Introduction of microsurgery in Vietnam by a charitable organization: a 15-year experience.
BACKGROUND
Microsurgical procedures, although equipment- and labor-intensive, allow efficient treatment of selected soft-tissue, bone, and peripheral nerve defects. The precise surgical skills required and the high equipment and institutional costs have been deterrents to initiating programs in developing countries. The authors report their 15-year international effort in facilitating the development of microsurgical techniques in Vietnam.


METHODS
The authors reviewed their educational, logistical, and operative experience from 11 Operation Smile International missions to Vietnam and the microsurgical procedures performed independently by Vietnamese surgeons at the Central Military Hospital 108 in Hanoi.


RESULTS
Over 15 years, Operation Smile International missions to Vietnam performed 108 free tissue transfer operations with 15 peripheral nerve transfer procedures and 143 nonmicrosurgical reconstructive operations. Visiting surgeons with specialized expertise taught facial reanimation, flap prefabrication, and perforator flaps. During this same period, Vietnamese surgeons became facile with microsurgical techniques and independently performed a wide array of these procedures in the institutions visited. Vietnamese surgeons have organized microsurgery divisions within some hospital departments and now teach microsurgical techniques. Repeated missions allowed for patient follow-up, staged procedures, educational exchange, and quality control. Several Vietnamese surgeons have traveled abroad to obtain additional training and have set up training programs in other areas of Vietnam.


CONCLUSIONS
Charitable organizations can help surgeons in developing countries master complex microsurgical techniques through short-term medical missions, donation of equipment and supplies, and the encouragement of institutional support. A continuing education program, including local conferences, microsurgical laboratory training facilities, and study abroad, can aid this introduction.
Merrell
J Craig
JC
Hanoi, Vietnam; Springfield, Ill.; Toronto, Ontario, Canada; Taipei, Taiwan; and Boston, Mass. From Military Hospital 108; Southern Illinois University; Toronto General Hospital; Chang Gung Memorial Hospital; and Brigham and Women's Hospital, Harvard Medical School.
Tien
Nguyen Viet
NV
Son
Nguyen Tai
NT
An
Luu Ngoc
LN
Sellers
Daniel
D
Russell
Robert
R
Manktelow
Ralph
R
Wei
Fu-Chan
FC
Orgill
Dennis P
DP
D002983:Clinical Competence; D005260:Female; D006772:Hospitals, Military; D006801:Humans; D007391:International Cooperation; D008297:Male; D008493:Medical Missions / Q000458:organization & administration*; D008866:Microsurgery / Q000193:education / Q000379:methods*; D009939:Organizations, Nonprofit; D016730:Program Development; D015397:Program Evaluation; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D016038:Skin Transplantation / Q000193:education / Q000379:methods; D013524:Surgical Flaps; D014744:Vietnam