Intersectoral collaboration for supporting the health and wellbeing of Aboriginal families and children in out-of-home care: perspectives from Western Australian Aboriginal Community Controlled Health Organisations.

Introduction: Western Australia has one of the highest rates of Aboriginal children entering out-of-home care in Australia. Kinship care is the preferred culturally safe out-of-home care option for Aboriginal children, yet all jurisdictions, including Western Australia, are far from meeting best-practice national standards. Intersectoral collaboration is a key primary healthcare principle and internationally recognized for improving health systems and outcomes. This paper presents findings from a qualitative research project investigating Aboriginal primary healthcare workers' experiences of intersectoral collaboration challenges and strengthening opportunities. Methods: Constructivist grounded theory guided this research involving 55 semi-structured interviews and four focus group discussions with Aboriginal primary healthcare workers. The research was guided by Indigenous methodologies and led by Indigenous researchers Participants were recruited from seven Aboriginal Community Controlled Health Organisations located across Perth metro, Pilbara, Midwest/Gascoyne and Southwest regions in Western Australia. Results: Key themes identified around intersectoral collaboration challenges were communication, including information sharing and interagency meetings, and the relationship with the government sector, including trust and the importance of the perception of Aboriginal health service independence. Key themes around strengthening areas to improve intersectoral collaboration included strengthening service resourcing and coverage, including the availability of services, and addressing high program turnover. The need for a shift in approach, including more emphasis on Aboriginal-led care and aligning approaches between sectors, was another area for strengthening. Discussion: This study addresses a significant research gap concerning out-of-home care, kinship care, and intersectoral collaboration in an Australian Aboriginal context. Findings highlighted the need to review the out-of-home and kinship models of care to strengthen the system, including creating more formal and structured modes of collaborating and better resourcing family support and kinship care.

Study protocol for a stepped-wedge implementation study investigating the intersectoral collaboration of implementering the TREAT INTERACT intervention for primary school teachers and the mhGAP for health care workers for child mental health promotion in Uganda.

BACKGROUND: Mental and neuropsychological disorders make up approximately 14% of the total health burden globally, with 80% of the affected living in low- and middle-income countries (LMICs) of whom 90% cannot access mental health services. The main objective of the TREAT INTERACT study is to adapt, implement, and evaluate the impact of a novel, intersectoral approach to prevent, identify, refer, and treat mental health problems in children through a user centred task-sharing implementation of the TREAT INTERACT intervention, inspired by the World Health Organization (WHO) Mental Health Gap Action Programme Intervention Guide (mhGAP-IG) for primary school staff in Mbale, Uganda. Health care personell will be trained in the mhGAP-IG. METHODS: This is a pragmatic mixed-methods hybrid Type II implementation-effectiveness study utilizing a co-design approach. The main study utilize a stepped-wedged trial design with six starting sequences, randomizing three schools to the intervention at each interval, while the remaining act as "controls". Other designs include a nested prospective cohort study, case control studies, cross-sectional studies, and qualitative research. Main participants' outcomes include teachers' mental health literacy, stigma, and violence towards the school children. Implementation outcomes include detection, reach, sustainability, and service delivery. Child and caregiver outcomes include mental health, mental health literacy, and help-seeking behaviour. DISCUSSION: Based on the results, we will develop sustainable and scalable implementation advice on mental health promotion and draft implementation guidelines in line with current WHO guidelines. This project will generate new knowledge on the structure, organization, delivery, and costs of mental health services in a LMIC setting, as well as new knowledge on the implementation and delivery of new health services. TRIAL REGISTRATION: ClinicalTrials, NCT06275672, 28.12.2023, retrospectively registered.

[New developments and innovations in psychotherapy for obesity]. / Neue Entwicklungen und Innovationen in der ­Psychotherapie bei Adipositas.

INTRODUCTION: This contribution highlights novel developments and innovations in psychological psychotherapy for patients with obesity. It underscores the importance of an interdisciplinary approach to treatment, which incorporates not only traditional methods but also contemporary psychotherapeutic modalities such as Acceptance and Commitment Therapy (ACT). Current research suggests that assessing the effectiveness of psychotherapy should not solely rely on changes in weight, but should also consider other outcomes such as subjective quality of life and mental health. Furthermore, the role of telemedicine and blended psychotherapy is emphasized as promising approaches to enhance accessibility and effectiveness of treatment. Through a case study of a 55-year-old woman with obesity and psychiatric comorbidities, the effectiveness of a multimodal psychotherapeutic approach is demonstrated.

