Microsurgical education without borders: Implementation of a low cost, reproducible global microsurgery course.
other · Level V
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- Record sourced from PubMed, PMID 42208201.
- Also identified by DOI 10.1016/j.bjps.2026.05.019.
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Abstract
Microsurgery is a critical component of reconstructive surgery but has limited adoption in low- and middle-income countries (LMICs) owing to resource constraints. We developed a multi-day microsurgery course for global microsurgery education and aimed to evaluate the educational benefits of this course. Global microsurgery courses were conducted from 2022 to 2025 in South Africa, Rwanda, Vietnam, and Egypt. Each site hosted a multi-day course covering basic and advanced microsurgical techniques. Pre- and post-course surveys assessed participants' confidence in microsurgical skills and perceptions of the value of microsurgery. Paired t-tests were used to compare pre- and post-course results to evaluate changes in comfort and confidence. Sixty participants from Egypt, South Africa, Rwanda, and Vietnam completed the course. Most were surgical residents (68.3%) specializing in plastic (66.7%) or orthopedic surgery (25.0%). Prior to the course, 61.7% had performed <5 microsurgical anastomoses. During the course, participants completed a median of 7.0 anastomoses, including 6.0 end-to-end and 1.0 end-to-side. Statistically significant improvements were observed across all self-assessed microsurgical skills, including microscope operation, instrument handling, vessel preparation, and anastomosis performance (all p<0.0001). Participants reported reduced anxiety about microsurgery and increased confidence in evaluating anastomosis quality. Perceived value of simulation-based training and belief in the positive impact of microsurgical skills on future careers also improved significantly (p=0.002 and p=0.02, respectively). Trends were consistent across sites, with minor variation related to site-specific curriculum differences. The implementation of an international microsurgical course significantly improves participant confidence and skills. Continued integration may enhance access to microsurgical care in LMICs by addressing gaps in surgical education and training.