Introduction of Microsurgery in Vietnam by a Charitable Organization: A 15-Year Experience

Abstract

Charitable organizations can help surgeons in developing countries master complex microsurgical techniques through short-term medical missions, donation of equipment and supplies, and the encouragement of institutional support. A continuing education program, including local conferences, microsurgical laboratory training facilities, and study abroad, can aid this introduction.

Surgical Management and Reconstruction Training (SMART) Course for International Orthopedic Surgeons

“…27,28 However, the missionbased service model has been criticized for being a temporary solution to a longitudinal problem. [7][8][9][10]16 In light of the criticism, it has been suggested that surgical mission and service trips be used as a bridge for the development of more long-term capacity to care for soft-tissue injuries. 24,25 Thus, given the flap success rate and dissemination of information demonstrated by LMIC-based orthopedic surgeons who participated in the SMART course, this study adds to the literature by providing a potential sustainable alternative to manage soft-tissue wounds and reduce amputation burden.…”

“…[12][13][14] From a technical skill and equipment perspective, soft-tissue coverage procedures can be performed effectively in lowresource settings. 15,16 A substantial deficit in the number of surgeons trained to manage soft tissue defects and prevent amputation has been documented in LMICs. 4,17,18 Opportunities to improve soft-tissue wound care and reduce disability-adjusted life years by providing increased flap reconstruction training or access to plastic surgery services have been suggested in the literature.…”

“…4,17,18 Opportunities to improve soft-tissue wound care and reduce disability-adjusted life years by providing increased flap reconstruction training or access to plastic surgery services have been suggested in the literature. 4,5,8,[14][15][16][17][18][19][20][21][22][23] Although surgical mission trips were devised to provide wound management care to trauma patients in LMICs, the mission-based model has been criticized for its lack of sustainability because volunteers can only provide surgical services for a finite period of time. [7][8][9][10] In response to criticism, recent publications have outlined guidelines for the plastic surgery community to deliver ethical and quality care in resource-poor settings.…”

Ethical Issues of Medical Missions: The Clinicians’ View

“…For instance, in Vietnam a 15 year continuing education program for microsurgery has helped local surgeons to master complex microsurgical techniques. Vietnam now has a cadre of surgeons very capable of performing these multifaceted surgical procedures (Merrell et al 2007). Also, in 2008, the continuing Physician Training Program brought 91 physicians, nurses, dentists and speech pathologists from 29 countries to Norfolk, Virginia, for 2 weeks of training.…”

Early experiences with microvascular free tissue transfer in Lagos, Nigeria

“…Virtually every specialty has benefited from this technique. [1] It circumvents the limitations of pedicle flaps where the arc of rotation may be restrained, as well as local flaps where local tissues may be have been compromised by previous surgery or irradiation. Free tissue transfer allows the provision of customized, well-vascularized, healthy tissues from distant sites.…”