Surgical Management and Reconstruction Training (SMART) Course for International Orthopedic Surgeons

<p>Background</p><p>The burden of complex <a title="Learn more about Orthopedic Trauma" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/orthopedic-trauma">orthopedic trauma</a> in low- and middle-income countries (LMICs) is exacerba...

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Autores principales:	Hao-Hua Wu, Kushal R. Patel, Amber M. Caldwell, R. Richard Coughlin, Scott L. Hansen, Joseph N. Carey
Formato:	article
Lenguaje:	EN
Publicado:	Ubiquity Press 2016
Materias:	Plastic surgery orthopedic surgery rotational flap reconstruction global health global surgery amputation cadaver course surgical education Infectious and parasitic diseases RC109-216 Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/328ebd7c9bc74b3b8631f682bd43be04
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spelling	oai:doaj.org-article:328ebd7c9bc74b3b8631f682bd43be042021-12-02T11:19:32ZSurgical Management and Reconstruction Training (SMART) Course for International Orthopedic Surgeons2214-999610.1016/j.aogh.2016.06.002https://doaj.org/article/328ebd7c9bc74b3b8631f682bd43be042016-12-01T00:00:00Zhttps://annalsofglobalhealth.org/articles/737https://doaj.org/toc/2214-9996<p>Background</p><p>The burden of complex <a title="Learn more about Orthopedic Trauma" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/orthopedic-trauma">orthopedic trauma</a> in low- and middle-income countries (LMICs) is exacerbated by <a title="Learn more about Soft Tissue Injury" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/soft-tissue-injury">soft-tissue injuries</a>, which can often lead to amputations. This study's purpose was to create and evaluate the <a title="Learn more about Surgical Management" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/surgical-management">Surgical Management</a> and Reconstruction Training (SMART) course to help <a title="Learn more about Orthopedic Surgeon" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/orthopedic-surgeon">orthopedic surgeons</a> from LMICs manage soft-tissue defects and reduce the rate of amputations.</p><p>Methods</p><p>In this prospective observational study, orthopedic surgeons from LMICs were recruited to attend a 2-day SMART course taught by plastic surgery faculty in San Francisco. Before the course, participants were asked to assess the burden of soft-tissue injury and amputation encountered at their respective sites of practice. A survey was then given immediately and 1-year postcourse to evaluate the quality of instructional materials and the course's effect in reducing the burden of amputation, respectively.</p><p>Results</p><p>Fifty-one practicing orthopedic surgeons from 25 countries attended the course. No participant reported previously attempting a flap reconstruction procedure to treat a soft-tissue defect. Before the course, participants cumulatively reported 580-970 amputations performed annually as a result of soft-tissue defects. Immediately after the course, participants rated the quality and effectiveness of training materials to be a mean of ≥4.4 on a Likert scale of 5 (Excellent) in all 14 instructional criteria. Of the 34 (66.7%) orthopedic surgeons who completed the 1-year postcourse survey, 34 (100%, 'P' < 0.01) reported performing flaps learned at the course to treat soft-tissue defects. Flap procedures prevented 116 patients from undergoing amputation; 554 (93.3%) of the cumulative 594 flaps performed by participants 1 year after the course were reported to be successful. Ninety-seven percent of course participants taught flap reconstruction techniques to colleagues or residents, and a self-reported estimate of 28 other surgeons undertook flap reconstruction as a result of information dissemination by 1 year postcourse.</p><p>Conclusion</p>The SMART Course can give orthopedic surgeons in LMICs the skills and knowledge to successfully perform flaps, reducing the self-reported incidence of amputations. Course participants were able to disseminate flap reconstructive techniques to colleagues at their home institution. While this course offers a collaborative, sustainable approach to reduce global surgical disparities in amputation, future investigation into the viability of teaching the SMART course in LMICs is warranted.Hao-Hua WuKushal R. PatelAmber M. CaldwellR. Richard CoughlinScott L. HansenJoseph N. CareyUbiquity PressarticlePlastic surgeryorthopedic surgeryrotational flap reconstructionglobal healthglobal surgeryamputationcadaver coursesurgical educationInfectious and parasitic diseasesRC109-216Public aspects of medicineRA1-1270ENAnnals of Global Health, Vol 82, Iss 4, Pp 652-658 (2016)
institution	DOAJ
collection	DOAJ
language	EN
topic	Plastic surgery orthopedic surgery rotational flap reconstruction global health global surgery amputation cadaver course surgical education Infectious and parasitic diseases RC109-216 Public aspects of medicine RA1-1270
