Ensuring Racial and Ethnic Inclusivity in Facial Vascularized Composite Allotransplantation
Background:. Facial vascularized composite allotransplantation (fVCA) represents a valuable surgical option for reconstruction of the most devastating facial defects. There is a mounting body of evidence suggesting that healthcare disparities exist for a variety of other surgical and nonsurgical pro...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer
2023-08-01
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| Series: | Plastic and Reconstructive Surgery, Global Open |
| Online Access: | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000005178 |
| _version_ | 1797732733834756096 |
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| author | Martin Kauke-Navarro, MD Leonard Knoedler Samuel Knoedler Fortunay Diatta, MD Lioba Huelsboemer, MD Viola A. Stoegner, MD Vikram G. Mookerjee, MD Adriana C. Panayi, MD Paris D. Butler, MD, MPH Bohdan Pomahac, MD |
| author_facet | Martin Kauke-Navarro, MD Leonard Knoedler Samuel Knoedler Fortunay Diatta, MD Lioba Huelsboemer, MD Viola A. Stoegner, MD Vikram G. Mookerjee, MD Adriana C. Panayi, MD Paris D. Butler, MD, MPH Bohdan Pomahac, MD |
| author_sort | Martin Kauke-Navarro, MD |
| collection | DOAJ |
| description | Background:. Facial vascularized composite allotransplantation (fVCA) represents a valuable surgical option for reconstruction of the most devastating facial defects. There is a mounting body of evidence suggesting that healthcare disparities exist for a variety of other surgical and nonsurgical procedures. We aimed to investigate the potential existence of racial and ethnic disparities in the field of fVCA.
Methods:. A comprehensive literature review was conducted by the authors of this review on PubMed/MEDLINE, and Embase databases from database inception to December 1, 2022 for studies published in the English and French languages. The search terms were (1) “face” OR “facial” AND (2) “transplant” OR “VCA” OR “vascularized composite allotransplantation” OR “vascularized composite allograft” OR “graft.”
Results:. Upon assessment of the racial and ethnic demographics of the 47 global cases of fVCA between 2005 and 2020, 36 were White, 10 were Asian, and one was Black. Sixteen of the 17 fVCA procedures performed in the United States involved White patients. The other patient self-identified as Black, equaling 6% of all US fVCA recipients.
Conclusion:. Our analysis showed that the ethnic and racial distribution of fVCA has not proportionally reflected the racial and ethnic demographics of the general US population, underscoring the risk of such healthcare imbalances. Although large-scale studies are needed before drawing definitive conclusions, leaders in the field should take preventive steps to avoid potential disparities. Further investigations into the factors that facilitate or prohibit access to fVCA referral and surgery will be necessary moving forward. |
| first_indexed | 2024-03-12T12:18:51Z |
| format | Article |
| id | doaj.art-8db5006d00b349249d97586c2f3395e9 |
| institution | Directory Open Access Journal |
| issn | 2169-7574 |
| language | English |
| last_indexed | 2024-03-12T12:18:51Z |
| publishDate | 2023-08-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Plastic and Reconstructive Surgery, Global Open |
| spelling | doaj.art-8db5006d00b349249d97586c2f3395e92023-08-30T06:13:50ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742023-08-01118e517810.1097/GOX.0000000000005178202308000-00023Ensuring Racial and Ethnic Inclusivity in Facial Vascularized Composite AllotransplantationMartin Kauke-Navarro, MD0Leonard Knoedler1Samuel Knoedler2Fortunay Diatta, MD3Lioba Huelsboemer, MD4Viola A. Stoegner, MD5Vikram G. Mookerjee, MD6Adriana C. Panayi, MD7Paris D. Butler, MD, MPH8Bohdan Pomahac, MD9From the * Division of Plastic Surgery, Department of Surgery, Yale New Haven Hospital, Yale School of Medicine, New Haven, Conn.From the * Division of Plastic Surgery, Department of Surgery, Yale New Haven Hospital, Yale School of Medicine, New Haven, Conn.‡ Department of Plastic Surgery and Hand Surgery, Technical University of Munich, Munich, GermanyFrom the * Division of Plastic Surgery, Department of Surgery, Yale New Haven Hospital, Yale School of Medicine, New Haven, Conn.From the * Division of Plastic Surgery, Department of Surgery, Yale New Haven Hospital, Yale School of Medicine, New Haven, Conn.From the * Division of Plastic Surgery, Department of Surgery, Yale New Haven Hospital, Yale School of Medicine, New Haven, Conn.From the * Division of Plastic Surgery, Department of Surgery, Yale New Haven Hospital, Yale School of Medicine, New Haven, Conn.§ Department of Surgery, Division of Plastic Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, Mass.From the * Division of Plastic Surgery, Department of Surgery, Yale New Haven Hospital, Yale School of Medicine, New Haven, Conn.From the * Division of Plastic Surgery, Department of Surgery, Yale New Haven Hospital, Yale School of Medicine, New Haven, Conn.Background:. Facial vascularized composite allotransplantation (fVCA) represents a valuable surgical option for reconstruction of the most devastating facial defects. There is a mounting body of evidence suggesting that healthcare disparities exist for a variety of other surgical and nonsurgical procedures. We aimed to investigate the potential existence of racial and ethnic disparities in the field of fVCA. Methods:. A comprehensive literature review was conducted by the authors of this review on PubMed/MEDLINE, and Embase databases from database inception to December 1, 2022 for studies published in the English and French languages. The search terms were (1) “face” OR “facial” AND (2) “transplant” OR “VCA” OR “vascularized composite allotransplantation” OR “vascularized composite allograft” OR “graft.” Results:. Upon assessment of the racial and ethnic demographics of the 47 global cases of fVCA between 2005 and 2020, 36 were White, 10 were Asian, and one was Black. Sixteen of the 17 fVCA procedures performed in the United States involved White patients. The other patient self-identified as Black, equaling 6% of all US fVCA recipients. Conclusion:. Our analysis showed that the ethnic and racial distribution of fVCA has not proportionally reflected the racial and ethnic demographics of the general US population, underscoring the risk of such healthcare imbalances. Although large-scale studies are needed before drawing definitive conclusions, leaders in the field should take preventive steps to avoid potential disparities. Further investigations into the factors that facilitate or prohibit access to fVCA referral and surgery will be necessary moving forward.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000005178 |
| spellingShingle | Martin Kauke-Navarro, MD Leonard Knoedler Samuel Knoedler Fortunay Diatta, MD Lioba Huelsboemer, MD Viola A. Stoegner, MD Vikram G. Mookerjee, MD Adriana C. Panayi, MD Paris D. Butler, MD, MPH Bohdan Pomahac, MD Ensuring Racial and Ethnic Inclusivity in Facial Vascularized Composite Allotransplantation Plastic and Reconstructive Surgery, Global Open |
| title | Ensuring Racial and Ethnic Inclusivity in Facial Vascularized Composite Allotransplantation |
| title_full | Ensuring Racial and Ethnic Inclusivity in Facial Vascularized Composite Allotransplantation |
| title_fullStr | Ensuring Racial and Ethnic Inclusivity in Facial Vascularized Composite Allotransplantation |
| title_full_unstemmed | Ensuring Racial and Ethnic Inclusivity in Facial Vascularized Composite Allotransplantation |
| title_short | Ensuring Racial and Ethnic Inclusivity in Facial Vascularized Composite Allotransplantation |
| title_sort | ensuring racial and ethnic inclusivity in facial vascularized composite allotransplantation |
| url | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000005178 |
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