Achieving microsurgery missions in Kenya—a 6-year experience of a non-governmental organization

Abstract

Background Microsurgery has enormously expanded the possibilities of reconstructive plastic surgery in the modern era. However, there is a vast difference in its spreading and utilization between developed and developing countries. Microsurgery missions can play a significant role in the evolution of reconstructive microsurgery in developing countries. We present our 6-year experience in a rural hospital in Kenya. Methods The humanitarian missions consisted of 19 consecutive visits to North Kinangop Catholic Hospital (Kenya) between 2014 and 2020. Every mission team consisted of a plastic surgery specialist with more than 10 years of experience and a final-year plastic surgery resident. All missions were organized and coordinated by a nonprofit organization alongside the Clinic of Plastic and Reconstructive Surgery of the University of Padova, Italy. Results During all missions, our plastic surgery teams evaluated a total of 749 patients, performed a total of 595 outpatient visits, and gave a total of 83 inpatient consultations. Among all surgical procedures performed, 17 were microsurgeries: six free flaps, one hand replantation, and ten propeller flaps. We experienced few complications and a success rate of 82%. Conclusions Our 6-year experience demonstrates that it is possible to safely carry out microsurgery procedures with local staff help and coordination. We believe that our missions are a real practical example of how foreign expertise can make local surgery evolve to perform safe microsurgery, even in a low-experience setting such as that of most developing countries. The education of local staff is crucial for the outcome of such missions. Level of Evidence: Level IV, risk / prognostic study Keywords Microsurgery • Free tissue flaps • Medical mission • Nonprofit organization • Eastern Africa