1
|
Wiedermann J, Douse DM, Green KJ, Pang JC, Blount Q, Yu K, Shrime M. Outcomes of Short-Term Surgical Trips in Otolaryngology-Head and Neck Surgery: A Scoping Review. Laryngoscope 2024; 134:32-39. [PMID: 37249184 DOI: 10.1002/lary.30764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 04/25/2023] [Accepted: 05/03/2023] [Indexed: 05/31/2023]
Abstract
OBJECTIVE This scoping review aims to explore the current body of literature to characterize how short-term surgical trips (STSTs) in Otolaryngology-Head and Neck Surgery (OtoHNS) contribute to surgical, educational, and sustainability-based outcomes in low- and middle-income countries (LMICs). We aim to use these data to synthesize aspects of STSTs that are successful with the hopes of shaping future global efforts. DATA SOURCES Data sources included Ovid MEDLINE, Ovid Embase, Ovid Cochrane Central Register of Controlled Trials, Ovid Cochrane Database of Systematic Reviews, and Scopus. REVIEW METHODS A comprehensive search was conducted on several databases from inception to October 14, 2021. We included primary studies exploring any surgical or educational outcomes of global short-term surgical endeavors within LMICs. Data were then extracted to evaluate the heterogenous body of literature that exists, characterizing the surgical, educational, and sustainability-based outcomes. RESULTS Forty-Seven studies were included in the final analysis. Most publications were focused on surgical interventions (39 of 47; 82.9%); 13 (27.7%) studies included education as the primary aim and 12 (25.5%) considered sustainability a significant aim. Of the 94 first and last authors, there were zero first authors and only one last author with an LMIC affiliation. Twenty-six studies (55%) mentioned that any patients were seen in follow-up, ranging from one day to five years. CONCLUSION Our scoping review demonstrates that most STSTs have focused primarily on surgical procedures with a lack of appropriate long-term follow-up. However, the available outcome-based information presented helps identify factors that characterize a strong short-term global surgical program. LEVEL OF EVIDENCE NA Laryngoscope, 134:32-39, 2024.
Collapse
Affiliation(s)
- Josh Wiedermann
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Dontre' M Douse
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Katerina J Green
- Department of Plastic and Reconstructive Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Jonathan C Pang
- Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, California, USA
- Institute for Global Health Sciences, University of California, San Francisco, California, USA
| | | | - Karina Yu
- Department of Otolaryngology-Head and Neck Surgery, Northwestern University, Chicago, IL, USA
| | - Mark Shrime
- Mercy Ships, Garden Valley, Texas, USA
- Program in Global Surgery and Social Change, Harvard Medical School, Boston, Massachusetts, USA
| |
Collapse
|
2
|
Borsche A. INTERPLAST-Germany-adapting to global plastic surgery. EUROPEAN JOURNAL OF PLASTIC SURGERY 2023; 46:1-11. [PMID: 36820226 PMCID: PMC9930718 DOI: 10.1007/s00238-023-02051-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 01/17/2023] [Indexed: 02/19/2023]
Abstract
Background INTERPLAST, Inc. was founded in 1969 by plastic surgeons in Stanford, CA, to create a financial basis through donations to operate foreign patients at Stanford or send surgical teams to developing countries. With the same financial effort, 50 to 100 times more patients can be operated on locally than in a hospital at home. Stanford's example was appealing to many plastic surgeons worldwide, who founded similar INTERPLAST NGOs in their own countries. Methods A literature review revealed worldwide humanitarian actions of INTERPLAST teams, whose annual effectiveness is comparable to the operation numbers of large plastic surgery departments. Six patients with complex facial deformities requiring multiple surgical interventions were selected for temporary stay and operations in Germany. Results Repeated missions at the same hospitals with training of local surgeons have increased significantly compared to earlier "parachute missions." Microsurgical procedures for free flaps with magnifying glasses are now possible for the experienced even in hospitals in developing countries. The most efficient medical aid in the future will be the expansion and establishment of departments or hospitals in developing countries supported or maintained by partner hospitals in our home country. Conclusions Operations of humanitarian plastic surgeons in developing countries are becoming increasingly difficult. Local health authorities require temporary surgical permits, customs offices try to clear surgical material and look at expiration dates of medicines, and pandemics complicate planning of INTERPLAST missions. It therefore seems increasingly necessary to go as single teacher, training engaged local surgeons and assisting operations. The alternative is inviting local surgeons to Western hospitals and introducing them to the basic skills of plastic surgery and empathy with the poor. However, the lack of recognition of medical degrees from all developing countries remains a problem for their training in Europe.Level of evidence: Level V, risk/prognostic.
