Barriers to Performing Soft Tissue Reconstruction Procedures among Orthopedic Surgeons in Low- and Middle-income Countries: Results of a Surgical Skills Training Course
| العنوان: | Barriers to Performing Soft Tissue Reconstruction Procedures among Orthopedic Surgeons in Low- and Middle-income Countries: Results of a Surgical Skills Training Course |
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| المؤلفون: | Syed H. Ali, David W. Shearer, Jordan T. Holler, Sravya Challa, Kari A. Keys, Patrick D Albright, Michael J. Terry, Deborah B. Martins |
| المصدر: | Plastic and Reconstructive Surgery, Global Open, Vol 7, Iss 10, p e2420 (2019) Plastic and Reconstructive Surgery Global Open |
| بيانات النشر: | Wolters Kluwer, 2019. |
| سنة النشر: | 2019 |
| مصطلحات موضوعية: | medicine.medical_specialty, business.industry, General surgery, Training course, lcsh:Surgery, Soft tissue, lcsh:RD1-811, 030230 surgery, medicine.disease, 03 medical and health sciences, Plastic surgery, 0302 clinical medicine, Low and middle income countries, 030220 oncology & carcinogenesis, Soft tissue reconstruction, Soft tissue injury, Orthopedic surgery, medicine, Surgical skills, Surgery, Original Article, business |
| الوصف: | 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. |
| اللغة: | English |
| تدمد: | 2169-7574 |
| DOI: | 10.1097/GOX.0000000000002420 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::978e365676ec601eaef02856ace8744e http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000002420 |
| Rights: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....978e365676ec601eaef02856ace8744e |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 21697574 |
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| DOI: | 10.1097/GOX.0000000000002420 |