Soft Tissue Coverage at the Resource-challenged Facility

Nguyen, Tuan Anh

doi:10.1007/s11999-008-0386-1

Cited by 7 publications

(5 citation statements)

References 2 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…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.…”

Section: Introductionmentioning

confidence: 99%

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

Holler

Albright²,

Challa³

et al. 2019

Plastic and Reconstructive Surgery - Global Open

View full text Add to dashboard Cite

Background:Appropriate management of soft tissue injury associated with orthopedic trauma is challenging in low- and middle-income countries (LMICs) due to the lack of available reconstructive surgeons. The Surgical Management and Reconstructive Training (SMART) course teaches orthopedic surgeons reconstructive techniques aimed at improving soft tissue management. This study aims to identify additional barriers to implementing these techniques for surgeons in LMICs who have attended SMART courses.Methods:This is a mixed-methods study including a Likert-scale-based survey administered to 150 surgeons from LMICs attending the 2018 SMART courses in Tanzania and San Francisco and key informant interviews with 20 surgeons who perform soft tissue coverage procedures.Results:In surveys, respondents reported inadequate local plastic surgeon availability for lower extremity fracture requiring muscle flaps (88%). Surgeons agreed that flap surgeries are important for patients with significant soft tissue injury following open fractures (97%). They reported inadequate access to instruments, such as dermatomes (59%) and Humby knives (32%), and senior-level support (31%). Fewer than half of surgeons with flap experience (n = 85) felt confident in training peers (45%). In interviews, delays in returning patients to operating rooms were frequently cited as a barrier (90%).Conclusions:Our study demonstrates that soft tissue procedures are perceived as a high priority among orthopedic surgeons, but there are multiple barriers, including a lack of plastic surgeons, and many modifiable barriers including a lack of surgical equipment, peer training, and senior colleague support.

show abstract

Section: Introductionmentioning

confidence: 99%

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

Holler

Albright²,

Challa³

et al. 2019

Plastic and Reconstructive Surgery - Global Open

View full text Add to dashboard Cite

show abstract

“…Based on those anatomy characteristics, we can design many kinds of distally based pedicle flaps to cover the ankle and Achilles tendon (fasciocutaneous flaps, perforator flaps, septocutaneous flaps). 3 – 5 The sural flap, a neurocutaneous flap, 2 , 5 is based on blood vessels accompanied by the sural nerve and can be used like distally based pedicle flaps for the same purpose. However, the pivot point of the flap must not be lower than three fingers width from the lateral malleolus (safe area).…”

Section: Discussionmentioning

confidence: 99%

“…We usually reserve a strip of skin at the middle of the pedicle 5 for the following reasons: to save skin, reduce pressure and tension on the pedicle during closure, and avoid injury to the vessel network of the flap. The donor site can then be closed with little mobility, or disruption to the area (Fig.…”

Section: Discussionmentioning

confidence: 99%

Using Medial Fasciocutaneous Flap to Reconstruct Tissue Defect at Achilles Tendon Area

Nguyen

Duong

et al. 2021

Plastic and Reconstructive Surgery - Global Open

Self Cite

View full text Add to dashboard Cite

Summary: A 49-year-old man presented with skin necrosis and soft tissue defects at the right Achilles tendon area after tendon rupture repair. The posterior tibial artery was also damaged. We performed a reconstruction using a medial fasciocutaneous flap (and distally based pedicle). After 2 weeks, the wound healed, and the tissue defect was overcome. We found that the medial fasciocutaneous flap at the posterior leg can be raised easily and can be a simple choice to resolve tissue defects in the Achilles tendon area. This type of flap can help reconstruct tissue defects in acute wounds early.

show abstract

“…[12][13][14] From a technical skill and equipment perspective, soft-tissue coverage procedures can be performed effectively in lowresource settings. 15,16 A substantial deficit in the number of surgeons trained to manage soft tissue defects and prevent amputation has been documented in LMICs. 4,17,18 Opportunities to improve soft-tissue wound care and reduce disability-adjusted life years by providing increased flap reconstruction training or access to plastic surgery services have been suggested in the literature.…”

Section: Introductionmentioning

confidence: 99%

“…4,17,18 Opportunities to improve soft-tissue wound care and reduce disability-adjusted life years by providing increased flap reconstruction training or access to plastic surgery services have been suggested in the literature. 4,5,8,[14][15][16][17][18][19][20][21][22][23] Although surgical mission trips were devised to provide wound management care to trauma patients in LMICs, the mission-based model has been criticized for its lack of sustainability because volunteers can only provide surgical services for a finite period of time. [7][8][9][10] In response to criticism, recent publications have outlined guidelines for the plastic surgery community to deliver ethical and quality care in resource-poor settings.…”

Section: Introductionmentioning

confidence: 99%

Surgical Management and Reconstruction Training (SMART) Course for International Orthopedic Surgeons

Patel

Caldwell

et al. 2016

Annals of Global Health

View full text Add to dashboard Cite

The SMART Course can give orthopedic surgeons in LMICs the skills and knowledge to successfully perform flaps, reducing the self-reported incidence of amputations. Course participants were able to disseminate flap reconstructive techniques to colleagues at their home institution. While this course offers a collaborative, sustainable approach to reduce global surgical disparities in amputation, future investigation into the viability of teaching the SMART course in LMICs is warranted.

show abstract

Soft Tissue Coverage at the Resource-challenged Facility

Cited by 7 publications

References 2 publications

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

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

Using Medial Fasciocutaneous Flap to Reconstruct Tissue Defect at Achilles Tendon Area

Surgical Management and Reconstruction Training (SMART) Course for International Orthopedic Surgeons

Contact Info

Product

Resources

About