Assessing the Availability and Need for Microsurgery-Trained Reconstructive Surgeons in Sub-Saharan Africa.
Meewon Olivia Park, Nitya Devisetti, Nikki Thrikutam, Owen Muzinda, Natalie Meyers, Godfrey Muguti, Jim Chang
Background Microsurgery is an essential component of plastic and reconstructive surgery, yet access remains limited in low- and middle-income countries (LMICs). The College of Surgeons of East, Central, and Southern Africa (COSECSA) region has identified a shortage of microsurgeons due to limited formal training, infrastructure needs, and resource constraints. This study aimed to assess the current microsurgical landscape in the COSECSA region, identifying key barriers and opportunities for training and practice development. Methods A cross-sectional, survey-based needs assessment was conducted among plastic surgery attending microsurgeons and trainees in the COSECSA region (n=20). The survey collected quantitative and qualitative data on microsurgical exposure, training experiences, clinical and structural needs, and opportunities for international collaboration. Results Limited access to reliable equipment and supplies, insufficient funding, and inadequate institutional support were identified as major barriers to the development of microsurgical practices in this region. Key clinical needs included lower extremity and head and neck reconstruction, followed by reconstruction of craniofacial and burn conditions. Respondents emphasized the need for structured hands-on training, improved access to equipment, and international exchange programs to enhance microsurgical capacity in the COSECSA region. Conclusion Addressing workforce shortages, improving microsurgery-specific training, and strengthening infrastructure are critical for expanding reconstructive microsurgical care in the COSECSA region. Given the current dearth of local training programs, international collaborations continue to play a vital role in bridging the gap in microsurgical training. However, to be effective, these partnerships should prioritize longitudinal, local engagement and capacity-building efforts to support the development of sustainable microsurgical practices in LMICs.
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