Perceptions and Limitations of Free Flap Procedures Among Surgeons in Jordan: A Cross-sectional Study.

Abstract

Background: Free flap procedures are essential in reconstructive surgery, yet their use is influenced by multiple factors, including infrastructure, training, financial constraints, and surgeon experience. This study explored the perceptions of Jordanian surgeons regarding the limitations of free flap procedures.

Methods: A cross-sectional survey was conducted among Jordanian surgeons, including plastic surgeons, neurosurgeons, ophthalmologists, orthopedic surgeons, and vascular surgeons. Data were collected through a structured questionnaire, assessing infrastructure, resources, training, education, funding, insurance, and surgeon experience. Statistical analysis was performed using R version 4.2.1, and comparisons between plastic and reconstructive surgeons and other surgical specialists were made using chi-square and independent t tests.

Results: A survey of 120 surgeons revealed that 70% had access to sufficient resources, but 55% had limited access to specialized tools and concerns about institutional budgeting and equipment maintenance. Additionally, 50% had no formal training in free flap procedures, whereas 40% received training during residency. Financial constraints influenced decision-making, with 53% citing affordability and insurance issues. Experience was a key factor, with 45.8% reporting limited exposure to free flaps and 88% recognizing surgeon expertise as critical to success. Plastic surgeons were more likely to have formal training and greater experience with free flap procedures than other specialists (P = 0.04, 0.002, respectively).

Conclusions: The study highlighted challenges in the adoption of free flap procedures in Jordan, such as limited access to specialized tools, inadequate training, financial constraints, and disparities in surgeon experience, emphasizing the need for structured training programs, improved institutional support, and improved insurance policies.