Nenad B Tajsic1, Puon Sambath2, Sophy Nguon3, Vannara Sokh3, Virak Chheang4, Gaute Landsem5, Ivan Zaletel6, Hans Husum7. 1. Orthopedic and Trauma Surgery Department, University Hospital Northern Norway, Tromsoe, 9036, Tromsoe, Norway. nenad.tajsic@gmail.com. 2. Sampov Luon Referral Hospital, Battambang, Cambodia. 3. Military Region 5 Hospital, Battambang, Cambodia. 4. Battambang Referral Hospital, Battambang, Cambodia. 5. Orthopedic and Trauma Surgery Department, University Hospital Northern Norway, Tromsoe, 9036, Tromsoe, Norway. 6. Institute of Histology and Embryology "Aleksandar Ð. Kostić", School of Medicine, University of Belgrade, 11000, Belgrade, Serbia. 7. University Hospital Northern Norway, Tromsoe, Norway.
Abstract
INTRODUCTION: A prospective interventional study has been carried out on the teaching effect and sustainability of low-cost trauma training program in open tibia fracture management for health workers. MATERIALS AND METHODS: In 2007, an external fixator and a patella-bearing orthosis were developed at a rural workshop in Cambodia. From 2010 to 2016, a core group of nine Cambodian health workers was trained in open fracture management by Norwegian senior surgeons, using the locally made fixator and brace. The training outcome was also assessed by a questionnaire comprising of assertions regarding theoretical understanding, technical skills and self-confidence in understanding the biomechanical properties of locally made external fixator and its application; the use of handmade orthosis and principle in covering of soft-tissue defects. RESULTS: The students managed 23 cases with the new technique with a primary healing rate of 70% (95% CI 48.1-85.5). A significant increase in self-reported technical skills, understanding, and self-confidence was reported. CONCLUSION: This study demonstrates that the capacity building of reconstructive surgery in low-resource settings by local doctors and paramedics is clearly a reasonable option that may substantially reduce amputation of the limbs.
INTRODUCTION: A prospective interventional study has been carried out on the teaching effect and sustainability of low-cost trauma training program in open tibia fracture management for health workers. MATERIALS AND METHODS: In 2007, an external fixator and a patella-bearing orthosis were developed at a rural workshop in Cambodia. From 2010 to 2016, a core group of nine Cambodian health workers was trained in open fracture management by Norwegian senior surgeons, using the locally made fixator and brace. The training outcome was also assessed by a questionnaire comprising of assertions regarding theoretical understanding, technical skills and self-confidence in understanding the biomechanical properties of locally made external fixator and its application; the use of handmade orthosis and principle in covering of soft-tissue defects. RESULTS: The students managed 23 cases with the new technique with a primary healing rate of 70% (95% CI 48.1-85.5). A significant increase in self-reported technical skills, understanding, and self-confidence was reported. CONCLUSION: This study demonstrates that the capacity building of reconstructive surgery in low-resource settings by local doctors and paramedics is clearly a reasonable option that may substantially reduce amputation of the limbs.
Authors: Katherine R Iverson; Emma Svensson; Kristin Sonderman; Ernest J Barthélemy; Isabelle Citron; Kerry A Vaughan; Brittany L Powell; John G Meara; Mark G Shrime Journal: Int J Health Policy Manag Date: 2019-09-01