Bridging the gap to meet complex needs: an intersectoral action well supported by appropriate policies and governance.

Many people face problems about physical, mental, and social dimensions of health, and may have complex needs. They often experience a mismatch between their needs and the ability of the healthcare system to meet them, resulting in under- or overutilization of the healthcare system. On one hand, improving access to community-based primary healthcare for hard-to-reach populations should bring all healthcare and social services to one point of contact, near the community. On the other hand, better addressing the unmet needs of people who overuse healthcare services calls for integrated care among providers across all settings and sectors. In either case, intersectoral action between healthcare and social professionals and resources remains central to bringing care closer to the people and the community, enhancing equitable access, and improving health status. However, efforts to implement integrated care are unevenly weighted toward clinical and professional strategies (micro level), which could jeopardize our ability to implement and sustain integrated care. The development of appropriate policies and governance mechanisms (macro level) is essential to break down silos, promote a coherent intersectoral action, and improve health equity.

[Current diagnostics and therapy in chronic rhinosinusitis]. / Aktuelle Diagnostik und Therapie der chronischen Rhinosinusitis.

INTRODUCTION: Chronic rhinosinusitis is a prevalent condition with significant implications for both patients and society at large. The diagnostic and treatment approaches are primarily guided by the EPOS2020 guidelines in Europe, which increasingly delve into the molecular -mechanism of the disease and its resulting phenotypes. In recent years, biologics have emerged as a promising option, in particular for cases that are refractory to conventional therapies. However, the management landscape has become more intricate, necessitating consideration and potential concurrent treatment of comorbidities. Moreover, the utilization of biologics is accompanied by substantial costs, warranting personalized assessment for each patient. Hence, the establishment of specialized boards comprising clinicians from diverse disciplines to collaborate on treatment recommendations is imperative.

[Importance of neuro-urological care in patients with spinal cord injuries/diseases]. / Stellenwert der neuro-urologischen Betreuung von Patienten mit Rückenmarkverletzungen/-erkrankungen.

Integrity, control and regulation of the urinary tract are subject to a complex neuronal regulation, in which portions of the sympathetic, parasympathetic and somatic nervous system are involved. The spinal cord plays a central role in regulation and serves as a transmitter for the motor and sensory pathways. Bladder dysfunction followed by renal dysfunction was the most frequent cause of death in patients with spinal cord injuries/diseases (paraplegia) as recently as half a decade ago. Thanks mainly to diagnostic and therapeutic advances made in neuro-urology, urological problems are no longer life-limiting. A vital role is played not only by the actual function of the urinary tract but also by the complex interactions in patients living with paraplegia. Issues such undertreated hyperactivity of the detrusor muscle with autonomous dysregulation, incontinence with secondary skin changes, or insufficient hand function to perform intermittent catheterisation must be evaluated in an interdisciplinary approach. Spinal cord injury/disease implies numerous functional disorders and secondary impairments of the organism. In addition to bladder function, sexual dysfunction also plays a crucial role. Especially in younger patients who sustain paraplegia before or during the family planning phase, this disruption and limitation is an essential reason for reduced quality of life. Neurogenic intestinal function plays an additional crucial role with regard to quality of life and management of everyday life. In recent years, the range of neuro-urological topics has expanded significantly. The focus of our work shifted from being merely on the urinary tract and urodynamics. In particular, the diagnostic investigation and treatment of neurogenic intestinal dysfunction is increasingly in the hands of neuro-urologists. The complex presentation of paraplegia involves an interaction of bladder, intestinal and sexual dysfunction in a way that these influence one another. Therefore, the sustained care and re-integration of these patients essentially includes lifelong and regular neuro-urological care in a paraplegia centre. Last but not least, it is exactly these neuro-urological topics such as urinary tract infections, urinary and intestinal incontinence and faecal impaction, which most commonly lead to re-hospitalisation.

[The National German Transplantation Certification : Interdisciplinary and innovative]. / Zusatzweiterbildung Transplantationsmedizin : Interdisziplinär und innovativ.

The interdisciplinary additional advanced training in transplantation medicine (ZWB) has been passed with the (Model) Advanced Training Regulation 2018 and is now implemented in all federal states. It includes joint interdisciplinary contents that must be mastered by all disciplines and special skills that are specific to the individual disciplines. An organ-specific training is also possible. With its interdisciplinary approach the ZWB transplantation certification is pioneering the structure of modern transplantation centers and will thus further improve the quality of treatment for patients on the waiting lists for organ transplantation and for patients with transplanted organs.

