleft care center model of care.
唇腭裂畸形影响了近每 500 至 700 例新生儿中的一例，如果不进行治疗，会导致发病率和死亡率增加。尽管如此，全球在获得及时和适当的护理方面仍存在显著差异。这些畸形需要相对基本的基础设施进行手术矫正，而大量未满足的疾病负担导致了许多专注于发展中国家的基于基金会的腭裂护理倡议。在这项研究中，作者评估了这些基金会产生的同行评议文献，试图评估其临床、科学、教育和经济影响。
使用关键搜索词对文献进行了全面审查，并确定了所确定文章的证据水平。然后分析数据，以确定发展中国家基于基金会的腭裂护理的不同模式，及其临床、科学、教育和经济影响。
作者的搜索共确定了 244 篇文章，并进行了审查。发展中国家的基于基金会的腭裂护理倡议极大地促进了对疾病流行病学、护理障碍、安全性考虑、并发症和结果以及国际和本地腭裂手术教育的更好理解。腭裂护理中心模式比手术任务模式更具成本效益，并提供更可持续的护理。
基于基金会的腭裂护理可预防发展中国家的重大发病率，并为能力建设提供了有价值的资源。手术任务模式应被视为建立更有效和可持续的腭裂护理中心模式的过渡性渠道。
