Reconstructive surgery including free flap transfers can be performed in low-resource settings: experiences from a wartime scenario.
BACKGROUND
Severe wartime injuries often require microsurgical reconstruction or pedicle flap transfer. The aim of the study is to explore if such reconstructive surgery can be performed under low-resource conditions in a rural area.


METHODS
A clinical intervention study was performed at rural hospital in a war scenario in the Balkans.


RESULTS
Thirty-four patients underwent microsurgical postinjury reconstructions for land mine or blast injuries. Five different types of flaps were used. Three patients developed postoperative complications and was reoperated (8.3%, 95% CI 1.8-22.5%).


CONCLUSIONS
The actual intervention demonstrates that skilled surgical teams can perform advanced reconstructive surgery in low-resource settings. The experience is not only relevant for wartime scenarios, but also in civilian trauma where decentralization of microsurgical service may be feasible.
Tajsic
Nenad B
NB
Department of Orthopaedic and Trauma Surgery, University Hospital Northern Norway, Tromsoe, Norway.
Husum
Hans
H
D000293:Adolescent; D000328:Adult; D000671:Amputation, Surgical; D000673:Amputation, Traumatic / Q000601:surgery; D001753:Blast Injuries / Q000601:surgery*; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D002648:Child; D002921:Cicatrix / Q000601:surgery; D003906:Developing Countries; D005061:Europe, Eastern; D005260:Female; D018409:Foot Injuries / Q000601:surgery*; D006230:Hand Injuries / Q000601:surgery*; D006295:Health Resources; D006780:Hospitals, Rural; D006801:Humans; D007869:Leg Injuries / Q000601:surgery*; D023821:Limb Salvage; D008297:Male; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D008889:Military Personnel; D010019:Osteomyelitis / Q000601:surgery; D011183:Postoperative Complications / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000379:methods*; D012086:Reoperation; D012878:Skin Neoplasms / Q000601:surgery; D017695:Soft Tissue Injuries / Q000601:surgery*; D013524:Surgical Flaps / Q000098:blood supply* / Q000294:innervation*; D016896:Treatment Outcome; D014857:Warfare