Do Hernia Operations in African International Cooperation Programmes Provide Good Quality?

Gil, José; Rodrı́guez, José Manuel; Hernández, Quiteria; Gilman, Elena; Balsalobre, María; González, Maraelys Morales; Torregrosa, Nuria; Verdú, T.; Alcaraz, M; P, Parrilla Paricio

doi:10.1007/s00268-012-1768-9

Cited by 35 publications

(29 citation statements)

References 40 publications

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“…Of 4,100 operations for cleft lip and palate by 1 organization in 40 simultaneous sites, for example, only 703 patients (17 %) returned for a 6- to 9-month postoperative visit [19]. Similarly, in a Spanish-African cooperation program for the repair of hernias, follow-up was 21 % [16]. …”

Section: Resultsmentioning

confidence: 99%

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Charitable Platforms in Global Surgery: A Systematic Review of their Effectiveness, Cost‐Effectiveness, Sustainability, and Role Training

2014

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ObjectiveThis study was designed to propose a classification scheme for platforms of surgical delivery in low- and middle-income countries (LMICs) and to review the literature documenting their effectiveness, cost-effectiveness, sustainability, and role in training. Approximately 28 % of the global burden of disease is surgical. In LMICs, much of this burden is borne by a rapidly growing international charitable sector, in fragmented platforms ranging from short-term trips to specialized hospitals. Systematic reviews of these platforms, across regions and across disease conditions, have not been performed.MethodsA systematic review of MEDLINE and EMBASE databases was performed from 1960 to 2013. Inclusion and exclusion criteria were defined a priori. Bibliographies of retrieved studies were searched by hand. Of the 8,854 publications retrieved, 104 were included.ResultsSurgery by international charitable organizations is delivered under two, specialized hospitals and temporary platforms. Among the latter, short-term surgical missions were the most common and appeared beneficial when no other option was available. Compared to other platforms, however, worse results and a lack of cost-effectiveness curtailed their role. Self-contained temporary platforms that did not rely on local infrastructure showed promise, based on very few studies. Specialized hospitals provided effective treatment and appeared sustainable; cost-effectiveness evidence was limited.ConclusionsBecause the charitable sector delivers surgery in vastly divergent ways, systematic review of these platforms has been difficult. This paper provides a framework from which to study these platforms for surgery in LMICs. Given the available evidence, self-contained temporary platforms and specialized surgical centers appear to provide more effective and cost-effective care than short-term surgical mission trips, except when no other delivery platform exists.

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Section: Resultsmentioning

confidence: 99%

“…Finally, teams that aim to establish residency or training programs have yet to publish enough of their outcomes to be evaluated. The few papers that have been published are, however, promising [16, 17]. …”

Section: Introductionmentioning

confidence: 99%

Charitable Platforms in Global Surgery: A Systematic Review of their Effectiveness, Cost‐Effectiveness, Sustainability, and Role Training

2014

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“…Of the groups we analyzed all (100%) reported that patients were evaluated preoperatively. However, one paper describes how the preoperative evaluation consisted of only vitals and a glucometer [54]. Many papers simply did not specify the nature of their evaluations.…”

Section: Selection Preoperative Evaluation and Preparationmentioning

confidence: 99%

“…However, it still stands that the community of surgical STMMs is largely underrepresented in the literature as previously discussed. At the moment, we expect that those surgical STMMs who are not writing papers for publication are using a quantitative rather than qualitative measure of success, the aforementioned "body count method" [11,54]. Small surgical STMM organizations are not exposed to the scrutiny that medical mission moguls such as Operation Smile and Médecins Sans Frontières must face on the international stage [9].…”

Section: Outcome Measuresmentioning

confidence: 99%

“…Although this rate was not ideal, it still provided sufficient information to implement quality improvement measures [61]. Other smaller groups have achieved a ~21% return rate, which however small, is at least promising in intention [54]. Perhaps the patients did not return because they had no complications, or perhaps they had a complication and had lost trust in the visiting surgeons.…”

Section: Postoperative Follow-up and Complication Managementmentioning

confidence: 99%

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Designing a set of safety standards for surgical short term medical missions

Wagner¹,

Schwaitzberg²,

Shah³

et al. 2017

Glob Surg

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The global burden of surgical disease is on the rise. In underserved areas this need is being increasingly met by surgical short-term medical missions (STMMs). However, access to safe surgical care is still of great concern to global health advocates. We sought to evaluate the current safety practices and outcomes of surgical care being provided by STMMs. We looked at 35 primary research papers from surgical STMMs between 1991-2016 and analyzed their documentation of safety standards and follow up procedures. This led us to two important conclusions: 1 -surgical STMM practices and outcomes are not well documented and 2 -there is a need for standardized safety guidelines when participating in surgical STMMs. Here we introduce an actionable set of international surgical safety standards that we invite all short-term surgeons and groups to utilize as a means of setting a foundation for the practice of safe surgery on mission trips.

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Global Outreach Using a Systematic, Competency-Based Training Paradigm for Inguinal Hernioplasty

et al. 2017

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Do Hernia Operations in African International Cooperation Programmes Provide Good Quality?

Abstract: The standard quality of surgery for the treatment of hernia in developing countries with few instrumental means, and in sub-optimal surgical conditions is similar to that provided in Spain.

Cited by 35 publications

References 40 publications

Charitable Platforms in Global Surgery: A Systematic Review of their Effectiveness, Cost‐Effectiveness, Sustainability, and Role Training

Charitable Platforms in Global Surgery: A Systematic Review of their Effectiveness, Cost‐Effectiveness, Sustainability, and Role Training

Designing a set of safety standards for surgical short term medical missions

Global Outreach Using a Systematic, Competency-Based Training Paradigm for Inguinal Hernioplasty

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