Plastic and Reconstructive Surgery, Global Open (Aug 2018)

Current Challenges of Plastic Surgical Care in Sub-Saharan Africa (Maputo, Mozambique)

  • Kevin J. Guzman, MS,
  • Natacha Gemo, MD,
  • Deborah B. Martins, MD,
  • Pedro Santos, MD,
  • Daniel A. DeUgarte, MD, MS,
  • Fatima Ademo, MD,
  • David Kulber, MD,
  • Celma Issufo, MD

DOI
https://doi.org/10.1097/GOX.0000000000001893
Journal volume & issue
Vol. 6, no. 8
p. e1893

Abstract

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Background:. Limited data exist on plastic surgery practices in Sub-Saharan Africa. The aim of this study was to characterize the spectrum of disease and operative procedures at a teaching hospital in Maputo, Mozambique to help understand the challenges of providing care for the local providers and to provide contextual relevance for training through partnerships. Methods:. A mixed-methods approach was utilized to perform an ongoing needs assessment. A retrospective review was performed of plastic surgery operative records, ward admissions records, and death records in a tertiary-care hospital in Maputo, Mozambique for the period January 2015 to December 2015. Results:. Limited resources (equipment, block-time, personnel, and perioperative services) were observed. The most common diagnoses for the 455 patients evaluated were burns (44%) and neoplasms (17%). Congenital abnormalities accounted for only 1% of the patient diagnoses. Of the 408 procedures performed, the majority were skin grafts (43%) and skin excisions (31%). Sepsis from burns accounted for 70% of documented deaths (14/20). The mean number of days to skin grafting for inpatients was 53 days. Conclusion:. We observed a large burden of burns and skin graft procedures at a public referral teaching hospital in Mozambique. Our findings provide contextual relevance to help focus public health efforts and improve plastic surgery training and practices.