The role of the hand surgeon in microsurgery in Brazil

Abstract

Objective The present study evaluates which conditions the hand surgeons have found in the Brazilian clinical practices for microvascular procedures. Methodology A prospective, observational, and analytical primary clinical research conducted during the 37th Brazilian Congress of Hand Surgery fromMarch 30 to April 1, 2017, in Belo Horizonte, to doctors responding 12 closed objective multiple choices questions involving geographic region, type of institution, whether public or private, their microsurgical training, time since graduation, technical conditions, the presence of standby team for emergencies, and their remuneration. Results The present study analyzed 143 hand surgeons, of which 65.7% are based in 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. A total of 43.4% of the hand surgeons had < 5 years of practice; 16.8% from 5 to 10 years; 23.8% from 10 to 20 years; and 23% had > 20 years of practice in microvascular surgery. A total of 7.0% of the surgeons had no training in microvascular surgery; 63.6% held training in their medical residency, 30.8% in other institutions; and 7.7% in another country. A total of 76.9% of the surgeons worked both in private and public hospitals, 14.7% in private hospitals, and 5.6% in public hospitals. Regarding the remuneration, 1.8% considered it adequate in public hospitals, and 98.2% considered it inadequate. A total of 5.0% considered it adequate in private hospitals, and 95.0% considering it inadequate. Conclusion The present research has shown that the majority of the surgeons received training in microsurgery, has never performed reimplantation, and considered the remuneration inadequate. There is a lack of a standby team; the distribution of hand surgeons with microsurgical ability in emergencies is scarce and uneven, with low reimbursement value.