INTERPLAST-Germany-adapting to global plastic surgery.

Background: INTERPLAST, Inc. was founded in 1969 by plastic surgeons in Stanford, CA, to create a financial basis through donations to operate foreign patients at Stanford or send surgical teams to developing countries. With the same financial effort, 50 to 100 times more patients can be operated on locally than in a hospital at home. Stanford's example was appealing to many plastic surgeons worldwide, who founded similar INTERPLAST NGOs in their own countries.

Methods: A literature review revealed worldwide humanitarian actions of INTERPLAST teams, whose annual effectiveness is comparable to the operation numbers of large plastic surgery departments. Six patients with complex facial deformities requiring multiple surgical interventions were selected for temporary stay and operations in Germany.

Results: Repeated missions at the same hospitals with training of local surgeons have increased significantly compared to earlier "parachute missions." Microsurgical procedures for free flaps with magnifying glasses are now possible for the experienced even in hospitals in developing countries. The most efficient medical aid in the future will be the expansion and establishment of departments or hospitals in developing countries supported or maintained by partner hospitals in our home country.

Conclusions: Operations of humanitarian plastic surgeons in developing countries are becoming increasingly difficult. Local health authorities require temporary surgical permits, customs offices try to clear surgical material and look at expiration dates of medicines, and pandemics complicate planning of INTERPLAST missions. It therefore seems increasingly necessary to go as single teacher, training engaged local surgeons and assisting operations. The alternative is inviting local surgeons to Western hospitals and introducing them to the basic skills of plastic surgery and empathy with the poor. However, the lack of recognition of medical degrees from all developing countries remains a problem for their training in Europe.Level of evidence: Level V, risk/prognostic.