在资源有限的情况下建立可持续的游离皮瓣项目：12 年的人道主义努力。
Building a sustainable free flap program in a resource-limited setting: A 12-year humanitarian effort.
机构信息
Department of Otolaryngology - Head and Neck Surgery, Vanderbilt University, Nashville, Tennessee, USA.
Department of Otolaryngology - Head and Neck Surgery, Loma Linda University, Loma Linda, California, USA.
出版信息
Head Neck. 2024 May;46(5):1051-1055. doi: 10.1002/hed.27640. Epub 2024 Jan 17.
BACKGROUND
We present a sustainable complex reconstructive program built through 12 years of surgical outreach work at Kijabe Hospital in Kenya.
METHODS
Retrospective chart review and anecdotal experiences.
RESULTS
In 2011, surgeons from a US-medical center performed Kijabe Hospital's first 3 successful free flap surgeries. Since then, they have returned 7 times, performing a total of 31 tumor excisions with microvascular reconstruction. One flap failure occurred that was reconstructed on a subsequent trip. In 2013, a US-trained missionary surgeon and a Kenyan-trained general surgeon began working with the visiting team with the goal of performing these surgeries independently. In 2016 they performed their first independent free flap reconstruction and have since performed 32 independent cases with only three flap losses. Establishing infrastructure, staff education, selective patient criteria, and continuous communication are the factors that enabled the success of this program.
CONCLUSIONS
Establishing a successful microvascular reconstruction program in a resource-limited setting is feasible.
背景
我们展示了一个通过在肯尼亚基贾贝医院开展 12 年的外展手术工作而建立的可持续的复杂重建计划。
方法
回顾性病历审查和轶事经验。
结果
2011 年，来自美国医疗中心的外科医生完成了基贾贝医院的首例 3 例成功游离皮瓣手术。从那时起，他们已经返回了 7 次，共进行了 31 例肿瘤切除和微血管重建。有 1 例皮瓣失败，随后在一次旅行中进行了重建。2013 年，一位接受过美国培训的传教士外科医生和一位肯尼亚培训的普通外科医生开始与访问团队合作，目标是独立开展这些手术。2016 年，他们进行了首例独立的游离皮瓣重建手术，此后已独立完成了 32 例手术，仅发生 3 例皮瓣失败。建立基础设施、员工教育、选择性患者标准和持续沟通是该计划取得成功的因素。
结论
在资源有限的环境中建立成功的显微血管重建计划是可行的。
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