{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T15:20:58Z","timestamp":1772983258831,"version":"3.50.1"},"reference-count":22,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,7,25]],"date-time":"2025-07-25T00:00:00Z","timestamp":1753401600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,7,25]],"date-time":"2025-07-25T00:00:00Z","timestamp":1753401600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Burn injuries are a major health concern in conflict\u2010affected settings, where displaced populations such as refugees and internally displaced persons (IDPs) face limited access to surgical and rehabilitative care. Postoperative follow\u2010up is often limited by socioeconomic and logistical barriers beyond the patient's control. This study examines follow\u2010up adherence, rehabilitation participation, and complication rates after secondary reconstructive surgery for complications resulting from burn injuries performed by Swisscross teams in northern Iraq.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective chart review was conducted for patients who underwent secondary reconstructive surgery for burn\u2010related injuries between October 1, 2021, and February 6, 2025, through the Swisscross Foundation. A total of 147 episodes of care (EoCs) across 123 patients were included. Data on demographics, socioeconomic status, follow\u2010up adherence, physical therapy participation, use of ad hoc care providers, and postoperative complications were collected and analyzed. Ethical approval was granted by the University of Toronto Research Ethics Board (protocol #00047579).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the 123 patients, 59 were IDPs, 19 were refugees, and 45 were local residents. Full follow\u2010up adherence was highest in locals (90%), followed by refugees (83%) and IDPs (64%). Overall noncompliance (&lt;\u00a020% adherence) was low at 4%. Formal physical therapy was prescribed in 34 cases, with the highest compliance among refugees (78%) and the lowest among IDPs (31%). Ad hoc care providers were used for rehabilitation in 47% of cases prescribed therapy, primarily among IDPs. Complications occurred in 36% of operations (53\/147 EoCs), the majority being minor and manageable without surgery (35\/147). Reoperation for immediate complications was required in 4% of cases and for relapse in 8%, with no significant difference between groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Despite significant barriers, structured support and interagency coordination enabled meaningful follow\u2010up and rehabilitation among displaced burn patients. Complex reconstructive care is both feasible and impactful in conflict settings, particularly when supported by transportation services and flexible rehabilitation strategies. These findings highlight the importance of targeted infrastructure to improve surgical outcomes in vulnerable populations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/wjs.70011","type":"journal-article","created":{"date-parts":[[2025,7,25]],"date-time":"2025-07-25T11:14:28Z","timestamp":1753442068000},"page":"2314-2324","source":"Crossref","is-referenced-by-count":1,"title":["Postoperative Care After Reconstructive Surgery for Burn Contractures in Communities Affected by War: A Retrospective Study in Iraq"],"prefix":"10.1002","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-2296-7917","authenticated-orcid":false,"given":"Ian M.","family":"Furst","sequence":"first","affiliation":[{"name":"Surgeon Swisscross Foundation  Z\u00fcrich Switzerland"},{"name":"Department of Surgery Cambridge Memorial Hospital  Cambridge Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarezh Mohammed","family":"Saber","sequence":"additional","affiliation":[{"name":"Patient Care Coordinator Swisscross Foundation  Erbil Iraq"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lass Azad","family":"Abdulkarim","sequence":"additional","affiliation":[{"name":"Patient Care Coordinator Swisscross Foundation  Erbil Iraq"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicola","family":"Keller","sequence":"additional","affiliation":[{"name":"Surgeon Swisscross Foundation  Z\u00fcrich Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mustafa Subhe","family":"Muhyadin","sequence":"additional","affiliation":[{"name":"Plastic &amp; Reconstructive Surgery Swisscross Foundation  Erbil Iraq"},{"name":"Plastic &amp; Reconstructive Surgery Rozhawa Emergency Hospital  Erbil Iraq"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarmad Nashat","family":"Ahmad","sequence":"additional","affiliation":[{"name":"Plastic &amp; Reconstructive Surgery Swisscross Foundation  Erbil Iraq"},{"name":"Plastic &amp; Reconstructive Surgery Shaqlawa Teaching Hospital  Shaqlawa Iraq"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ala Ismail","family":"Shakur","sequence":"additional","affiliation":[{"name":"Plastic &amp; Reconstructive Surgery Swisscross Foundation  Erbil Iraq"},{"name":"Plastic &amp; Reconstructive Surgery Rozhawa Emergency Hospital  Erbil Iraq"},{"name":"Plastic &amp; Reconstructive Surgery Breast Center  Erbil Iraq"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-8668-2007","authenticated-orcid":false,"given":"Ahmed Ibrahim","family":"Berzenji","sequence":"additional","affiliation":[{"name":"Orthopaedic Surgery Swisscross Foundation  Erbil Iraq"},{"name":"Orthopaedic Surgery Rozhawa Emergency Hospital  Erbil Iraq"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6248-5977","authenticated-orcid":false,"given":"Michael","family":"Glogauer","sequence":"additional","affiliation":[{"name":"Department of Dentistry University Health Network  Toronto Canada"},{"name":"Faculty of Dentistry University of Toronto  Toronto Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathrin","family":"Schulze","sequence":"additional","affiliation":[{"name":"Operating Theatre Nurse Swisscross Foundation  Z\u00fcrich Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4505-2181","authenticated-orcid":false,"given":"Sarkhell","family":"Radha","sequence":"additional","affiliation":[{"name":"Surgeon Swisscross Foundation  Z\u00fcrich Switzerland"},{"name":"Orthopaedic Surgery Croydon University Hospital  London UK"},{"name":"Chief of Surgery Swisscross Foundation  Z\u00fcrich Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Enrique","family":"Steiger","sequence":"additional","affiliation":[{"name":"Surgeon Swisscross Foundation  Z\u00fcrich Switzerland"},{"name":"Founder Swisscross Foundation  Z\u00fcrich Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Walter","family":"K\u00fcnzi","sequence":"additional","affiliation":[{"name":"Surgeon Swisscross Foundation  Z\u00fcrich Switzerland"},{"name":"Orthopaedic Surgery University of Baghdad  Baghdad Iraq"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natasha","family":"Forster","sequence":"additional","affiliation":[{"name":"Surgeon Swisscross Foundation  Z\u00fcrich Switzerland"},{"name":"Plastic &amp; Reconstructive Surgery Swisscross Foundation  Z\u00fcrich Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,7,25]]},"reference":[{"issue":"3","key":"e_1_2_11_2_1","first-page":"214","article-title":"Refugee Camps, Fire Disasters and Burn Injuries","volume":"30","author":"Atiyeh B. 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