Operation Smile

Designing a surgical training model to teach surgeons how to restore form, function and feeling through local flap surgery

Team Lead: Dr. Priyanka Naidu

Lead Institution: Operation Smile South Africa

Team Countries: South Africa, Ghana, United Kingdom, United States

Team Operation Smile is designing a surgical training model to teach surgeons how to restore form, function and feeling through local flap surgery from wounds and defects due to burns, trauma, cancer and congenital conditions. 

The team plans to implement a unique mixed methods approach to surgical training that will use a simulation platform that will incorporate virtual learning modules and simulations with a low cost, adaptable psychomotor training system. 

“Through the development of this mixed methods training platform, we hope to increase awareness, training capabilities and workforce capacity,” said Dr. Zachary Collier, a member of the team. 


Patients in low- and middle-income countries (LMICs) are disproportionately burdened by surgically treatable conditions such as burns, trauma, infection, cancer, and congenital conditions, which have debilitating physical and psychological consequences if left untreated. These patients often live in areas without adequate access to the corrective surgical procedures that would allow their physical wounds to be reconstructed in order to restore form, function and feeling. While a considerable number of medical and surgical treatment options exist for these pathologies, there is one surgical intervention – reconstructive flap surgery – that can effectively ameliorate a large proportion of the complications arising from these pathologies and allow patients to have an improved quality of life. 

Team Operation Smile is building a model to teach reconstructive surgery using local flaps, the transfer of skin and underlying tissues to reconstruct a wound or a congenital condition such as cleft lip. It is an essential skill that surgeons rely on to successfully treat many highly prevalent conditions encountered in Sub-Saharan Africa and other regions around the world. 

“Treating these conditions with local flap surgery is ideal for low-resource settings because surgeons can effectively treat many complex yet common forms of physical, psychological and societal disabilities while only requiring a small number of surgical instruments,” says Dr. Zachary Collier, a global surgery fellow and plastic surgeon with Operation Smile. 

Operation Smile is a global surgical NGO that provides cleft surgery and ongoing care for people in limited-resource environments through partnerships with communities and governments, and training and education for health care workers, bringing patients hope, healing and health. 

The multidisciplinary global team working on the development of this surgical module consists of clinicians with expertise in local flap surgery, simulation technical experts, health policy advocates, regional and country managers and experts. This diverse team will allow implementation of a contextually relevant, unique mixed methods approach to surgical training that will use a simulation platform that incorporates virtual learning modules and simulations, along with a low cost and adaptable psychomotor skill training system. In this mixed methods approach, the virtual education platform that accompanies the physical training platform will contain interactive step-by-step surgical modules specifically designed to facilitate self-directed learning and training for local flap surgery.  

This will help trainees learn critical elements of this procedure, including understanding which flap to select for different reconstructive requirements, best practices for designing these flaps, and the step-by-step approach to performing these procedures. Finally, trainees will learn the optimal way of performing closure, so they can achieve the best reconstructive results for their patients.