Background Microsurgery is essential in modern reconstructive surgery and plastic surgery training. Surgeon's proficiency and experience are crucial for effective microsurgical interventions. Despite anecdotal evidence of varying quality of microsurgery training globally, no empirical studies have investigated this. We conducted a global survey to investigate microsurgical training and clinical case exposure among plastic surgery trainees worldwide.

Methods An online survey was conducted using a secure platform to gather information on microsurgical case exposure and training among plastic surgery trainees between August 2020 and April 2021. Participants provided consent and completed a 37-question survey across four themes: clinical caseload, surgical exposure to microsurgery, microsurgical simulation training exposure, and barriers and opportunities.

Results A total of 202 responses were received, with most respondents in formal training programs (86.7%). The data highlighted regional variation in microsurgery case indications and flap types, with North America and Europe exhibiting the highest activity levels in microsurgery. Trainees in Asia have the highest cumulative practical exposure in microsurgery, followed by Australia and Oceania, and North America. Only 39.6% of respondents reported formal microsurgical simulation training, and almost one-third (29.7%) received no simulation training. Trainee access to practical experience is limited by several factors, including insufficient time and procedure complexity. Notably, practical experience was most commonly denied without reason being given.

Conclusion Our study highlights significant disparities in microsurgical training and exposure among plastic surgery trainees globally. Further research is needed to identify strategies for addressing these issues, given the growing demand for complex reconstructive microsurgery and its impact on health care inequalities.

This manuscript has not been published elsewhere and is not under consideration by another journal. There are no previous publications or reports that may be regarded as redundant publication of this work. All authors have approved the manuscript and agree with its submission to this journal. We are not using any copyrighted information, patient's photographs, identifiers, or other protected health information in this article. No text, text boxes, figures, or tables in this article have been previously published or owned by another party. We have no commercial associations or financial relationships that might pose or create a conflict of interest.

Received: 23 June 2023

Accepted: 24 August 2023

Accepted Manuscript online:
29 August 2023

Article published online:
09 October 2023

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