Collapse
Affiliation(s)
- Andre´ Borsche
- Department of Plastic and Reconstructive Surgery, Diakonie-Krankenhaus, Ringstr. 64, 55543 Bad Kreuznach, Germany
| |
Collapse
|
3
|
Akmal M, Zahir R, Zahir Z, Ahmed J, Lateef T. SaveSmile: an annual cleft repair mission in Sudan. JOURNAL OF GLOBAL HEALTH REPORTS 2022. [DOI: 10.29392/001c.35266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Low- and middle-income countries (LMICs) are often burdened by disease, beyond the scope of their healthcare capabilities. Sudan, in particular, lacks the resources and expertise to surgically repair orofacial clefts. This paper highlights Sudan’s need for medical aid from other countries and outside organizations and the procedures by which they collaborate with local entities to provide relief to those affected by cleft in Sudan. Additionally, this study reports on the prevalence of type of cleft lip and palate as well as rates and explanations of surgical complications over a period of 10 years and the short and long-term benefits to society. Paper copies of patient data was digitalized and run through statistical programs to look for patterns of demographics and diagnoses. Most patients were male, under four years old, and had a cleft lip.
Collapse
Affiliation(s)
| | - Rhea Zahir
- George Washington University School of Medicine and Pediatric Specialists of Virginia, USA
| | | | | | - Tarannum Lateef
- George Washington University School of Medicine and Pediatric Specialists of Virginia, USA
| |
Collapse
|
4
|
Boztepe H, Çınar S, Kanbay Y, Acımış B, Özgür F, Terzioglu F. Validity and reliability of the Family Empowerment Scale for parents of children with cleft lip and/or palate. Child Care Health Dev 2022; 48:277-285. [PMID: 34786745 DOI: 10.1111/cch.12928] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 10/11/2021] [Accepted: 11/07/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Empowerment is recognized as a crucial concept in strengthening the position of parents in healthcare services. This study aimed to evaluate the validity and reliability of the Turkish Family Empowerment Scale (FES). METHODS This methodological study was conducted between January and March 2021, with 348 family members actively caring for their children in the age group of 0-18 years with cleft lip and/or palate (CL/P). The English FES was translated into Turkish using back translation and modified so that it is generic and convenient for all families. The construct validity, internal validity, internal consistency, and split-half test reliability and responsiveness of the Turkish FES were examined. RESULTS The original FES structure with three factors (family, health services provided to the child and community participation) and 34 items was verified in Turkish culture. This obtained structure can explain 66% of the variance of the relevant concept. Scores of parents ranged between 34 and 170 points. Increasing scores indicated a positive significance regarding family empowerment. The Cronbach's α reliability coefficient of the scale was calculated as 0.976. CONCLUSION The study findings and the goodness-of-fit values indicated that the FES and its Turkish version are a valid and reliable measurement instrument to be used in Turkish culture.
Collapse
Affiliation(s)
- Handan Boztepe
- Department of Nursing, Faculty of Health Sciences, Atılım University, Ankara, Turkey
| | - Sevil Çınar
- Faculty of Health Sciences, Artvin Çoruh University, Artvin, Turkey
| | - Yalçın Kanbay
- Department of Nursing, Faculty of Health Sciences, Artvin Coruh University, Artvin, Turkey
| | - Burcu Acımış
- Plastic, Reconstructive and Esthetic Surgery, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Figen Özgür
- Department of Plastic, Reconstructive and Esthetic Surgery, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Füsun Terzioglu
- Faculty of Health Sciences, Kocaeli Health and Technology University, Kocaeli, Turkey
| |
Collapse
|
5
|
The Impact of Middle Eastern Crisis on Cleft Care: Evaluation of Demographic and Perioperative Data in Syrian Refugees With Cleft Lip and Palate. J Craniofac Surg 2021; 31:1668-1671. [PMID: 32604304 DOI: 10.1097/scs.0000000000006649] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The cleft lip and palate (CL/P) define a heterogeneous group of congenital deformities, which are morphologically highly diverse, with a complex and multifactorial etiology. Affected children may experience social problems due to negative effects on speech, hearing, facial appearance, as well as negative psychological effects on the parents. In 2011, after the civil war began in Syria, a great wave of immigration began to Turkey and other neighboring countries. Refugees may not be able to receive optimal health care because of cultural differences, socioeconomic status, language problems, and psychosocial problems. To increase awareness about this issue, the authors investigated the demographic, perioperative, and post-operative data of Syrian refugee patients with CL/P who were admitted to our cleft center between January 2016 and May 2019. Sixty-eight refugees with CL/P were detected as the result of the screening. Unlike the protocol the authors follow in our center, cleft lip repair was performed at an average of 7.6 months and cleft palate repair was performed at an average of 28.7 months of age. The rate of fistula was found 26.2%.The civil war in Syria has caused the repair of the patients with cleft lip and palate at a later age, hampered the follow-up and treatment, and caused more complications. Considering the demographic, social, economic and cultural characteristics of the patients, it was demonstrated that the necessary health precautions and infrastructure should be provided on the pillar of plastic surgery.
