Extremity and Mandibular Reconstruction After Gunshot Trauma-Orthoplastic Strategies from Five Years of Humanitarian Missions in a Resource-Limited Setting

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F65269705%3A_____%2F25%3A00082368" target="_blank" >RIV/65269705:_____/25:00082368 - isvavai.cz</a>

Alternative codes found

RIV/00216224:14110/25:00141721 RIV/00216208:11120/25:43928684

Result on the web

<a href="https://www.mdpi.com/2077-0383/14/14/4852" target="_blank" >https://www.mdpi.com/2077-0383/14/14/4852</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.3390/jcm14144852" target="_blank" >10.3390/jcm14144852</a>

Result language

angličtina

Original language name

Extremity and Mandibular Reconstruction After Gunshot Trauma-Orthoplastic Strategies from Five Years of Humanitarian Missions in a Resource-Limited Setting

Original language description

Background: Surgical care in conflict regions like Tigray, Ethiopia, faces severe challenges due to limited resources, infrastructural deficiencies, and high trauma burden. From 2019 to 2023, a multidisciplinary team conducted five humanitarian missions focusing on orthoplastic reconstruction of extremity and mandibular injuries from high-energy gunshot trauma. Methods: A retrospective analysis was performed on 98 patients who underwent free or pedicled flap reconstruction. Data included demographics, flap type, technique, complications, follow-up, and early clinical outcomes score as well as mobility scores. Flaps were harvested using loupes anastomosis performed using microscopes, depending on availability. Results: Among 98 patients (25.5% female, 74.5% male), 69 free flaps and 38 pedicled flaps were performed. Free fibula flaps (n = 54) included 33 mandibular and 21 extremity reconstructions. Additional flaps included ALT, gracilis, and LD flaps. Pedicled flaps included 18 fibula and 20 ALT/LD flaps. Mean age was 35.5 years; mean operative time was 429.5 min, with mandibular fibula transfers being longest. Microsurgical techniques were used in 34% of cases. Median follow-up was 10 months. Microsurgical complications occurred in 18.4%, mainly in fibula transfers (25.9%). Non-microsurgical issues included wound infections (n = 15), graft loss (n = 3), and bleeding (n = 5). Flap loss occurred in 16.3% overall. Early clinical outcome results were good (30.6%), acceptable (28.6%), and moderate (24.5%). Conclusions: Orthoplastic reconstruction using both free and pedicled flaps is feasible in low-resource, conflict settings. Despite infrastructural challenges, functional outcomes were achievable, supporting the value of adaptable microsurgical strategies in humanitarian surgery.

Czech name

—

Czech description

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Type

J_imp - Article in a specialist periodical, which is included in the Web of Science database

CEP classification

—

OECD FORD branch

30218 - General and internal medicine

Project

—

Continuities

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Publication year

2025

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

Journal of Clinical Medicine

ISSN

2077-0383

e-ISSN

2077-0383

Volume of the periodical

14

Issue of the periodical within the volume

14

Country of publishing house

CH - SWITZERLAND

Number of pages

10

Pages from-to

4852

UT code for WoS article

001535738400001

EID of the result in the Scopus database

2-s2.0-105011632525