Resumption of Short-term Burn Reconstruction Missions to Ukraine in Light of COVID-19: A Paradigm Shift

Abstract

The COVID-19 pandemic has disrupted the lives of billions of people globally. Some medical systems continue to be overburdened due to the viral illness leading to incredible public health challenges domestically as well as abroad. However, with vaccination distribution increasing globally, many are pushing for a return to some form of normalcy. In the medical community, some are weighing the risks of returning to global health missions and considering protective strategies to minimize risk of viral spread. Here we describe our experience in returning to an annual burn reconstruction mission in a low- and middle-income country. We have successfully carried out a return surgical mission trip. Our team of ten individuals was able to perform over 75 procedures on 25 pediatric patients in four operative days. We applied a variety of protective strategies and altered mission protocol to limit exposure and transmission risk while focusing heavily on education and training Additionally, we increased the use of telemedicine and eliminated typical in person clinic visits. We increased operative complexity to increase impact while limiting patient exposure. Rigorous perioperative safety and follow-up protocols were implemented. The increased use of telemedicine, reduction of in person visits, emphasis on education, and implementation of safety and follow-up protocols have led to an improvement in efficiency, safety, and accountability. Our adaptations have provided guidance on responsibly resuming surgical outreach missions, with changes that are likely to endure beyond the COVID-19 pandemic.

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

“…From the perspective of staff surgeons, the advantages of participating as a resident included learning surgical skills faster by working on a high volume in a short period of time and seeing unique pathologies 26 . Both foreign and local residents could be successfully incorporated into the mission’s surgical team, thus benefitting a diagonal approach 27 . From the perspective of a senior resident on the mission, working with limited resources and on a high volume of cases, all while adapting to a new culture were only some of the many perks of participating.…”

“…26 Both foreign and local residents could be successfully incorporated into the mission's surgical team, thus benefitting a diagonal approach. 27 From the perspective of a senior resident on the mission, working with limited resources and on a high volume of cases, all while adapting to a new culture were only some of the many perks of participating. The author thus argues these missions have an integral role to play in modern surgical training.…”

Adverse reactions to cosmetic implants after COVID‐19 vaccination: A literature review

“…With waves of new variants emerging, 28–35 of which the omicron variant carries about 50 mutations not seen in combination before (World Health Organization 2021), 36–40 new vaccines may formulate. It generates the discussion of the need to continue booster doses indefinitely, which will inevitably increase the risk of DIRs in patients with implants 41 …”

“…[17][18][19] As for the time to onset of complications after vaccination, it may depend on the type and dose of vaccine, immune status, history of COVID-19 pneumonia, and comorbidities. [20][21][22][23][24][25][26][27] With waves of new variants emerging, [28][29][30][31][32][33][34][35] of which the omicron variant carries about 50 mutations not seen in combination before (World Health Organization 2021), [36][37][38][39][40] new vaccines may formulate. It generates the discussion of the need to continue booster doses indefinitely, which will inevitably increase the risk of DIRs in patients with implants.…”

The war in Ukraine: the invasion of genocide

“…Children are innocent victims of wars. 22,25 Fel et al 26 studied a group of Ukrainian civilians during this war and found that the most important predictors for the development of post-traumatic stress disorder (PTSD) were loss of a loved one, place of residence, gender, continued education and health insurance. These authors found that having children is associated with a risk of more severe PTSD and that material security reduces PTSD, but only among people who do not have children.…”