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Volunteers in Plastic Surgery Guidelines for Providing Surgical Care for Children in the Less Developed World

Schneider, William J. M.D.; Politis, George D. M.D., M.P.H.; Gosain, Arun K. M.D.; Migliori, Mark R. M.D.; Cullington, James R. M.D.; Peterson, Elizabeth L. M.D.; Corlew, D. Scott M.D., M.P.H.; Wexler, Andrew M. M.D.; Flick, Randall M.D., M.P.H.; Van Beek, Allen L. M.D.

Plastic and Reconstructive Surgery: June 2011 - Volume 127 - Issue 6 - p 2477-2486
doi: 10.1097/PRS.0b013e3182131d2a
Special Topics

Background: A significant need is met by volunteer groups who provide free reconstructive plastic surgery for underserved children in developing countries. However, at present there are no consistent guidelines for volunteer groups in plastic surgery seeking to provide high-quality and safe care.

Methods: With these quality and safety standards in mind, in 2006, the Volunteers in Plastic Surgery Committee of the American Society of Plastic Surgeons/Plastic Surgery Educational Foundation undertook a project to develop a detailed set of guidelines for volunteer groups from developed countries seeking to provide plastic surgery services to children in developing countries. To make the guidelines include both surgical and anesthetic needs, they were developed in conjunction with the Society for Pediatric Anesthesia.

Results: Guidelines for the delivery of plastic surgery care by volunteer groups to developing countries have been reviewed and approved by the boards of both organizations (the American Society of Plastic Surgeons/Plastic Surgery Educational Foundation and the Society for Pediatric Anesthesia). These include guidelines for the initial site visit, site and patient selection, staff and equipment that should be available, and procedures that can be safely performed based on the site and available facilities. Guidelines for assessment of outcomes, dealing with adverse outcomes, and quality improvement are also provided.

Conclusions: Any plastic surgery group undertaking an international mission trip should be able to go to one source to find a detailed discussion of the perceived needs in providing high-quality, safe care for children. The present document was created to satisfy this need.

Knoxville, Tenn.; Charlottesville, Va.; Cleveland, Ohio; Minneapolis, Rochester, and Edina, Minn.; Austin, Texas; Spokane, Wash.; and Mountain View and Los Angeles, Calif.

From Fort Sanders Regional Medical Center; the Department of Anesthesiology, University of Virginia Health System; the Department of Plastic Surgery, Case Western Reserve University; Abbott Northeastern Hospital; the Division of Plastic Surgery, University of Texas Medical Branch at Austin; Providence Sacred Heart Medical Center and Children's Hospital; Interplast; the Division of Plastic Surgery, University of Southern California; the Department of Anesthesiology, Mayo Clinic College of Medicine; and the Division of Plastic Surgery, University of Minnesota.

Received for publication June 13, 2010; accepted August 25, 2010.

Disclosure:The authors have no financial interest to declare in relation to the content of this article. The article did not require external funding.

Arun K. Gosain, M.D.; Department of Plastic Surgery; Case Western Reserve University; University Hospitals of Cleveland; MS 5044; 11100 Euclid Avenue; Cleveland, Ohio 44106;

©2011American Society of Plastic Surgeons