Impact of short-term reconstructive surgical missions: A systematic review

Thom C. C. Hendriks, Matthijs Botman, Charissa N. S. Rahmee, Johannes C. F. Ket, Margriet G. Mullender, Barend Gerretsen, Emanuel Q. Nuwass, Klaas W. Marck, Henri A. H. Winters

Research output: Contribution to journalReview articleAcademicpeer-review

Abstract

Introduction Short-term missions providing patients in low-income countries with reconstructive surgery are often criticised because evidence of their value is lacking. This study aims to assess the effectiveness of short-term reconstructive surgical missions in low-income and middle-income countries. Methods A systematic review was conducted according to PRISMA guidelines. We searched five medical databases from inception up to 2 July 2018. Original studies of short-term reconstructive surgical missions were included, which reported data on patient safety measurements, health gains of individual patients and sustainability. Data were combined to generate overall outcomes, including overall complication rates. Results Of 1662 identified studies, 41 met full inclusion criteria, which included 48 546 patients. The overall study quality according to Oxford CEBM and GRADE was low. Ten studies reported a minimum of 6 months' follow-up, showing a follow-up rate of 56.0% and a complication rate of 22.3%. Twelve studies that did not report on duration or follow-up rate reported a complication rate of 1.2%. Fifteen out of 20 studies (75%) that reported on follow-up also reported on sustainable characteristics. Conclusions Evidence on the patient outcomes of reconstructive surgical missions is scarce and of limited quality. Higher complication rates were reported in studies which explicitly mentioned the duration and rate of follow-up. Studies with a low follow-up quality might be under-reporting complication rates and overestimating the positive impact of missions. This review indicates that missions should develop towards sustainable partnerships. These partnerships should provide quality aftercare, perform outcome research and build the surgical capacity of local healthcare systems. PROSPERO registration number CRD42018099285.
LanguageEnglish
Article numbere001176
JournalBMJ Global Health
Volume4
Issue number2
DOIs
Publication statusPublished - 2019

Cite this

@article{98116919f171413dba8b2f8b1a4ec393,
title = "Impact of short-term reconstructive surgical missions: A systematic review",
abstract = "Introduction Short-term missions providing patients in low-income countries with reconstructive surgery are often criticised because evidence of their value is lacking. This study aims to assess the effectiveness of short-term reconstructive surgical missions in low-income and middle-income countries. Methods A systematic review was conducted according to PRISMA guidelines. We searched five medical databases from inception up to 2 July 2018. Original studies of short-term reconstructive surgical missions were included, which reported data on patient safety measurements, health gains of individual patients and sustainability. Data were combined to generate overall outcomes, including overall complication rates. Results Of 1662 identified studies, 41 met full inclusion criteria, which included 48 546 patients. The overall study quality according to Oxford CEBM and GRADE was low. Ten studies reported a minimum of 6 months' follow-up, showing a follow-up rate of 56.0{\%} and a complication rate of 22.3{\%}. Twelve studies that did not report on duration or follow-up rate reported a complication rate of 1.2{\%}. Fifteen out of 20 studies (75{\%}) that reported on follow-up also reported on sustainable characteristics. Conclusions Evidence on the patient outcomes of reconstructive surgical missions is scarce and of limited quality. Higher complication rates were reported in studies which explicitly mentioned the duration and rate of follow-up. Studies with a low follow-up quality might be under-reporting complication rates and overestimating the positive impact of missions. This review indicates that missions should develop towards sustainable partnerships. These partnerships should provide quality aftercare, perform outcome research and build the surgical capacity of local healthcare systems. PROSPERO registration number CRD42018099285.",
author = "Hendriks, {Thom C. C.} and Matthijs Botman and Rahmee, {Charissa N. S.} and Ket, {Johannes C. F.} and Mullender, {Margriet G.} and Barend Gerretsen and Nuwass, {Emanuel Q.} and Marck, {Klaas W.} and Winters, {Henri A. H.}",
year = "2019",
doi = "10.1136/bmjgh-2018-001176",
language = "English",
volume = "4",
journal = "BMJ Global Health",
issn = "2059-7908",
publisher = "BMJ Publishing Group",
number = "2",

}

Impact of short-term reconstructive surgical missions: A systematic review. / Hendriks, Thom C. C.; Botman, Matthijs; Rahmee, Charissa N. S.; Ket, Johannes C. F.; Mullender, Margriet G.; Gerretsen, Barend; Nuwass, Emanuel Q.; Marck, Klaas W.; Winters, Henri A. H.

