gms | German Medical Science

Objectives/Interrogation: In the last 35 years INTERPAST-Germany, as a non-profit organizaion for plastic surgery in developing countries, operated on 95.000 patients in more than 1.300 missions all over the world. About 10 % of the patients were handsurgery cases with partly extreme burn contractures, syndactlies or other malformations who need more than only a skin graft for correction. Although in many developing countries only limited facilities are available a varity of plastic reconstructive procedures could be performed savely.

Methods: The design of reconstructive porocedures will be discussed under the aspect of safety, effectivness and recurrence of contractures. The therapy management differs from the experience in our country due to the lack of post-op compression and physiotherapy which often could not put into practice.

Results and Conclusions: Longterm results show that even under poor condition improvement could be achieved, but often secondary surgery is necessary to restore better function. The major problem remains the post operative management. Woundhealing of skingrafts, temporary arthrodesis and flap necrosis need specialized after care. Differntial immobilisation and mobilistaion are usually not under professional control possible. To begin an operation wihtout thinking of the post op care should be avoided.

Regular INTERPLAST camps with handsurgery specialized colleagues are a meanigful help for many patients who get no chance of any operation elswhere. Repeated camps at the same place allow us to follow up many patients even with severe deformities. Learning from poor results we developed basic principles which we can teach the local surgeons to enable them to help their own people. Humanitarian aid in the field of hand surgey should not only remain a national task. A worldwide collaboration with many other charitable organizations like MSF show us the effectiveness of our efforts.