Truche Paul, Moeller Ellie, Wurdeman Taylor, Zimmerman Kathrin, Cruz Norma, Nakarmi Kiran, Rai Shankar M, Eado Yegeremu, Pompermaier Laura, Meara John G, Corlew D Scott
Program in Global Surgery and Social Change, Harvard Medical School, Boston, Mass.
International Confederation of Plastic Surgery Societies, Utrecht, the Netherlands.
Plast Reconstr Surg Glob Open. 2021 Apr 23;9(4):e3428. doi: 10.1097/GOX.0000000000003428. eCollection 2021 Apr.
Plastic surgery varies in scope, especially in different settings. This study aimed to quantify the plastic surgery workforce in low-income countries (LICs), understand commonly treated conditions by plastic surgeons working in these settings, and assess the impact on reducing global disease burden.
We queried national and international surgery societies, plastic surgery societies, and non-governmental organizations to identify surgeons living and working in LICs who provide plastic surgical care using a cross-sectional survey. Respondents reported practice setting, training experience, income sources, and perceived barriers to care. Surgeons ranked commonly treated conditions and reported which of the Disease Control Priorities-3 essential surgery procedures they perform.
An estimated 63 surgeons who consider themselves plastic surgeons were identified from 15 LICs, with no surgeons identified in the remaining 16 LICs. Responses were obtained from 43 surgeons (70.5%). The 3 most commonly reported conditions treated were burns, trauma, and cleft deformities. Of the 44 "Essential Surgical Package'' procedures, 37 were performed by respondents, with the most common being skin graft (73% of surgeons performing), cleft lip/palate repair (66%), and amputations/escharotomy (61%). The most commonly cited barrier to care was insufficient equipment. Only 9% and 5% of surgeons believed that there are enough plastic surgeons to handle the burden in their local region and country, respectively.
Plastic surgery plays a significant role in the coverage of essential surgical conditions in LICs. Continued expansion of the plastic surgical workforce and accompanying infrastructure is critical to meet unmet surgical burden in low- and middle-income countries.
整形手术的范围各不相同，尤其是在不同的环境中。本研究旨在量化低收入国家（LICs）的整形手术人力，了解在这些环境中工作的整形外科医生通常治疗的疾病，并评估其对减轻全球疾病负担的影响。
我们通过横断面调查，向国家和国际外科学会、整形外科学会及非政府组织进行询问，以确定在低收入国家生活和工作且提供整形手术治疗的外科医生。受访者报告了执业环境、培训经历、收入来源以及感知到的治疗障碍。外科医生对常见治疗疾病进行排序，并报告他们实施的《疾病控制优先事项-3》基本外科手术程序中的哪些程序。
从15个低收入国家中确定了约63名自认为是整形外科医生的外科医生，其余16个低收入国家未找到相关外科医生。43名外科医生（70.5%）回复了调查。报告的最常见的3种治疗疾病是烧伤、创伤和腭裂畸形。在44项“基本外科手术包”程序中，受访者实施了37项，最常见的是植皮手术（实施的外科医生占73%）、唇腭裂修复（66%）和截肢/焦痂切开术（61%）。最常提到的治疗障碍是设备不足。分别只有9%和5%的外科医生认为当地和本国有足够的整形外科医生来应对负担。
整形手术在低收入国家基本外科疾病的覆盖方面发挥着重要作用。持续扩大整形手术人力及相关基础设施对于满足低收入和中等收入国家未得到满足的手术负担至关重要。
