Health-Related Quality of Life and Social Reintegration Indicators Following Reconstructive Surgery: A Prospective Observational Study.

Abstract

Background: Studies focusing on disease severity and reconstructive surgical treatment's impact on health-related quality of life (HRQOL) are lacking, particularly in low- and middle-income countries (LMICs). This study aims to assess the impact of reconstructive surgery-related conditions on basic indicators of quality of life and social integration within the context of limited resources and short-term surgical missions.

Methods: We conducted a pre-post cohort study at Tumbi Regional Referral Hospital in Tanzania from July 2023 to July 2024. Patients undergoing reconstructive surgery for postburn contractures (PBC), congenital malformations, and trauma-related conditions were included. Surgical outcomes and HRQOL were assessed using patient-reported outcome measures (PROMs) preoperatively and at 12 months postoperatively.

Results: Of 120 scheduled patients, 82 were included, with a 12-month follow-up rate of 77.7% and a median age of 3.5 years old. PBC accounted for 73.2% of cases. The patients' primary expectation after surgery was functional recovery (64%). Patient-reported disabilities improved significantly, decreasing from 72% to 9% postoperatively (p < 0.001). The impact on family life improved from 58.8% to 6% (p < 0.001), and reductions in social exclusion and discrimination were observed. Notably, perceptions of witchcraft association declined from 23% to 7.8% (p < 0.014).

Conclusions: Assessing the impact of disabilities and surgical outcomes on HRQOL using PROMs is feasible and seems essential during short-term surgical missions. The findings suggest that reconstructive surgery restores functionality and improves quality of life 1 year after the procedure, highlighting its positive impact on patients' social lives and overall well-being.