Suicide Prevention Takes a Nation: Collaborative Approaches to Universalize Suicide Prevention.

Suicide is a complex public health issue impacting many children and adolescents-and their families-each year, and it requires a complex public health solution. Local, state, and national collaboratives that leverage evidence-based strategies, foster community engagement, and prioritize equity are necessary to holistically address this issue. Here, the authors discuss the necessary steps for fostering inclusive community partnerships and outline the rationale for partnering with schools, youth groups, faith organizations, parent-teacher organizations, clinical settings, and professional organizations, as well as collaborating with the juvenile justice and child welfare systems and working together to foster suicide prevention policy.

[Portrait of an IPA PSM specialising in suicide prevention]. / Portrait d'un IPA PSM spécialisé en prévention du suicide.

Suicide prevention is a major public health issue, both nationally and internationally. The management of suicidal patients leaving emergency departments is crucial to preventing the risk of suicidal recurrence. Advanced practice nurses in psychiatry and mental health can provide real added value thanks to their specialist training, their ability to carry out a comprehensive and detailed clinical assessment, their mastery of medicinal and non-medicinal therapeutic interventions, their skills in coordinating the various players involved in the care pathway, their commitment to prevention and their skills in supporting the development of the skills of care and research teams.

Initiative on Urban Governance for Health and Well-being in Bogota

Rapid, unplanned urbanization is one of the significant ecological and human challenges of the 21st century. UN-Habitat predicts that, by 2050, nearly 70% of the world’s population will be living in cities, with disproportionate urban growth in low- and middle-income countries. The Region of the Americas is one of the most urbanized and unequal regions in the world. The World Health Organization (WHO) Urban Governance for Health and Wellbeing initiative seeks to support local-level actions to promote good urban governance for health and well-being, emphasizing community participation. Urban governance for health and well-being refers to focused processes of interaction and subsequent decision-making to generate collective solutions to enhance health and well-being through co-creation practices, social change, and institutional engagement as part of whole-of-government and whole-of-society approaches. The World Health Organization is working with five cities: Bogota (Colombia), Douala (Cameroon), Mexico City (Mexico), Khulna (Bangladesh), and Tunis (Tunisia) in the first phase. This brief aims to share the progress achieved until in Bogotá, Colombia in implementing the World Health Organization (WHO) Initiative on Urban Governance for Health and Well-being throughout the first phase. Bogotá is the capital of Colombia, and it constitutes 16.4% of the country's total urban population. It presents the context and principles of the global initiative, achievements in Bogotá, and the next steps. The target audience of this publication is city officials, national governments, and donors.

Initiative on Urban Governance for Health and Well-being in Mexico City

Rapid, unplanned urbanization is one of the significant ecological and human challenges of the 21st century. UN-Habitat predicts that, by 2050, nearly 70% of the world’s population will be living in cities, with disproportionate urban growth in low- and middle-income countries. The Region of the Americas is one of the most urbanized regions in the world. The World Health Organization (WHO) Urban Governance for Health and Wellbeing initiative seeks to support local-level actions to promote good urban governance for health and well-being, emphasizing community participation. Urban governance for health and well-being refers to focused processes of interaction and subsequent decision-making to generate collective solutions to enhance health and well-being through co-creation practices, social change, and institutional engagement as part of whole-of-government and whole-of-society approaches. WHO is working with five cities: Bogota (Colombia), Douala (Cameroon), Mexico City (Mexico), Khulna (Bangladesh), and Tunis (Tunisia). Mexico City (Ciudad de México) is the capital and largest city of Mexico, with the population of Mexico City alone representing 7.52% of the total urban population of Mexico. This brief aims to share the progress achieved in Mexico City in implementing the World Health Organization (WHO) Initiative on Urban Governance for Health and Well-being throughout the first phase. It presents the context and principles of the global initiative, achievements in Mexico City, and the next steps. The target audience of this publication is city officials, national governments, and donors.

Pistas genealógicas de um Consultório na Rua: criminalização e assimilação / Genealogical clues from a Street Clinic: criminalization and assimilation / Pistas genealógicas de un Consultorio em la Calle: criminalización y asimilación

Este artigo, por meio de aproximação genealógica, buscou investigar o que chamaremos de pistas genealó-gicas do equipamento Consultório na Rua em município de médio porte no Sul do Brasil. Para o percurso da pesquisa, junto a uma vivência em um Consultório na Rua, nesse município do país, foram realizados entrevistas e levantamentos de documentos. Na investigação foi possível encontrar pistas que apontam para uma produção de criminalização e assimilação histórica dos viventes da rua pelo Estado brasileiro, de maneira que esses pontos precisam ser discutidos e problematizados para que tais regimes de verdade não sejam norteadores das políticas públicas para tais pessoas.

