Outcomes of external versus internal fixation for traumatic lower limb fractures in low- and middle-income countries.

Aims: Lower limb fractures are common in low- and middle-income countries (LMICs) and represent a significant burden to the existing orthopaedic surgical infrastructure. In high income country (HIC) settings, internal fixation is the standard of care due to its superior outcomes. In LMICs, external fixation is often the surgical treatment of choice due to limited supplies, cost considerations, and its perceived lower complication rate.

Context matters for disability and priority setting for musculoskeletal diseases: revisiting the egalitarian approach to disability weights and disability-adjusted life-years.

Health metrics have evolved with increasing sophistication. The disability-adjusted life-year (DALY) has emerged as a widely used metric. While DALYs vary between countries, the global disability weights (DWs) that are integral to the DALY ignore the potential impact of local factors on the burden of disease.

Who Gets Burned in Brazil?

Burns are preventable injuries that still represent a relevant public health issue. The identification of risk factors might contribute to the development of specific preventive strategies. Data of patients admitted at the Hospital due to acute burn injuries from May 2017 to December 2019, was extracted manually from medical records.

An assessment of the impact of developmental dysplasia of the hip on patients' wellbeing.

Within healthcare, several measures are used to quantify and compare the severity of health conditions. Two common measures are disability weight (DW), a context-independent value representing severity of a health state, and utility weight (UW), a context-dependent measure of health-related quality of life. Neither of these measures have previously been determined for developmental dysplasia of the hip (DDH).

The Impact of COVID-19 on Burns: A Brazilian Study.

Unlabelled: During the COVID-19 pandemic, some of the strategies chosen to contain the spread, such as social isolation and use of alcohol-based hand sanitizer, were suspected to increase the risk of domestic accidents, especially burns. The aim of this study was, therefore, to investigate possible differences in epidemiological trends among burned patients admitted to the main referral hospital of the State of Minas Gerais, Brazil, before and during the pandemic.

Methods: All categories of new burns admitted at the Burn Unit of the João XXIII Hospital in Belo Horizonte, Minas Gerais.

The impact of socio-economic factors on parental non-adherence to the Ponseti protocol for clubfoot treatment in low- and middle-income countries: A scoping review.

Background: The Ponseti treatment is considered the gold standard for clubfoot globally, but requires strong engagement from parents. The aim of this review is to assess the impact of socio-economic factors on the presence of drop-out, relapse or non-compliance during Ponseti treatment in low and middle-income countries (LMICs).

Methods: This scoping review includes all articles available from inception until 4.

The Plastic Surgery Workforce and Its Role in Low-income Countries.

Background: Plastic surgery varies in scope, especially in different settings. This study aimed to quantify the plastic surgery workforce in low-income countries (LICs), understand commonly treated conditions by plastic surgeons working in these settings, and assess the impact on reducing global disease burden.

Methods: We queried national and international surgery societies, plastic surgery societies, and non-governmental organizations to identify surgeons living and working in LICs who provide plastic surgical care using a cross-sectional survey.

Towards resilient health systems: opportunities to align surgical and disaster planning.

Natural disasters significantly contribute to human death and suffering. Moreover, they exacerbate pre-existing health inequalities by imposing an additional burden on the most vulnerable populations. Robust local health systems can greatly mitigate this burden by absorbing the extraordinary patient volume and case complexity immediately after a disaster.

The Role of the US Surgeon in Global Care: Melding the Reality at Home with Global Need.

There is a great mismatch between surgeon workforce capacity in the US and other high income countries (HICs) and that in low and lower middle income countries (LMICs). Many surgeons in HICs are willing to try to be of assistance in LMICs. It is not intuitive, though, exactly how such assistance is best delivered.

Economic valuation of the impact of a large surgical charity using the value of lost welfare approach.

Background: The assessment of the economic burden of surgical disease is integral to determining allocation of resources for health globally. We estimate the economic gain realised over an 11-year period resulting from a vertical surgical programme addressing cleft lip (CL) and cleft palate (CP).

