Plastic Surgery—Myths and Realities in Developing Countries: Experience from Eastern Nepal

Abstract

B.P. Koirala Institute of Health Sciences, Dharan, Nepal, is the only tertiary care referral centre in the eastern region of Nepal. This paper discusses the author's experience of starting a plastic surgery unit in eastern Nepal regarding need and present status of plastic surgery care in Nepal. Methods. We analyzed the data of patients treated in Plastic surgery unit from July 2007 to February 2009. We did evaluation regarding type of patients, procedures, and their outcome. We also evaluated the limitations and their possible solutions to overcome the barriers to establish effective plastic surgical centers in developing countries. Results. Plastic surgery services were started as a unit in general surgery by single plastic surgeon and one general surgery resident on rotation. Total 848 patients were treated for different plastic-surgery-related conditions, which included 307 acute burn patients 541 general plastic surgery patients. Trauma constituted the major bulk 22%, followed by tumors 20%, while aesthetic surgery operations were only 10.1%. Conclusions. In developing countries, aesthetic procedures constitute very small part of plastic surgery interventions and plastic surgery units are primarily required for reconstructive needs for optimum management of patients.

Barriers to Performing Soft Tissue Reconstruction Procedures among Orthopedic Surgeons in Low- and Middle-income Countries: Results of a Surgical Skills Training Course

“…13,14 Thus, there has been a subsequent call for plastic and orthopedic surgeons from high-income countries to engage in soft tissue coverage procedure training for surgeons in LMICs. 7,15,16 The advent of ortho-plastic surgery and its subsequent success may represent a possible solution for addressing the surgical disease burden. 17,18 Training orthopedic surgeons in locations where plastic surgeons are not readily available may be an effective intervention for scaling patient access to soft tissue coverage procedures in LMICs.…”

The characteristics of private plastic surgery practice in developing country: An epidemiological study

“…Studies in Eastern Nepal and Zambia found that only 0,1%–10% of plastic surgery procedure was done for a solely cosmetic purpose. [419] However, the studies did not further specify the type of procedure. This finding is in contrast with data from other developing nations such as Brazil and Colombia.…”

“…Earlier medical reports showed that plastic surgery practices in developing countries were still focussing on the unmet-need for reconstructive purposes in severe trauma, advanced malignancies, burn contractures and congenital deformities cases. [34] However, research in International Studies found evidence for globalisation of aesthetic plastic surgery that caused its increasing demand in several other developing countries such as Brazil, Russia, India and China. The reasons behind this normalisation and cultural habituation were Western world's interest in the global market, which led to its higher than ever influences to third-world countries; booming capitalist economy; a new trend of hyper-consumerism; emerging beauty industry and pageants and the dominance of youth culture, which is focusing on achieving modernity.…”

Knowledge deficits and barriers to performing soft-tissue coverage procedures: An analysis of participants in an orthopaedic surgical skills training course in Mexico

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