spellingShingle	Plastic surgery orthopedic surgery rotational flap reconstruction global health global surgery amputation cadaver course surgical education Infectious and parasitic diseases RC109-216 Public aspects of medicine RA1-1270 Hao-Hua Wu Kushal R. Patel Amber M. Caldwell R. Richard Coughlin Scott L. Hansen Joseph N. Carey Surgical Management and Reconstruction Training (SMART) Course for International Orthopedic Surgeons
description	<p>Background</p><p>The burden of complex <a title="Learn more about Orthopedic Trauma" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/orthopedic-trauma">orthopedic trauma</a> in low- and middle-income countries (LMICs) is exacerbated by <a title="Learn more about Soft Tissue Injury" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/soft-tissue-injury">soft-tissue injuries</a>, which can often lead to amputations. This study's purpose was to create and evaluate the <a title="Learn more about Surgical Management" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/surgical-management">Surgical Management</a> and Reconstruction Training (SMART) course to help <a title="Learn more about Orthopedic Surgeon" href="https://www.sciencedirect.com/topics/medicine-and-dentistry/orthopedic-surgeon">orthopedic surgeons</a> from LMICs manage soft-tissue defects and reduce the rate of amputations.</p><p>Methods</p><p>In this prospective observational study, orthopedic surgeons from LMICs were recruited to attend a 2-day SMART course taught by plastic surgery faculty in San Francisco. Before the course, participants were asked to assess the burden of soft-tissue injury and amputation encountered at their respective sites of practice. A survey was then given immediately and 1-year postcourse to evaluate the quality of instructional materials and the course's effect in reducing the burden of amputation, respectively.</p><p>Results</p><p>Fifty-one practicing orthopedic surgeons from 25 countries attended the course. No participant reported previously attempting a flap reconstruction procedure to treat a soft-tissue defect. Before the course, participants cumulatively reported 580-970 amputations performed annually as a result of soft-tissue defects. Immediately after the course, participants rated the quality and effectiveness of training materials to be a mean of ≥4.4 on a Likert scale of 5 (Excellent) in all 14 instructional criteria. Of the 34 (66.7%) orthopedic surgeons who completed the 1-year postcourse survey, 34 (100%, 'P' < 0.01) reported performing flaps learned at the course to treat soft-tissue defects. Flap procedures prevented 116 patients from undergoing amputation; 554 (93.3%) of the cumulative 594 flaps performed by participants 1 year after the course were reported to be successful. Ninety-seven percent of course participants taught flap reconstruction techniques to colleagues or residents, and a self-reported estimate of 28 other surgeons undertook flap reconstruction as a result of information dissemination by 1 year postcourse.</p><p>Conclusion</p>The SMART Course can give orthopedic surgeons in LMICs the skills and knowledge to successfully perform flaps, reducing the self-reported incidence of amputations. Course participants were able to disseminate flap reconstructive techniques to colleagues at their home institution. While this course offers a collaborative, sustainable approach to reduce global surgical disparities in amputation, future investigation into the viability of teaching the SMART course in LMICs is warranted.
format	article
author	Hao-Hua Wu Kushal R. Patel Amber M. Caldwell R. Richard Coughlin Scott L. Hansen Joseph N. Carey
author_facet	Hao-Hua Wu Kushal R. Patel Amber M. Caldwell R. Richard Coughlin Scott L. Hansen Joseph N. Carey
author_sort	Hao-Hua Wu
title	Surgical Management and Reconstruction Training (SMART) Course for International Orthopedic Surgeons
title_short	Surgical Management and Reconstruction Training (SMART) Course for International Orthopedic Surgeons
title_full	Surgical Management and Reconstruction Training (SMART) Course for International Orthopedic Surgeons
title_fullStr	Surgical Management and Reconstruction Training (SMART) Course for International Orthopedic Surgeons
title_full_unstemmed	Surgical Management and Reconstruction Training (SMART) Course for International Orthopedic Surgeons
title_sort	surgical management and reconstruction training (smart) course for international orthopedic surgeons
publisher	Ubiquity Press
publishDate	2016
url	https://doaj.org/article/328ebd7c9bc74b3b8631f682bd43be04
work_keys_str_mv	AT haohuawu surgicalmanagementandreconstructiontrainingsmartcourseforinternationalorthopedicsurgeons AT kushalrpatel surgicalmanagementandreconstructiontrainingsmartcourseforinternationalorthopedicsurgeons AT ambermcaldwell surgicalmanagementandreconstructiontrainingsmartcourseforinternationalorthopedicsurgeons AT rrichardcoughlin surgicalmanagementandreconstructiontrainingsmartcourseforinternationalorthopedicsurgeons AT scottlhansen surgicalmanagementandreconstructiontrainingsmartcourseforinternationalorthopedicsurgeons AT josephncarey surgicalmanagementandreconstructiontrainingsmartcourseforinternationalorthopedicsurgeons
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Surgical Management and Reconstruction Training (SMART) Course for International Orthopedic Surgeons

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