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被忽视热带病的重建外科手术:全球差距与未来方向

Reconstructive Surgery for the Neglected Tropical Diseases: Global Gaps and Future Directions.

作者信息

Pham Kala T, Hotez Peter J, Hamilton Kristy L

机构信息

From the Departments of Biology and Biochemistry, University of Houston, Houston, Tex.

Houston Premedical Academy, University of Houston and Baylor College of Medicine, Houston, Tex.

出版信息

Plast Reconstr Surg Glob Open. 2023 May 17;11(5):e4987. doi: 10.1097/GOX.0000000000004987. eCollection 2023 May.

Abstract

UNLABELLED

Several neglected tropical diseases (NTDs) are highly disfiguring, particularly those in resource-poor countries that lack access to basic surgery. There has been a push to integrate surgery into treatment programs for NTDs. In this article, we provide an overview of the major disfiguring NTDs and discuss the processes and barriers that impede access to reconstructive surgical treatments or their integration into health systems.

METHODS

A review of the literature was conducted using the online database PubMed, from 2008 to 2021 with the specific diseases listed as NTDs either on the World Health Organization or the websites. Reference lists of identified articles and reviews were also searched, as were databases from the World Health Organization's .

RESULT

Success in the surgical treatment and postoperative care of disfiguring NTDs would benefit from standardization and harmonization of surgical approaches and procedures. In some settings, reconstructive surgery should be used cautiously, emphasizing appropriate use of antibiotics, partnerships with global and local surgical teams, and local capacity building. Preventative hygiene approaches remain paramount in resource-poor areas.

CONCLUSIONS

Surgery is a promising treatment for NTDs that result in disfigurement and disability. The expansion of local capacity building, with medical trips and surgical training of local health workers, together with the development of universal surgical protocols remain essential cornerstones for NTD reconstructive surgery. Antibiotics and drug management should comprise key first steps before turning to surgery.

摘要

未标注

几种被忽视的热带病(NTDs)具有高度毁容性,尤其是在那些缺乏基本外科手术条件的资源匮乏国家。目前一直在推动将外科手术纳入NTDs的治疗方案。在本文中,我们概述了主要的毁容性NTDs,并讨论了阻碍获得重建性外科治疗或其融入卫生系统的过程和障碍。

方法

使用在线数据库PubMed对2008年至2021年的文献进行了综述,具体疾病在世界卫生组织或相关网站上被列为NTDs。还搜索了已识别文章和综述的参考文献列表,以及世界卫生组织的数据库。

结果

毁容性NTDs的外科治疗和术后护理的成功将受益于手术方法和程序的标准化与协调统一。在某些情况下,应谨慎使用重建性手术,强调合理使用抗生素、与全球和当地外科团队建立伙伴关系以及当地能力建设。在资源匮乏地区,预防性卫生措施仍然至关重要。

结论

外科手术是治疗导致毁容和残疾的NTDs的一种有前景的治疗方法。通过医疗援助和对当地卫生工作者的外科培训来扩大当地能力建设,以及制定通用的外科手术方案,仍然是NTDs重建性手术的重要基石。在进行手术之前,抗生素和药物管理应作为关键的首要步骤。

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