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Hendriks TCC, Botman M, Rahmee CNS, et al. Impact of short-term reconstructive surgical missions: a systematic review. BMJ Glob Health. 2019;4(2):e001176doi: 10.1136/bmjgh-2018-001176.
Hendriks, T. C. C., Botman, M., Rahmee, C. N. S., Ket, J. C. F., Mullender, M. G., Gerretsen, B., Nuwass, E. Q., Marck, K. W., & Winters, H. A. H. (2019). Impact of short-term reconstructive surgical missions: a systematic review. BMJ global health, 4(2), e001176. https://doi.org/10.1136/bmjgh-2018-001176
Hendriks, Thom C C, et al. "Impact of short-term reconstructive surgical missions: a systematic review." BMJ global health vol. 4,2 (2019): e001176. doi: https://doi.org/10.1136/bmjgh-2018-001176
Hendriks TCC, Botman M, Rahmee CNS, Ket JCF, Mullender MG, Gerretsen B, Nuwass EQ, Marck KW, Winters HAH. Impact of short-term reconstructive surgical missions: a systematic review. BMJ Glob Health. 2019 Apr 03;4(2):e001176. doi: 10.1136/bmjgh-2018-001176. eCollection 2019. PMID: 31139438; PMCID: PMC6509599.
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BMJ Glob Health. 2019 Apr 03;4(2):e001176. doi: 10.1136/bmjgh-2018-001176. eCollection 2019.

Impact of short-term reconstructive surgical missions: a systematic review.

BMJ global health

Thom C C Hendriks, Matthijs Botman, Charissa N S Rahmee, Johannes C F Ket, Margriet G Mullender, Barend Gerretsen, Emanuel Q Nuwass, Klaas W Marck, Henri A H Winters

Affiliations

  1. Plastic, Reconstructive and Hand Surgery, VU Medisch Centrum, Amsterdam, The Netherlands.
  2. Global Surgery Amsterdam, Amsterdam, The Netherlands.
  3. Medical library, Vrije Universiteit, Amsterdam, The Netherlands.
  4. Koninklijk Instituut voor de Tropen, Amsterdam, The Netherlands.
  5. Department of Surgery, Haydom Lutheran Hospital, Haydom, Tanzania.
  6. Department of Plastic Surgery, Medisch Centrum Leeuwarden, Leeuwarden, The Netherlands.

PMID: 31139438 PMCID: PMC6509599 DOI: 10.1136/bmjgh-2018-001176

Abstract

INTRODUCTION: Short-term missions providing patients in low-income countries with reconstructive surgery are often criticised because evidence of their value is lacking. This study aims to assess the effectiveness of short-term reconstructive surgical missions in low-income and middle-income countries.

METHODS: A systematic review was conducted according to PRISMA guidelines. We searched five medical databases from inception up to 2 July 2018. Original studies of short-term reconstructive surgical missions were included, which reported data on patient safety measurements, health gains of individual patients and sustainability. Data were combined to generate overall outcomes, including overall complication rates.

RESULTS: Of 1662 identified studies, 41 met full inclusion criteria, which included 48 546 patients. The overall study quality according to Oxford CEBM and GRADE was low. Ten studies reported a minimum of 6 months' follow-up, showing a follow-up rate of 56.0% and a complication rate of 22.3%. Twelve studies that did not report on duration or follow-up rate reported a complication rate of 1.2%. Fifteen out of 20 studies (75%) that reported on follow-up also reported on sustainable characteristics.

CONCLUSIONS: Evidence on the patient outcomes of reconstructive surgical missions is scarce and of limited quality. Higher complication rates were reported in studies which explicitly mentioned the duration and rate of follow-up. Studies with a low follow-up quality might be under-reporting complication rates and overestimating the positive impact of missions. This review indicates that missions should develop towards sustainable partnerships. These partnerships should provide quality aftercare, perform outcome research and build the surgical capacity of local healthcare systems.

PROSPERO REGISTRATION NUMBER: CRD42018099285.

Keywords: burns; disease; disorder; injury; other infection; public health; surgery; systematic review; treatment

Conflict of interest statement

Competing interests: None declared.

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