Binocular single-refraction magnifying glasses for free flap surgery: a reliable method for developing countries

Abstract

Although free flaps are gaining more popularity, the logistic reasons and slow training curve are still major obstacles, particularly in developing countries. Binocular magnification glasses seemed an appealing alternative to surgical microscopes and loupes. From May 2008 to December 2010, 16 gracilis free flaps were performed by five surgeons using binocular-magnifying eye glass in the Plastic Surgery Unit of Suez Canal University Hospital. Survival rate of the flaps was 100%. Only two patients (one smoker and one diabetic) had complications: partial flap loss with infection and hematoma. Both were treated conservatively. The main advantages of this magnification method were very low cost, availability, and short training period compared with a standard microsurgery training. Other advantages were the freedom of movement during operation, same orientation, wide field, adjustability of working distance, and permission of team work. The only inconvenience was the restriction of working distance, although longer or similar to that of loupes. We therefore recommend the use of this method in developing countries as well as relief and war field hospitals. Furthermore, these glasses seem to be of value in all surgeries needing magnification.