Survey-based Study to Assess the Self-perceived Competency in and Knowledge about Reconstructive Microsurgery among Young Plastic Surgeons

Objective: Microvascular free tissue transfer has become a preferred reconstructive technique for managing complex wounds and defects. The aim of this questionnaire-based study was to assess self-perceived competency in and knowledge about reconstructive microsurgery among plastic surgeons who graduated from the Faculty of Medicine Siriraj Hospital, Mahidol University during 2015-2019. Materials and Methods: Questionnaire was sent by email elicited information about the amount of microsurgery performed in practice, types of microsurgeries performed, reconstructive methods, types of flaps used, and respondent’s opinion about the microsurgery course attended during residency/fellowship training. Results: The total response rate was 87.5%. Almost all respondents work in a government hospital (90.4%), and responses came from all regions of Thailand. Thirty-eight percent of respondents reported no microsurgery cases, and the majority of those who did perform microsurgery did so less than 20 times/year. Hand reconstruction was the most common type of microsurgical procedure. The factors that negatively influence microsurgery in clinical practice include insufficiency of resources and personnel (29.1%), excessive workload (27.3%), and long operative time (23.6%). Suggestions for improvement of the microsurgical training course include having a good objective method for assessing microsurgical practices (27.7%), increasing the volume of practice on animal model (25.5%), and an appropriate number of microsurgery cases to gain necessary experience (25.5%). Conclusion: Reconstructive microsurgery was found to be a challenging procedure for many junior-level plastic surgeons. A low volume of cases limits a surgeon’s ability to develop needed skills. Important improvements in the microsurgery training course were also recommended.