Citation

Flynn-O'Brien KT, Trelles M, Dominguez L, Hassani GH, Akemani C, Naseer A, Ntawukiruwabo IB, Kushner AL, Rothstein DH, Stewart BT. J. Pediatr. Surg. 2015; 51(4): 659-669.

Affiliation

Department of Surgery, University of Washington, Seattle, WA, USA; School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana; Department of Surgery, Komfo Anokye Teaching Hospital, Kumasi, Ghana.

Copyright

(Copyright © 2015, Elsevier Publishing)

DOI

10.1016/j.jpedsurg.2015.08.063

PMID

26454469

Abstract

PURPOSE: Pediatric surgical care is deficient in developing countries disrupted by crisis. We aimed to describe pediatric surgical care at Médecins Sans Frontières-Brussels (MSF-OCB) projects to inform resource allocation and define the pediatric-specific skillset necessary for humanitarian surgical teams.

METHODS: Procedures performed by MSF-OCB from July 2008 to December 2014 were reviewed. Project characteristics, patient demographics and clinical data were described. Multivariable logistic regression was performed to determine predictors of perioperative death.

RESULTS: Of 109,828 procedures, 26,284 were performed for 24,576 children (22% of all procedures). The most common pediatric operative indication was trauma (13,984; 57%). Nine percent of all surgical indications were due to violence (e.g., land mines, firearms, gender-based violence, etc.). The majority of procedures (19,582; 75%) were general surgical, followed by orthopedic (4350; 17%), and obstetric/gynecologic/urologic (2135; 8%). Perioperative death was low (42; 0.17%); independent predictors of death included age <1year, use of general anesthesia with a definitive airway, and operation during conflict.

CONCLUSION: Surgical care for children comprised nearly a quarter of all procedures performed by MSF-OCB between 2008 and 2014. Attention to trauma surgery and infant perioperative care is particularly needed. These findings are important when resourcing projects and training surgical staff for humanitarian missions.

Language: en