Plastic Surgery Essentials for Students-Chapter 21: International Plastic Surgery

Chapter 21: International Plastic Surgery

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The chapter from "International Plastic Surgery" by Yemi Ogunleye, MD, SM, and Richard L. Agag, MD, discusses the global dimension of plastic surgery, emphasizing its roots and contemporary practice variations worldwide. Historically, plastic surgery dates back to ancient India's surgical practices around 800 BC. Over the past century, although there have been significant clinical and technological advances, their benefits have not been equitably distributed between developed and developing regions.<br /><br />In low and middle-income countries (LMICs), plastic surgery tends to focus on chronic wound care, burn treatment, and reconstructive procedures for congenital deformities. These services are often inadequate, especially for children, due to issues like poverty and insufficient surgical personnel.<br /><br />Efforts to mitigate these disparities include international plastic surgery outreach. Surgeons from the United States, alongside NGOs such as Operation Smile, Smile Train, and others, organize missions to LMICs, offering free surgical care. These initiatives aim to bridge care gaps, enhance local healthcare infrastructure, and foster self-sufficient surgical practices. They also help improve participants' clinical, cultural, and ethical competencies, although concerns about maintaining practice standards and cultural sensitivities persist.<br /><br />Key principles in delivering surgical care in resource-constrained settings include building local capacity, ensuring sustainability, and maintaining high standards. The "diagonal approach" to healthcare delivery, as proposed by Patel et al., encompasses these elements to provide broad-reaching benefits.<br /><br />Education and training are integral to these efforts, with surgical trainees participating in missions and residency programs incorporating international rotations to expose residents to diverse medical challenges. Further educational opportunities are available through global surgery fellowships, focusing on continued clinical and research training in plastic surgery within international contexts. These efforts help evolve plastic and reconstructive surgery's role in global health, aiming to reconstruct and improve surgical care access worldwide.

Keywords

plastic surgery

global health

surgical outreach

LMICs

reconstructive surgery

chronic wound care

capacity building

medical missions

surgical education

international rotations