Long-term outcomes associated with short-term surgical missions treating complex head and neck disfigurement in Ethiopia: A retrospective cohort study.
J Plast Reconstr Aesthet Surg
; 73(5): 951-958, 2020 May.
Article
in En
| MEDLINE
| ID: mdl-32063454
ABSTRACT
BACKGROUND:
Long-term follow-up after short-term reconstructive missions is challenging, often due to financial constraints, remote geography and lack of post-operative communication with patients. The aim of this study was to conduct long-term follow-up of patients who have undergone surgery for complex facial disfigurement in Ethiopia.METHODS:
A retrospective cohort study was conducted in Ethiopia over a 2-week period between February and March 2017. All patients who were previously operated on by the charity Project Harar were eligible. Data were collected from semi-structured interviews and clinical examinations.RESULTS:
Seventy patients (41 males 29 females) were included in this study. This equates to a follow-up rate of 20% (70/350) of all patients operated on by the charity since 2008. Mean patient age was 26.8 years (range, 3-61 years). The most common pathologies were noma (24%), ameloblastoma (16%) and trauma (11%). The mean follow-up time after final surgery was 47 months (range, 12-180) with an average of 1.3 (range, 1-6) operations per patient. Long-term complications were reported by 30% of patients, with chronic fistula (nâ¯=â¯6) and chronic infection (nâ¯=â¯3) the most common. Following surgery, stigma experienced by patients decreased from 92% to 3%.CONCLUSIONS:
This study demonstrates that complex head and neck reconstruction can be safely undertaken in resource-limited settings with improvements in stigma experienced and quality of life for patients. However, despite a decade of experience and refinements, early and late complications do occur, and this should be factored into pre-mission planning and careful follow-up. New, cost-neutral follow-up protocols are being developed.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Plastic Surgery Procedures
/
Esthetics
/
Head
/
Medical Missions
/
Neck
Type of study:
Etiology_studies
/
Guideline
/
Observational_studies
/
Qualitative_research
/
Risk_factors_studies
Limits:
Adolescent
/
Adult
/
Child
/
Child, preschool
/
Female
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
Africa
Language:
En
Journal:
J Plast Reconstr Aesthet Surg
Year:
2020
Type:
Article