Plastic surgery within global surgery: the incidence of plastic surgery cases in a rural Gabonese hospital

Background: Although plastic surgeons often demonstrate interest and ability in global surgery, it is not always clear how much of the surgical pathology that presents at a typical community hospital in the African bush could be well-treated by a plastic surgeon. This is compounded by the fact that many surgeons in Africa do not recognize the full breadth of disorders that can be treated by a plastic surgeon. We aim to quantify the cases that fall under the purview of plastic surgery at our 158-bed rural hospital in southern Gabon in central Africa. Methods: We reviewed the entire operative case log for 2018 for Bongolo Hospital in Lébamba, Gabon, and we filtered for all cases that fell under the purview of plastic surgery. We compared this number to the number of cases that had previously been categorized as plastic surgery cases. Results: Of the 1718 surgical cases in 2018, 27 (1.6%) had originally been classified as plastic surgery cases. Upon our re-review, 186 cases (11%) fell under the purview of plastic surgery, and up to 16% of cases would be adequately treated by a plastic surgeon. Conclusion: At least 1 in 9 surgical cases at this first-level, rural, African hospital can be classified as plastic surgery. This case load testifies to the impact plastic surgeons can have in the sub-Saharan African context, even at smaller, rural hospitals. Level of Evidence: Level IV, risk study.