This article, employing a genealogical approach, aimed to examine the genealogical traces of the Street Clinic equipment in a medium-sized city in Brazil's southern region. In order to follow the path of the research, along with an experience in a Street Clinic in a Brazilian city, interviews and document surveys were conducted. In the investigation, it was possible to find elements of the production of criminalization and historical assimilation by the Brazilian State that need to be discussed and problematized so that such regimes of truth are not guiding the production of health care for people experiencing homelessness.

Este artículo, a través de un abordaje genealógico, buscó investigar pistas genealógicas del Consultorio en la Calle en una ciudad de tamaño medio en el sur de Brasil. Para el transcurso de la investigación, junto con una experiencia en un Consultorio en la Calle en un municipio de tamaño medio en el sur de Brasil, se efectuaron entrevistas y encuestas documentales. En la investigación, fue posible encontrar pistas que apuntan a una producción de criminalización y asimilación histórica de las personas en situación de calle por parte del Estado brasileño, por lo que estos puntos necesitan ser discutidos y problematizados para que tales regímenes de verdad no guíen políticas públicas para dicha población.

Integração da vigilância e atenção à saúde no tratamento da sífilis gestacional: análise dos indicadores do PQAVS e do Previne Brasil na Paraíba / Integration of surveillance and health care in the management of gestational syphilis: analysis of PQAVS and Previne Brasil indicators in Paraíba / Integración de la vigilancia y la atención a la salud en el tratamiento de la sífilis gestacional: análisis de los indicadores PQAVS y Previne Brasil en Paraíba

Este artigo se baseia em um estudo feito com o objetivo de analisar indicadores sobre a testagem da sífilis na gestação no Programa de Qualificação das Ações de Vigilância em Saúde (PQAVS) e no Programa Previne Brasil no estado da Paraíba, e também de levantar aspectos do tratamento terapêutico para sífilis gestacional. Trata-se de uma pesquisa descritiva-exploratória, na qual foram sistematizados dados do indicador 11, testes por gestantes, do PQAVS e do indicador de desempenho da Atenção Primária à Saúde (APS), com base na proporção de gestantes que realizaram exames de sífilis e HIV durante o pré-natal em 2020; também foi feita a sistematização do webquestionário direcionado a profissionais da APS (médicos/enfermeiros) e autoaplicado sobre a atuação e tratamento terapêutico para sífilis gestacional. Dos 223 municípios da Paraíba, apenas 12% atingiram a meta do PQAVS e 39% a do Previne Brasil em 2020. Em relação ao webquestionário, houve a participação de 142 profissionais, dos quais 85% realizam o tratamento terapêutico preconizado pelo Ministério da Saúde para a APS. Desse modo, deve ser ressaltada a importância da ampliação da oferta de testes para sífilis, dos insumos para o tratamento adequado e da qualificação dos profissionais e da informação em saúde.

This article is based on a study to analyze indicators on syphilis testing during pregnancy in the PQAVS - Programa de Qualificação das Ações de Vigilância em Saúde (Health Surveillance Actions Qualification Programme) and in the Programa Previne Brasil (Previne Brasil Programme) in the state of Paraíba, Brazil, and also to survey aspects of the therapeutic management for gestational syphilis. It is a descriptive-exploratory research, in which data from indicator 11, tests for pregnant women, from the PQAVS and from the Primary Health Care (PHC) performance indicator, based on the proportion of pregnant women with syphilis and HIV tests during prenatal care in 2020 were systematised; in addition to this systematization, a self-administered webquestionnaire on the performance and therapeutic management for gestational syphilis by professionals (doctors/nurses) from the PHC was also systematised. Taking into account the 223 municipalities in Paraíba, only 12% reached the PQAVS goal and 39% reached the Previne Brasil goal in 2020. Regarding the webquestionnaire, 85% of the 142 professionals who answered it, carry out the therapeutic management recommended by the Ministry of Health for the PHC. Thus, it is fundamental to emphasise the importance of expanding the supply of tests for syphilis, supplies for adequate treatment, and the qualification of health professionals and information.

