The burden of death and disability attributable to lack of access to surgical care for traumatic injuries, as well as of nontraumatic chronic conditions and soft tissue and bone infections, falls most heavily on people in low- and middle-income countries (LMICs) (Ozgediz and others 2008; Spiegel and others 2008). Human and technical capacities are insufficient to address the existing burden of injuries in these countries. Selected surgical interventions for trauma have proven cost-effective in these settings, and innovative low-cost programs and interventions have improved trauma care outcomes at individual hospitals. It is critical that LMICs create or strengthen existing trauma systems to improve outcomes. Identifying effective and cost-effective interventions and strategies to inform the future direction of these resource-challenged countries is an essential step in this process.
The chapter on surgery in the Disease Control Priorities in Developing Countries, second edition (DCP2) (Jamison and others 2006) exposed the scarcity of relevant evidence on outcomes, effectiveness, and cost-effectiveness in the literature from the developing world; unfortunately, this situation has improved only mildly. Although some interventions and strategies have been identified (Tollefson and Larrabee 2012), deficiencies in both the quantity and the quality of data remain glaring (Vos 2009).
This chapter addresses the surgical aspects of care for these conditions. It presents available epidemiological data, as well as data on systematic approaches to trauma and interventions in specific anatomic areas.
© 2015 International Bank for Reconstruction and Development / The World Bank.