​What kinds of symptoms do patients experience before receiving treatment?

Patients often need this reconstruction technique following the removal of tumors or larger growths that resulted in prominent defects. This may include a skin defect due to an injury or a defect in the bone due to a non-union fracture or tumor.

​What is the impact on patients’ lives of living with these conditions?

Patients are functionally disabled, and risk infection or death without correction of these defects. When the defects are repaired, patients are able to return to a better function and higher quality of life.

What cultural or regional factors affect the treatment of these conditions?

For Cambodians, serious disabilities - whether from poverty or lack of medical care - may mean decreased earning capability and discrimination in the workforce.

What does the treatment process look like?

The surgeon will select tissue in the body that will do the best job of restoring the function and the appearance of tissue destroyed by the defect. Surgeons look for suitable vessels to attach the flap.

What is the impact of this treatment on the patient’s life?

Patients can have better physical function, acceptance in their community, and subsequently a higher quality of life; they can also increase their earning capability.

What potential side effects or risks come with this treatment?

Poor healing, infection, bleeding, or rejection of the flap are risks. Patients need 6-8 weeks of recovery prior to resuming normal activity. Driving, exercise, or other strenuous activity could damage recovering tissues or open up wounds, which could result in the need for additional surgery or treatment.

How accessible is treatment in the area? What is the typical journey like for a patient to receive care?

CSC is the only center in Cambodia that regularly offers free vascularized flap procedures. Poor and disabled Cambodians come to CSC from all over the country. They usually stay in the hospital ward for 3-5 days, during which time they receive appropriate medicine, including anticoagulation and painkillers, and daily wound care until the flap has well settled. Many of our patients are from poor, rural areas in other provinces, often traveling four to eight hours on dirt or poorly constructed roads to receive care. Patients are referred for this treatment from local health care providers and clinics in their province, or from neighbors or relatives who received care at CSC.

What are the alternatives to this treatment?

An alternative to functional muscle transfer in the case of a paralyzed arm is an amputation & shoulder fusion. For an open wound in the face or other areas, a local pedicle flap can be used but its reach and cosmetic concern are limiting factors. Skin grafting can be done only if there is no tendon or bone exposed. Patients often seek help from local Khmer healers, and this is almost always unsuccessful, but all the patient can afford until they learn about CSC.