El presente artículo se basa en un estudio efectuado con el objetivo de analizar indicadores sobre la prueba de sífilis durante el embarazo en el PQAVS - Programa de Qualificação das Ações de Vigilância em Saúde (Programa de Calificación para Acciones de Vigilancia en Salud) y en el Programa Previne Brasil en el estado de Paraíba, Brasil, y de resaltar aspectos del tratamiento terapéutico de la sífilis gestacional. Se trata de una investigación descriptiva-exploratoria, en la que se sistematizaron datos del indicador 11, pruebas realizadas por embarazadas, del PQAVS y del indicador de desempeño de la Atención Primaria de Salud (APS), a partir de la proporción de gestantes que se sometieron a pruebas de sífilis y de HIV durante la atención prenatal en 2020; también se sistematizóel cuestionario web dirigido a profesionales de la APS (médicos/enfermeros) y autoadministrado sobre el desempeño y el tratamiento terapéutico de la sífilis gestacional. De los 223 municipios de Paraíba, apenas 12% alcanzaron la meta del PQAVS y 39% lograron la meta del Previne Brasil en 2020. En relación al cuestionario web, participaron 142 profesionales, de los cuales 85% realizan el tratamiento terapéutico recomendado por el Ministerio de Salud para la APS. Así, es fundamental la importancia de ampliar la oferta de pruebas para la sífilis, de los medicamentos para el tratamiento adecuado, la calificación de los profesionales e la información relacionada a la salud.

Assessing capacities to strengthen intersectoral collaboration in Territorial Public Health Councils in the Republic of Moldova.

BACKGROUND: The government of the Republic of Moldova, endorsed the principle of Health in All Policies (HiAP) through its health sector reforms to address the rising burden of non-communicable diseases and health inequalities. Territorial Public Health Councils (TPHCs) were created to ensure the coordination and management of the population's health in their respective district. This study assessed the capacities of the TPHCs to identify areas in need of support for strengthening their intersectoral collaboration role in public health at local level. METHODS: A mixed-method approach, using qualitative and quantitative techniques, was used to compare the perceptions of all TPHC members (n = 112) and invitees (n = 53) to council meetings from 10 districts covering all geographical areas of Moldova. The quantitative information was obtained using a cross-sectional survey, while the qualitative aspects were assessed within focus group discussions (FGDs). RESULTS: Half of all TPHC members, including 75% from groups with a non-medical background, did not attend a public health course within the last three years. Overall, groups with a medical background were more aware of the legislation that governs TPHC activity and intersectoral collaboration compared with those with a non-medical background. The FGDs of TPHC meetings revealed that members had an insufficient level of understanding of intersectoral collaboration to solve public health issues and lacked clarity about their place and role within the TPHC. CONCLUSIONS: HiAP implementation was found to be suboptimal with insufficient capacity at local level. TPHC members' ability to deal with public health issues were severely impaired by a general lack of knowledge and understanding of how to utilize the TPHC platform for maximum benefit. Reforming TPHC regulation is required in addition to extensive capacity building for TPHC members to increase member understanding of their roles as intended by TPHC regulations, including the facilitation of intersectoral collaborations.

Rethinking organizational culture in intersectoral coordination: the perspective of boundary work.

PURPOSE: The purpose of this paper is to rethink the concept of organizational culture as something that emerges bottom-up by using the sociological concepts of boundary object and boundary work as an analytical lens and to show how this approach can help understand and facilitate intersectoral coordination. DESIGN/METHODOLOGY/APPROACH: We used observations and qualitative interviews to develop "deep" knowledge about processes of intersectoral coordination. The study draws on a conceptual framework of "boundary work" and "boundary objects" to show how a bottom-up perspective on organizational culture can produce better understanding of and pave the way for intersectoral coordination. We use a case of health professionals engaged in two Danish intersectoral programs developing and providing health promotion services for women with gestational diabetes mellitus (GDM). FINDINGS: The study showed how boundary work revolves around negotiations on how to define, understand and act on the diagnosis of GDM. This diagnosis has the characteristics of a "boundary object", being more loosely structured in general terms, but strongly structured in local settings. Boundary objects help connect different professionals and facilitate coordination. The analysis showed how the introduction of time and the concept of "lifelong health promotion" helped to transgress existing organizational and professional boundaries. RESEARCH LIMITATIONS/IMPLICATIONS: The findings contribute to the literature on organizational culture and intersectoral coordination. We highlight the benefits of a practice-oriented, bottom-up perspective for a better understanding of how shared meaning is produced in cross professional coordination and collaboration. While the theoretical implications will be general applicable when studying organizational culture, the implications for practice are sensitive to context and the processes we have described as the outcomes of boundary work are generated from cases that were most likely to provide deep insight into our research topic. PRACTICAL IMPLICATIONS: For practice this can build bridges between organizational and professional boundaries. ORIGINALITY/VALUE: The findings contribute to the literature on organizational culture and intersectoral coordination. We highlight the benefits of a practice-oriented, bottom-up perspective for a better understanding of how shared meaning is produced in cross professional coordination. This may build bridges between organizational and professional boundaries in practice settings.