Collapse
|
6
|
Hendriks TCC, Botman M, Rahmee CNS, Ket JCF, Mullender MG, Gerretsen B, Nuwass EQ, Marck KW, Winters HAH. Impact of short-term reconstructive surgical missions: a systematic review. BMJ Glob Health 2019; 4:e001176. [PMID: 31139438 PMCID: PMC6509599 DOI: 10.1136/bmjgh-2018-001176] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 01/19/2019] [Accepted: 01/25/2019] [Indexed: 01/04/2023] Open
Abstract
Introduction Short-term missions providing patients in low-income countries with reconstructive surgery are often criticised because evidence of their value is lacking. This study aims to assess the effectiveness of short-term reconstructive surgical missions in low-income and middle-income countries. Methods A systematic review was conducted according to PRISMA guidelines. We searched five medical databases from inception up to 2 July 2018. Original studies of short-term reconstructive surgical missions were included, which reported data on patient safety measurements, health gains of individual patients and sustainability. Data were combined to generate overall outcomes, including overall complication rates. Results Of 1662 identified studies, 41 met full inclusion criteria, which included 48 546 patients. The overall study quality according to Oxford CEBM and GRADE was low. Ten studies reported a minimum of 6 months’ follow-up, showing a follow-up rate of 56.0% and a complication rate of 22.3%. Twelve studies that did not report on duration or follow-up rate reported a complication rate of 1.2%. Fifteen out of 20 studies (75%) that reported on follow-up also reported on sustainable characteristics. Conclusions Evidence on the patient outcomes of reconstructive surgical missions is scarce and of limited quality. Higher complication rates were reported in studies which explicitly mentioned the duration and rate of follow-up. Studies with a low follow-up quality might be under-reporting complication rates and overestimating the positive impact of missions. This review indicates that missions should develop towards sustainable partnerships. These partnerships should provide quality aftercare, perform outcome research and build the surgical capacity of local healthcare systems. PROSPERO registration number CRD42018099285.
Collapse
Affiliation(s)
- Thom C C Hendriks
- Plastic, Reconstructive and Hand Surgery, VU Medisch Centrum, Amsterdam, The Netherlands.,Global Surgery Amsterdam, Amsterdam, The Netherlands
| | - Matthijs Botman
- Plastic, Reconstructive and Hand Surgery, VU Medisch Centrum, Amsterdam, The Netherlands.,Global Surgery Amsterdam, Amsterdam, The Netherlands
| | - Charissa N S Rahmee
- Plastic, Reconstructive and Hand Surgery, VU Medisch Centrum, Amsterdam, The Netherlands.,Global Surgery Amsterdam, Amsterdam, The Netherlands
| | | | - Margriet G Mullender
- Plastic, Reconstructive and Hand Surgery, VU Medisch Centrum, Amsterdam, The Netherlands
| | | | - Emanuel Q Nuwass
- Department of Surgery, Haydom Lutheran Hospital, Haydom, Tanzania
| | - Klaas W Marck
- Department of Plastic Surgery, Medisch Centrum Leeuwarden, Leeuwarden, The Netherlands
| | - Henri A H Winters
- Plastic, Reconstructive and Hand Surgery, VU Medisch Centrum, Amsterdam, The Netherlands.,Global Surgery Amsterdam, Amsterdam, The Netherlands
| |
Collapse
|
7
|
Affiliation(s)
- Young-Wook Park
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Gangneung-Wonju National University, Gangneung, Korea
| |
Collapse
|