Yan Allison, Castellanos Sydney L, Chao Albert H
From Ohio State University College of Medicine, Columbus, Ohio.
Department of Plastic and Reconstructive Surgery, Ohio State University, Columbus, Ohio.
Plast Reconstr Surg Glob Open. 2023 Dec 26;11(12):e5477. doi: 10.1097/GOX.0000000000005477. eCollection 2023 Dec.
Conditions that are treated by surgery constitute a significant portion of the global burden of disease. In low- and middle-income countries (LMICs), allocation of resources toward the most cost-effective surgical procedures (essential surgery) and care delivery platforms is critical. Nongovernmental organizations (NGOs) and the plastic surgeons who work with them play a significant role in plastic surgical outreach to LMICs. However, it is unknown whether their work aligns with existing global public health recommendations.
A previously established internet-based methodology was used to identify plastic surgical NGOs. Through direct correspondence with NGOs and publicly available data, plastic surgical NGOs were cataloged with respect to the subspecialty areas of plastic surgery performed, care delivery platforms, and geographic sites. These results were then compared with the existing global public health recommendations.
A total of 96 NGOs met inclusion criteria. The most common subspecialty area was cleft surgery (80.3%), followed by pediatric plastic surgery (46.9%). No NGOs used a continuous care delivery platform. Instead, all NGOs used an intermittent model through short-term surgical missions, of which 62.8% used a nonrotating care model and returned to the same site(s) annually, whereas 37.2% used a rotating care model.
Most NGOs perform cleft surgery, an area considered essential surgery, and thus, collectively, the work of NGOs largely aligns with global public health priorities. However, there is room for improvement for both the types of procedures performed and the care delivery platforms to provide the most cost-effective and sustainable care.
需通过手术治疗的疾病构成了全球疾病负担的重要部分。在低收入和中等收入国家（LMICs），将资源分配到最具成本效益的外科手术（基本外科手术）和护理提供平台至关重要。非政府组织（NGO）以及与之合作的整形外科医生在向LMICs开展整形外科外展服务方面发挥着重要作用。然而，尚不清楚他们的工作是否符合现有的全球公共卫生建议。
采用一种先前建立的基于互联网的方法来识别整形外科非政府组织。通过与非政府组织直接通信以及公开可得的数据，对整形外科非政府组织在进行的整形外科亚专业领域、护理提供平台和地理位置方面进行了编目。然后将这些结果与现有的全球公共卫生建议进行比较。
共有96个非政府组织符合纳入标准。最常见的亚专业领域是唇腭裂手术（80.3%），其次是小儿整形外科（46.9%）。没有非政府组织使用持续护理提供平台。相反，所有非政府组织都通过短期手术任务采用间歇性模式，其中62.8%使用非轮换护理模式，每年返回相同地点，而37.2%使用轮换护理模式。
大多数非政府组织开展唇腭裂手术，这是一个被视为基本外科手术的领域，因此，总体而言，非政府组织的工作在很大程度上符合全球公共卫生优先事项。然而，在手术类型和护理提供平台方面仍有改进空间，以提供最具成本效益和可持续的护理。
