October 18, 2007 | Read Time: 2 minutes
When plastic surgeons in developing countries are confronted with difficult cases, they often don’t have colleagues nearby with whom they can consult. Interplast, a charity in Mountain View, Calif., is trying to lessen the effects of that isolation with an online system that lets those surgeons post challenging or unusual cases and get advice from colleagues around the world.
Earlier this year, Goran Jovic, the only plastic surgeon practicing in Zambia, a country of more than 11 million people, was treating a 14-month-old child with a bilateral cleft that split his face into three sections. Dr. Jovic, in his own research, was able to find only two studies that documented similar cases, so he posted photographs of his patient and a description of the case on a site known as Interplast Grand Rounds.
Less than six hours later, a surgeon from California proposed one way to approach the problem, and over the next week, surgeons in Ghana, India, Massachusetts, and Texas chimed in with other ideas and what to watch out for, sometimes illustrating their points with drawings and photographs.
Dr. Jovic says that ultimately he chose an approach that was different from those his colleagues suggested, but that their advice was very valuable as he planned for and did the complicated surgery.
“I would have done it one way or another, even without that help, but with those warnings and help, I’m sure I did it much better,” he says.
Dr. Jovic says the suggestions he receives from other surgeons in developing countries are sometimes the most helpful.
“We are all working in the same conditions, and we all see similar cases,” he says. “In the United States or Canada, everything is sorted out at the very early stage.” For example, genetic anomalies, burns, and other injuries are less likely to be neglected or left to develop into bigger problems, as often happens in developing countries.
The Interplast Grand Rounds service is relatively inexpensive to administer — less than $5,000 a year. Roughly 25 to 30 plastic surgeons in developing countries make use of the system, mostly doctors Interplast has worked with before, along with 50 to 75 surgeons in Europe and North America.
The online system also complements Interplast’s change in approach over the years, from primarily sending Western surgeons overseas to do surgeries to a greater emphasis on providing support to surgeons who live and practice in developing countries, says Scott Corlew, the organization’s chief medical officer.
Says Dr. Corlew: “The model of just going into places, breezing in and operating, and then breezing out is not really something in 2007 that is needed or necessarily a good thing to do.”
For a virtual tour of the system: Go to http://www.interplastgrandrounds.org.