[Geriatric ophthalmologic co-management : A case report of interdisciplinary collaboration]. / Geriatrisch-ophthalmologisches Co-Management : Ein Fallbeispiel interdisziplinärer Zusammenarbeit.

This case report details the assessment and interdisciplinary collaboration in the management of an 81-year-old patient presenting with acute visual impairment, dizziness, general weakness, gait disturbances and fear of falling. A holistic geriatric evaluation revealed orthostatic dysregulation and an underlying multifactorial gait disorder exacerbated by visual impairment. Ophthalmological findings included left central retinal artery branch occlusion and cataracts. A comprehensive geriatric assessment showed frailty, impaired mobility and decreased functional abilities. Subsequent patient-centered interdisciplinary approaches included treatment for retinal ischemia, orthostatic testing, medication reconciliation, physiotherapy and occupational therapy. This case emphasizes how interdisciplinary collaboration between ophthalmology and geriatrics enables proactive assessment and intervention to reduce the risk of functional decline and loss of autonomy in visually impaired patients, which is of particular relevance considering the increasing prevalence of visual impairment in the ageing population.

[Interdisciplinary Management of Orbital Diseases]. / Interdisziplinäre Therapie der Erkrankungen der Orbita.

Diagnosis and therapy of orbital diseases is an interdisciplinary challenge, in which i.e. otorhinolaryngologists, ophthalmologists, radiologists, radiation therapists, maxillo-facial surgeons, endocrinologists, and pediatricians are involved. This review article describes frequent diseases which both, otolaryngologists and ophthalmologists are concerned with in interdisciplinary settings. In particular the inflammatory diseases of the orbit including orbital complications, autoimmunological diseases of the orbit including Grave´s orbitopathy, and primary and secondary tumors of the orbit are discussed. Beside describing the clinical characteristics and diagnostic steps the article focusses on the interdisciplinary therapy. The review is completed by the presentation of most important surgical approaches to the orbit, their indications and possible complications. The authors tried to highlight the relevant facts despite the shortness of the text.

Interdisciplinary plastic and reconstructive surgery of head and neck squamous cell carcinomas. / Interdisziplinäre Plastische und Rekonstruktive Chirurgie von Plattenepithelkarzinomen des Kopf-Hals-Bereichs.

Squamous cell carcinomas are the most common malignancies in the oral cavity, pharynx, and larynx. Even in the age of the most modern drug treatment methods, radical resection of these tumors is and currently remains the therapeutic gold standard. The loss of anatomical structures associated with surgery inevitably increases the functional deficits caused by the tumor itself. In this context, the extent of functional deficits is largely determined by the extent of resection. Complete organ resections, such as glossectomy, complete palate resection, laryngectomy, or transverse pharyngo-laryngectomy, lead to severe functional deficits, such as swallowing disturbances with life-threatening aspiration and articulation disorders up to the inability to speak. With the help of plastic reconstructive surgery, the lost tissue can be replaced and the specific functions of the upper aerodigestive tract can be preserved or restored.In recent decades, reconstructive surgical procedures have developed enormously in the treatment of malignant tumors of the head and neck. In order to make optimal use of them, a comprehensive, interdisciplinary therapy concept is a prerequisite for positive oncological and functional outcome. In addition to general medical and social parameters, surgical parameters play a crucial role in the choice of the reconstruction method. The extent to which the surgical measures must be interdisciplinary depends on the localization of the defects in the head and neck region and on the type of replacement tissue required. Here, the expertise of plastic surgery, oral and maxillofacial surgery, and abdominal surgery comes into play in particular. The use of different tissues, the combination of different grafts and flaps, or the preforming of donor regions allow reconstructions far beyond the level of simply restoring surface integrity. The functional results and thus the quality of life of patients after surgical therapy of extensive tumors of the mentioned localizations depend decisively on the type of reconstruction. Therefore, in the following review, special emphasis 1 be placed on the choice of reconstruction method and reconstruction technique for tissue loss after resections of HNSCC.