Acta Medica Okayama volume73 issue5
2019-10 発行

Developing Microsurgery through Experience in Yangon General Hospital, Myanmar

Yi Yi Cho Thein Department of Plastic, Maxillofacial and Oral Surgery, Yangon General Hospital, University of Medicine (1)
Win, Myitzu Department of Plastic, Maxillofacial and Oral Surgery, Yangon General Hospital, University of Medicine (1)
Thuzara, Moe Department of Plastic, Maxillofacial and Oral Surgery, Yangon General Hospital, University of Medicine (1)
Matsumoto, Hiroshi Department of Plastic and Reconstructive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
Yamada, Kiyoshi Department of Plastic and Reconstructive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
Kimata, Yoshihiro Department of Plastic and Reconstructive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
Leung, Michael Department of Plastic and Reconstructive Surgery, Monash Health
Publication Date
2019-10
Abstract
Although many surgical centers perform microsurgery routinely in developed countries, performing microsurgery is challenging in resource-poor developing countries, such as Myanmar. With the establishment of educational training programs and the assistance of volunteer plastic surgical teams, local plastic surgeons can learn the techniques of microsurgery and apply them clinically. The purpose of this study was to establish baseline data and define the challenges of performing microsurgery in Yangon General Hospital, Myanmar. Sixty-four patients underwent reconstruction with free flaps from January 2015 to January 2018. All clinical records of these cases were assessed. The number of free flap reconstructions performed increased from 11 in the first year to 24 in the third year. The anterolateral thigh flap was the most commonly used (42%). The most common sites of reconstruction were mandible and intraoral defects. Total flap survival occurred in 58 of 64 patients (89%). The total salvageable flap rate for revision surgery was 66.6%; the successful revision rate was highest in 2017, with fewer complications. The flap salvage rates increased and the operative duration decreased as clinical experience improved. Establishing a microsurgical center requires a strong multidisciplinary team, clinical experience, continuous learning, sensible clinical application, and effective interdepartmental and intradepartmental cooperation.
Document Type
Original Article
Keywords
microsurgery
educational programs
challenges of microsurgical free flaps
reoperation
flap salvageable rate
Link to PubMed
Thumnail 73_5_393.pdf 8.05 MB