The Plastic Surgery Workforce and Its Role in Low-income Countries

Abstract

Background: Plastic surgery varies in scope, especially in different settings. This study aimed to quantify the plastic surgery workforce in low-income countries (LICs), understand commonly treated conditions by plastic surgeons working in these settings, and assess the impact on reducing global disease burden. Methods: We queried national and international surgery societies, plastic surgery societies, and non-governmental organizations to identify surgeons living and working in LICs who provide plastic surgical care using a cross-sectional survey. Respondents reported practice setting, training experience, income sources, and perceived barriers to care. Surgeons ranked commonly treated conditions and reported which of the Disease Control Priorities-3 essential surgery procedures they perform. Results: An estimated 63 surgeons who consider themselves plastic surgeons were identified from 15 LICs, with no surgeons identified in the remaining 16 LICs. Responses were obtained from 43 surgeons (70.5%). The 3 most commonly reported conditions treated were burns, trauma, and cleft deformities. Of the 44 “Essential Surgical Package'' procedures, 37 were performed by respondents, with the most common being skin graft (73% of surgeons performing), cleft lip/palate repair (66%), and amputations/escharotomy (61%). The most commonly cited barrier to care was insufficient equipment. Only 9% and 5% of surgeons believed that there are enough plastic surgeons to handle the burden in their local region and country, respectively. Conclusions: Plastic surgery plays a significant role in the coverage of essential surgical conditions in LICs. Continued expansion of the plastic surgical workforce and accompanying infrastructure is critical to meet unmet surgical burden in low- and middle-income countries.

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

“…For example, 62% of domestic plastic surgeons state that traumarelated amputation is a top 3 most common surgery in lowincome nations. 6 Injuries from burns are also a common occurrence in LMICs, as many people use indoor fires for cooking and heating. Roughly 180 000 people die each year from burn-related injuries, and nearly 66% of those deaths occur in Africa and South East Asia.…”

“…20 Sixty-seven percent of domestic plastic surgeons who operate in low-income countries state that CLP surgery is one of the top 3 most practiced surgery in their area. 6…”

“…For example, 62% of domestic plastic surgeons state that trauma-related amputation is a top 3 most common surgery in low-income nations. 6…”

“…23 Sixty-seven percent of plastic surgeons from low-income countries state that burns are one of the most common cases they see. 6 For example, in Malawi, an estimated 1.5% to 9% of all injuries are burns and 4% to 15% in the pediatric population. 24…”

Thinking like a Lawyer—Human Rights and Their Association with the Plastic Surgeon of Today

“…The plastic surgeons of today are willing to face this responsibility; both in humanitarian deployment and in everyday clinical practice [4][5][6][7]. They handle a wide range of clinical problems from cleft lip and palate to trauma and burn injuries [8,9]. Jurisdiction gradually enters this field and creates legal principles, e.g., in preoperative outcome simulation, telemedicine, and digital patient-practitioner-communication [10][11][12].…”