Abstract
Background
While the need for reconstructive microsurgical procedures has increased across the
developing world, several constraints in low- and middle-income settings prevent its
consistent performance. Our study aimed to understand the impact of microsurgery training
on local capacity in a low-income setting, and to understand limitations that may
affect long-term build-up of microsurgical capacity.
Methods
Cross-sectional study evaluating survey responses of trainees and surgeons who participated
in a Flap Transfer and Microsurgery course held in Ibadan, Nigeria. The survey consisted
of a pre- and postcourse questionnaire, and a 2-year posttraining survey. The questionnaire
sought to assess training impact on microsurgical capacity and limitations at each
participants institution. Fourteen surgeons completed all questionnaires and were
included in the study.
Results
Thirteen (92.3%) participants had encountered at least one defect requiring microvascular
surgery within 2 years of the training, and 9 (69.2%) reported having performed at
least one surgery. Most surgeons indicated having performed less procedures than needed
across all defect anatomical site/etiology. The most common limitation reported by
participants consisted of man-power shortage (78.6%), followed by expense of each
procedure, difficulty procuring materials, and trainers with limited experience.
Conclusion
There is a significant need for microsurgical reconstruction in sub-Saharan Africa,
with varied local challenges preventing consistent delivery of microsurgical care.
The analysis complements previous literature on microsurgical care in developing countries
and highlights significant constraints preventing widespread adoption and the role
of local training opportunities that help in building long-term local capacity.
Keywords
microsurgery - reconstruction - LMIC - capacity-building - surgical education