In: BMJ Global Health, Vol. 4, No. 2, e001176, 2019.

Research output: Contribution to journalReview articleAcademicpeer-review

TY - JOUR

T1 - Impact of short-term reconstructive surgical missions: A systematic review

AU - Hendriks, Thom C. C.

AU - Botman, Matthijs

AU - Rahmee, Charissa N. S.

AU - Ket, Johannes C. F.

AU - Mullender, Margriet G.

AU - Gerretsen, Barend

AU - Nuwass, Emanuel Q.

AU - Marck, Klaas W.

AU - Winters, Henri A. H.

PY - 2019

Y1 - 2019

N2 - Introduction Short-term missions providing patients in low-income countries with reconstructive surgery are often criticised because evidence of their value is lacking. This study aims to assess the effectiveness of short-term reconstructive surgical missions in low-income and middle-income countries. Methods A systematic review was conducted according to PRISMA guidelines. We searched five medical databases from inception up to 2 July 2018. Original studies of short-term reconstructive surgical missions were included, which reported data on patient safety measurements, health gains of individual patients and sustainability. Data were combined to generate overall outcomes, including overall complication rates. Results Of 1662 identified studies, 41 met full inclusion criteria, which included 48 546 patients. The overall study quality according to Oxford CEBM and GRADE was low. Ten studies reported a minimum of 6 months' follow-up, showing a follow-up rate of 56.0% and a complication rate of 22.3%. Twelve studies that did not report on duration or follow-up rate reported a complication rate of 1.2%. Fifteen out of 20 studies (75%) that reported on follow-up also reported on sustainable characteristics. Conclusions Evidence on the patient outcomes of reconstructive surgical missions is scarce and of limited quality. Higher complication rates were reported in studies which explicitly mentioned the duration and rate of follow-up. Studies with a low follow-up quality might be under-reporting complication rates and overestimating the positive impact of missions. This review indicates that missions should develop towards sustainable partnerships. These partnerships should provide quality aftercare, perform outcome research and build the surgical capacity of local healthcare systems. PROSPERO registration number CRD42018099285.

AB - Introduction Short-term missions providing patients in low-income countries with reconstructive surgery are often criticised because evidence of their value is lacking. This study aims to assess the effectiveness of short-term reconstructive surgical missions in low-income and middle-income countries. Methods A systematic review was conducted according to PRISMA guidelines. We searched five medical databases from inception up to 2 July 2018. Original studies of short-term reconstructive surgical missions were included, which reported data on patient safety measurements, health gains of individual patients and sustainability. Data were combined to generate overall outcomes, including overall complication rates. Results Of 1662 identified studies, 41 met full inclusion criteria, which included 48 546 patients. The overall study quality according to Oxford CEBM and GRADE was low. Ten studies reported a minimum of 6 months' follow-up, showing a follow-up rate of 56.0% and a complication rate of 22.3%. Twelve studies that did not report on duration or follow-up rate reported a complication rate of 1.2%. Fifteen out of 20 studies (75%) that reported on follow-up also reported on sustainable characteristics. Conclusions Evidence on the patient outcomes of reconstructive surgical missions is scarce and of limited quality. Higher complication rates were reported in studies which explicitly mentioned the duration and rate of follow-up. Studies with a low follow-up quality might be under-reporting complication rates and overestimating the positive impact of missions. This review indicates that missions should develop towards sustainable partnerships. These partnerships should provide quality aftercare, perform outcome research and build the surgical capacity of local healthcare systems. PROSPERO registration number CRD42018099285.

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U2 - 10.1136/bmjgh-2018-001176

DO - 10.1136/bmjgh-2018-001176

M3 - Review article

VL - 4

JO - BMJ Global Health

T2 - BMJ Global Health

JF - BMJ Global Health

SN - 2059-7908

IS - 2

M1 - e001176

ER -