CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2019; 54(03): 309-315
DOI: 10.1055/s-0039-1692433
Artigo Original | Original Article
Sociedade Brasileira de Ortopedia e Traumatologia. Published by Thieme Revnter Publicações Ltda Rio de Janeiro, Brazil

The Role of the Hand Surgeon in Microsurgery in Brazil[]

Article in several languages: português | English
1  Serviço de Cirurgia de Mão e Microcirurgia, Hospital do Servidor Público Municipal, São Paulo, SP, Brasil
,
Carlos Henrique Fernandes
2  Departamento de Ortopedia e Traumatologia, Escola Paulista de Medicina, Instituto de Cirurgia da Mão, Universidade Federal de São Paulo, São Paulo, Brasil
,
Marcela Fernandes
2  Departamento de Ortopedia e Traumatologia, Escola Paulista de Medicina, Instituto de Cirurgia da Mão, Universidade Federal de São Paulo, São Paulo, Brasil
,
Joao Baptista Gomes dos Santos
2  Departamento de Ortopedia e Traumatologia, Escola Paulista de Medicina, Instituto de Cirurgia da Mão, Universidade Federal de São Paulo, São Paulo, Brasil
,
Luiz Carlos Angelini
3  Disciplina de Anatomia da Ortopedia, Universidade Metropolitana de Santos, Santos, SP, Brasil
,
Luis Renato Nakachima
2  Departamento de Ortopedia e Traumatologia, Escola Paulista de Medicina, Instituto de Cirurgia da Mão, Universidade Federal de São Paulo, São Paulo, Brasil
› Author Affiliations
Further Information

Publication History

21 January 2018

02 July 2018

Publication Date:
27 June 2019 (online)

Abstract

Objective This study evaluates the conditions for microvascular procedures found by hand surgeons in Brazilian clinical practices.

Methodology A prospective, observational, and analytical primary clinical research conducted during the 37th Brazilian Congress of Hand Surgery, from March 30th to April 1st, 2017, in Belo Horizonte, in which physicians answered 12 closed, objective, multiple-choice questions regarding their geographic region, type of institution (public or private), microsurgical training, time of experience, technical conditions, the availability of a standby team for emergencies and compensation.

Results The study analyzed 143 hand surgeons; among them, 65.7% participants were based at the Southeast region, 13.3% in the Northeast region, 11.9% in the South region, 6.3% in the Central-West region and 2.8% in the North region. Regarding the time of experience, 43.4% of the hand surgeons had less than 5 years, 16.8% had 5 to 10 years, 23.8% 10 to 20 years, and 23% had more than 20 years of practice in microvascular surgery. Seven percent of the surgeons had no training in microvascular surgery; for 63.6%, training occurred during medical residency, whereas 30.8% were trained in another institution, and 7.7% in another country. Among these surgeons, 76.9% worked at both private and public hospitals, 14.7% at private hospitals and 5.6% at public hospitals. Regarding compensation, 1.8% of the surgeons considered it adequate, and 98.2%, inadequate in public hospitals, whereas 5.0% considered it adequate, and 95.0%, inadequate in private hospitals.

Conclusion This research shows that most surgeons were trained in microsurgery, had never performed reattachments, and considered that compensation is inadequate; moreover, standby teams were not available. There are few, unevenly distributed hand surgeons with microsurgical ability in emergency settings, and their compensation is low.

Work performed at the Hand Surgery Institute, Department of de Orthopedics and Traumatology of the Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil.