The Feasibility of Free Flap Surgery in Foreign Medical Missions

Abstract

Objectives: Determine the feasibility and efficacy of microvascular free flap reconstruction of head and neck defects during foreign medical mission trips in the low resource setting. Methods: Retrospective review of foreign medical mission trips by a single tertiary care institution. Eight patients with benign tumors of the maxilla or mandible underwent microvascular free flap reconstruction of a head and neck defect following composite resection. Patient charts were reviewed for demographic data, reconstruction type, tumor location, pathology, length of stay, complications, and follow-up. Results: Eight patients underwent free flap reconstruction during four trips taking place over the span of two years in three different hospitals in Kenya. Seventy-five percent of patients were male and the average age was 26. Final pathology was benign in all patients. There were no flap failures. One patient had a small fistula managed with packing and secondary closure. Conclusions: Free flap reconstruction of head and neck defects is feasible in the foreign medical mission setting. Careful patient selection and diligent pre-operative planning for supplies is necessary. Partnership with a local physician comfortable with the care of the patients in the post-operative setting is extremely helpful.