Global Plastic Surgery: A Review of the Field and a Call for Virtual Training in Low- and Middle-Income Countries

Abstract

Lack of surgical access severely harms countless populations in many low- and middle-income countries (LMICs). Many types of surgery could be fulfilled by the plastic surgeon, as populations in these areas often experience trauma, burns, cleft lip and palate, and other relevant medical issues. Plastic surgeons continue to contribute significant time and energy to global health, primarily by participating in short mission trips intended to provide many surgeries in a short time frame. These trips, while cost-effective for lack of long-term commitments, are not sustainable as they require high initial costs, often neglect to educate local physicians, and can interfere with regional systems. Education of local plastic surgeons is a key step toward creating sustainable plastic surgery interventions worldwide. Virtual platforms have grown popular and effective—particularly due to the coronavirus disease 2019 pandemic—and have shown to be beneficial in the field of plastic surgery for both diagnosis and teaching. However, there remains a large potential to create more extensive and effective virtual platforms in high-income nations geared to educate plastic surgeons in LMICs to lower costs and more sustainably provide capacity to physicians in low access areas of the world.

The Implementation of International Electives for Plastic Surgery Residents: Current State and Future Directions

“…Despite COVID-19 shedding light on ways technology can benefit mission trips, residents may find they can now contribute virtually (eg, through virtual education and training platforms) without having to travel internationally, which can potentially have implications for future resident participation in service medicine. 58 Furthermore, despite no formal reports found in the literature, one can assume that the long hiatus related to the pandemic led to the extinction of certain global health organizations decreasing the available opportunities for residents. This along with additional health measures implemented for missions in the post-pandemic era may create barriers not worthwhile overcoming for residents without proper faculty and administrative support as well as clear guidelines for participation.…”

Transforming Plastic and Reconstructive Surgical Care in Low- and Middle-Income Countries: A Paradigm Shift to the Diagonal Model

“…Several case reports illustrate instances of induction aspiration in patients on GLP-1 agonist therapy despite a 24-hour fast. 1 More in-depth study is necessary to fully understand the implications of the delayed gastric emptying and the duration of cessation necessary to mitigate these effects.…”

“…[1][2][3] In low-and middleincome countries (LMICs), access is critically constrained, with only 3.5% of all surgical procedures being provided to 34.8% of the world's population. 1 Within this context, plastic and reconstructive surgery represents a sizeable portion of the unmet surgical need in LMICs, accounting for approximately 16% of all surgically treatable conditions. 2 To address this challenge, a comprehensive and multifaceted approach is required.…”

Remote Robotic Surgery and Virtual Education Platforms: How Advanced Surgical Technologies Can Increase Access to Surgical Care in Resource-Limited Settings

“…In the field of plastic surgery, virtual simulations and augmented reality have been incorporated into some training paradigms. 11 Virtual training for both minimally invasive and open techniques is a valid alternative to in-person training. 5 Additionally, simulation and video-based coaching hold significant promise in improving training in and assessment of surgical skills.…”

“…The first surgical nongovernmental organizations that established the framework for many global surgery efforts were founded by plastic surgeons to reduce the burden of cleft lip and palate malformations. 11 The World Bank has worked to identify surgeries that are critical to reducing the disease burden in resource-limited settings. As a result, the World Bank established a list of 44 essential surgeries that include the fields of general surgery, neurosurgery, obstetrics and gynecology, ophthalmology, oral and maxillofacial surgery, orthopaedics, otolaryngology, and plastic surgery.…”