Methods: The database from a large non-governmental organisation (Smile Train) over an 11-year period was analysed.

International Disease Burden of Hand Burns: Perspective from the Global Health Arena.

Measuring the extent and impact of a health problem is key to being able to address it appropriately. This review uses available information within the framework of the Global Burden of Disease studies to estimate the disease burden due to burn injuries of the hands. The GBD indicates that since 1990 there has been an approximately 30% decrease in the disease burden related to burn injuries.

Palatal Fistula Risk after Primary Palatoplasty: A Retrospective Comparison of a Humanitarian Organization and Tertiary Hospitals.

Background: Humanitarian surgical organizations provide palatoplasties for patients without access to surgical care. Few organizations have evaluated the outcomes of these trips. This study evaluates the palatal fistula rate in patients from two cohorts in rural China and one in the United States.

Factors Affecting Burn Contracture Outcome in Developing Countries: A Review of 2506 Patients.

Introduction: Burn contractures hinder joint mobility, resulting in functional impairment and reduced quality of life. This is of greater significance in developing countries where there are fewer resources for assistance with such impairments. Contracture release reduces deformity, but multiple factors affect the extent of postsurgical improvements and outcomes.

Economic modeling of surgical disease: a measure of public health interventions.

The measurement of the burden of disease and the interventions that address that burden can be done in various units. Reducing these measures to the common denominator of economic units (i.e.

Comparison of fistula rates after palatoplasty for international and local surgeons on surgical missions in Ecuador with rates at a craniofacial center in the United States.

Background: International organizations have performed palatoplasties in low- and middle-income countries for decades, often working with local providers. Few studies report long-term outcomes, especially for palatal fistulas. A fistula after palatoplasty may affect speech, socialization, and nutrition.

Plastic and reconstructive surgery in Zambia: epidemiology of 16 years of practice.

Background: The epidemiology of surgical conditions in developing countries is not well studied, but plastic and reconstructive surgery can play a significant role in meeting the need for surgical care. Knowledge of the conditions treated by a plastic surgeon in a low-income country would inform the development of surgical services.

Methods: The surgical log of the lead author from 1993 to 2008 was reviewed.

Volunteers in plastic surgery guidelines for providing surgical care for children in the less developed world.

Background: A significant need is met by volunteer groups who provide free reconstructive plastic surgery for underserved children in developing countries. However, at present there are no consistent guidelines for volunteer groups in plastic surgery seeking to provide high-quality and safe care.

Methods: With these quality and safety standards in mind, in 2006, the Volunteers in Plastic Surgery Committee of the American Society of Plastic Surgeons/Plastic Surgery Educational Foundation undertook a project to develop a detailed set of guidelines for volunteer groups from developed countries seeking to provide plastic surgery services to children in developing countries.

Association between preoperative measurements and resection weight in patients undergoing reduction mammaplasty.

Current guidelines used to predict appropriate resection weight for patients undergoing reduction mammaplasty are typically based on relatively nondescript patient characteristics and are most often inaccurate. The determination of patient measurements that correlate with resection weight could enable appropriate resection weight to be predicted more precisely and on an individualized basis. To better elucidate this, data from 348 patients undergoing bilateral reduction mammaplasty (696 breasts) between October 2001 and March 2009 were reviewed retrospectively.

Estimation of impact of surgical disease through economic modeling of cleft lip and palate care.

Background: Assessing burden of disease encompasses the prevalence of disease entities, but it is the impact that affects the populace. Similarly, optimal evaluation of intervention programs shows impact rather than simply an enumeration of services. Economic effects are a fungible measure but are difficult to assess.

Perspectives on plastic surgery and global health.

Of the many factors affecting the health of the human race, those amenable to correction by plastic surgical intervention comprise a significant number. The interface between the global health community and the plastic surgery community historically has been quite diminutive, but this is changing with globalization. This overview provides a primer of global health for the plastic surgeon, and a discussion of the global burden of disease as it relates to plastic surgery.