Plastic Surgery—Myths and Realities in Developing Countries: Experience from Eastern Nepal

B.P. Koirala Institute of Health Sciences, Dharan, Nepal, is the only tertiary care referral centre in the eastern region of Nepal. This paper discusses the author’s experience of starting a plastic surgery unit in eastern Nepal regarding need and present status of plastic surgery care in Nepal. Methods. We analyzed the data of patients treated in Plastic surgery unit from July 2007 to February 2009. We did evaluation regarding type of patients, procedures, and their outcome. We also evaluated the limitations and their possible solutions to overcome the barriers to establish effective plastic surgical centers in developing countries. Results. Plastic surgery services were started as a unit in general surgery by single plastic surgeon and one general surgery resident on rotation. Total 848 patients were treated for different plastic-surgery-related conditions, which included 307 acute burn patients 541 general plastic surgery patients. Trauma constituted the major bulk 22%, followed by tumors 20%, while aesthetic surgery operations were only 10.1%. Conclusions. In developing countries, aesthetic procedures constitute very small part of plastic surgery interventions and plastic surgery units are primarily required for reconstructive needs for optimum management of patients. 1. Introduction Plastic surgery is a special branch of medicine that deals with correction of head-to-toe disfigurement and other anomalies in the physical form that are either congenital or acquired. In developing countries, plastic surgery is usually considered a nonessential super specialty service as it is commonly correlated with cosmetic surgery and hence, it is one of the last departments to be started in a government hospital. Advancements in technology have broadened the scope of plastic surgery and today it is performed for a variety of reconstructive and aesthetic purposes. This paper briefly discusses the author’s experience of plastic surgery services in the eastern region of Nepal; it discusses the demand of masses, limitations of infrastructure, and future perspectives in development of plastic surgery in eastern Nepal. 2. Material and Methods B.P. Koirala Institute of Health Sciences receives patients from different parts of eastern Nepal and neighbouring Indian states, namely, Bihar and west Bengal. This study would highlight the relevant observations, limitations, and suggestions for better fulfilment of the objectives of a plastic surgical centre for eastern Nepal. Plastic surgery services were provided by single plastic surgeon and one resident as a specialty unit