Open AccessCurrent Challenges of Plastic Surgical Care in Sub-Saharan Africa (Maputo, Mozambique)
Author(s) -
Kevin J. Guzman,
Natacha Gemo,
Deborah B. Martins,
Pedro Santos,
Daniel A. DeUgarte,
Fatima Ademo,
David A. Kulber,
Celma Issufo
Publication year - 2018
Publication title -
plastic and reconstructive surgery. global open
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.759
H-Index - 28
ISSN - 2169-7574
DOI - 10.1097/gox.0000000000001893
Subject(s) - medicine , referral , plastic surgery , perioperative , public hospital , public health , medical emergency , retrospective cohort study , general surgery , family medicine , emergency medicine , surgery , nursing
Background: Limited data exist on plastic surgery practices in Sub-Saharan Africa. The aim of this study was to characterize the spectrum of disease and operative procedures at a teaching hospital in Maputo, Mozambique to help understand the challenges of providing care for the local providers and to provide contextual relevance for training through partnerships. Methods: A mixed-methods approach was utilized to perform an ongoing needs assessment. A retrospective review was performed of plastic surgery operative records, ward admissions records, and death records in a tertiary-care hospital in Maputo, Mozambique for the period January 2015 to December 2015. Results: Limited resources (equipment, block-time, personnel, and perioperative services) were observed. The most common diagnoses for the 455 patients evaluated were burns (44%) and neoplasms (17%). Congenital abnormalities accounted for only 1% of the patient diagnoses. Of the 408 procedures performed, the majority were skin grafts (43%) and skin excisions (31%). Sepsis from burns accounted for 70% of documented deaths (14/20). The mean number of days to skin grafting for inpatients was 53 days. Conclusion: We observed a large burden of burns and skin graft procedures at a public referral teaching hospital in Mozambique. Our findings provide contextual relevance to help focus public health efforts and improve plastic surgery training and practices.