Building Sustainable Reconstructive Microsurgery in Countries with Limited Resources: The Rwandan Experience

Background:. Reconstructive microsurgery practice has been well adopted in developed countries, but this has not been the same in low- and middle-income countries (LMICs). Injuries related to road traffic accidents are highest in these countries, with 93% of the world's fatalities on the roads...

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Main Authors: Ian Shyaka, MD, Yves Nezerwa, MD, Francoise Mukagaju, MD, Rushil R. Dang, BDS, DMD, Charles Furaha, MD, Faustin Ntirenganya, MD, PhD
Format: Article
Language:English
Published: Wolters Kluwer 2023-10-01
Series:Plastic and Reconstructive Surgery, Global Open
Online Access:http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000005332
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author Ian Shyaka, MD
Yves Nezerwa, MD
Francoise Mukagaju, MD
Rushil R. Dang, BDS, DMD
Charles Furaha, MD
Faustin Ntirenganya, MD, PhD
author_facet Ian Shyaka, MD
Yves Nezerwa, MD
Francoise Mukagaju, MD
Rushil R. Dang, BDS, DMD
Charles Furaha, MD
Faustin Ntirenganya, MD, PhD
author_sort Ian Shyaka, MD
collection DOAJ
description Background:. Reconstructive microsurgery practice has been well adopted in developed countries, but this has not been the same in low- and middle-income countries (LMICs). Injuries related to road traffic accidents are highest in these countries, with 93% of the world's fatalities on the roads occurring in LMICs. The objective of this study was to highlight the need for sustainable microsurgery in LMICs and share strategies undertaken in Rwanda. Methods:. We review the contemporary literature about the needs and challenges facing reconstructive microsurgery in LMICs. We describe the strategies undertaken in Rwanda towards developing microsurgery. We also report the outcomes of the first ever microsurgery visiting professorship organized in the country and the steps taken towards achieving sustainable microsurgery practice in Rwanda. Results:. There is a huge unmet need for reconstructive microsurgery in LMICs. Most of the microsurgical operations in these countries are done in short term surgical mission setups. No data focusing on sustaining reconstructive microsurgery in LMICs has been described in the contemporary literature. There is a 2.5-fold increase in the number of trained plastic surgeons in Rwanda over the past 5 years, with increasing skills in microsurgery and opportunities for formal overseas fellowships. Conclusion:. With dedicated local champions, a comprehensive approach, and reliable partners, establishing sustainable microsurgery services is possible in countries with limited resources. In our experience, the fly-in-fly-out microsurgical missions aimed at mainly providing surgical care to patients seem to have a limited long-term impact and sustainability. We recommend integrating these missions into planned microsurgical initiatives of pre-existing local plastic surgery training programs.
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spelling doaj.art-19a8cdca7bcc41eba4b3a82d2a9a115f2023-10-30T03:42:32ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742023-10-011110e533210.1097/GOX.0000000000005332202310000-00028Building Sustainable Reconstructive Microsurgery in Countries with Limited Resources: The Rwandan ExperienceIan Shyaka, MD0Yves Nezerwa, MD1Francoise Mukagaju, MD2Rushil R. Dang, BDS, DMD3Charles Furaha, MD4Faustin Ntirenganya, MD, PhD5From the * Department of Plastic Surgery, Rwanda Military Hospital, Kigali, RwandaFrom the * Department of Plastic Surgery, Rwanda Military Hospital, Kigali, Rwanda‡ Department of Plastic Surgery, King Faisal Hospital, Kigali, Rwanda† Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung University and Medical College, Taoyuan, TaiwanFrom the * Department of Plastic Surgery, Rwanda Military Hospital, Kigali, Rwanda§ Department of Plastic Surgery, University Teaching Hospital of Kigali (CHUK), Kigali, RwandaBackground:. Reconstructive microsurgery practice has been well adopted in developed countries, but this has not been the same in low- and middle-income countries (LMICs). Injuries related to road traffic accidents are highest in these countries, with 93% of the world's fatalities on the roads occurring in LMICs. The objective of this study was to highlight the need for sustainable microsurgery in LMICs and share strategies undertaken in Rwanda. Methods:. We review the contemporary literature about the needs and challenges facing reconstructive microsurgery in LMICs. We describe the strategies undertaken in Rwanda towards developing microsurgery. We also report the outcomes of the first ever microsurgery visiting professorship organized in the country and the steps taken towards achieving sustainable microsurgery practice in Rwanda. Results:. There is a huge unmet need for reconstructive microsurgery in LMICs. Most of the microsurgical operations in these countries are done in short term surgical mission setups. No data focusing on sustaining reconstructive microsurgery in LMICs has been described in the contemporary literature. There is a 2.5-fold increase in the number of trained plastic surgeons in Rwanda over the past 5 years, with increasing skills in microsurgery and opportunities for formal overseas fellowships. Conclusion:. With dedicated local champions, a comprehensive approach, and reliable partners, establishing sustainable microsurgery services is possible in countries with limited resources. In our experience, the fly-in-fly-out microsurgical missions aimed at mainly providing surgical care to patients seem to have a limited long-term impact and sustainability. We recommend integrating these missions into planned microsurgical initiatives of pre-existing local plastic surgery training programs.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000005332
spellingShingle Ian Shyaka, MD
Yves Nezerwa, MD
Francoise Mukagaju, MD
Rushil R. Dang, BDS, DMD
Charles Furaha, MD
Faustin Ntirenganya, MD, PhD
Building Sustainable Reconstructive Microsurgery in Countries with Limited Resources: The Rwandan Experience
Plastic and Reconstructive Surgery, Global Open
title Building Sustainable Reconstructive Microsurgery in Countries with Limited Resources: The Rwandan Experience
title_full Building Sustainable Reconstructive Microsurgery in Countries with Limited Resources: The Rwandan Experience
title_fullStr Building Sustainable Reconstructive Microsurgery in Countries with Limited Resources: The Rwandan Experience
title_full_unstemmed Building Sustainable Reconstructive Microsurgery in Countries with Limited Resources: The Rwandan Experience
title_short Building Sustainable Reconstructive Microsurgery in Countries with Limited Resources: The Rwandan Experience
title_sort building sustainable reconstructive microsurgery in countries with limited resources the rwandan experience
url http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000005332
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