Table 1

Study characteristics

Authors (year)Affiliated organisationsCountry of missionYear of missionNumber of patients treateda Length of follow-upb Follow-up rateComplication ratec Health gains
Aziz et al (2009)27 NABangladesh2006–2008146≤10 daysNA8/146 (5.5%)NA
Bello et al (2018)28 CFDFNigeria2011–20174482 months155/448 (34.6%)35/155 (34.6%)NA
Bermudez and Lizarraga (2009)69 Operation Smile40 countries200740861 year812/4086 (19.9%)NANA
Calis et al (2016)33 Interplast TurkeyUzbekistan2009–2014529NANA1/529 (0.2%)NA
Daniels et al (2016)34 ReSurge Int.China2005–20092011–5 yearsb 116/201 (57.7%)*34/96 (35.4%)*NA
Fayyaz et al (2015)36 Cleft Lip and Palate Association PakistanPakistan20143123 monthsNA18/312 (5.8%)NA
Guneren et al (2015)40 Turkish international development agencya Asia, Middle East, Africa2007–201425NANANANA
Hackenberg et al (2015)41 Operation SmileIndia2006–20123503NANANATotal 21 006 DALYs averted
6.0 DALYs averted per patient
Hughes et al (2016)42 Hands Across the WorldEcuador201527NANANANA
Hughes et al (2012)43 Hands Across the WorldEcuador1996–201111427 days1089/1142 (97.1%)*40/1122 (3.6%)*Total 396–1042 DALY averted
3.9–10.2 DALY averted per patient
MacIntosh et al, (2013)46 Healing the ChildrenColombia1994–20112558NANA10/2727 (0.4%)d NA
Madsen et al (2015)47 US militaryDominican Republic2005–200922330 months205/223 (91.1%)13/223 (5.8%)Speech score improved from 11.4 (6–24) to 5 postoperatively (borderline=6)
Magee et al (2010)48 Operation SmileKenya, Russia, Nicaragua, Vietnam2008303NANANATotal 3099.52 DALYs averted
10.1 DALYs averted per patient
Maine et al (2012)49 ReSurge Int and Rostros FelicesEcuador2000–2005315>14 days128/315 (40%)72/128 (56.3%)NA
McQueen et al (2007)53 Operation SmileJordan, Iraq200571NANA4/71 (5.6%)NA
McQueen et al (2009)67 Operation Smile18 CountriesNA8151NANA67/8151 (0.8%)NA
Moon et al (2012)55 Smile for ChildrenVietnam2007–2010303NANANATotal 377 to 458 DALYs averted on average mission
Navarro (2015)56 CIRPLASTPeru1994–2014610812 days (range 12 days to 9 years)b 5162/6108 (84.5%)377/5162 (7.3%)NA
Park et al (2018)39 Operation SmileIndia2010–20118907 days662/890 (74.4%)101/662 (15.3%)NA
Rauso et al (2015)57 Emergenza Sorrisi OnlusUganda, Gabon2012–201456NANA2/56 (3.6%)NA
Rivera et al (2013)58 Operation SmileHonduras2007456 months22/45 (48.9%)3/22 (13.6%)NA
de Buys Roessingh et al (2012)16 SedoGoho hospital, TdH, CHUV Laus.Benin and Togo1993–2008131*5.6–7.6 years36/71 (50.7%)*14/71 (19.7%)*Speech follow-up: 36 patients. Acceptable 17/36=47.2%. Unacceptable 19/36=52.8%
Rossell-Perry et al (2015)60 ReSurge International and Smile TrainPeru2002–20122571–5 yearsb 97/353 (27.5%)d 34/257 (13.2%)*NA
Sharp et al (2008)61 Operation SmilePhilippines20031206 months52/99 (52.5%)*10/50 (20.0%)*
  • Improved speech 52%

  • Improved eating 25%

  • Improved social benefit 14%

  • Improved appearance 6%

Sieg et al (2004)62 NAAfrica, Asia, Central AmericaNA14≥1 year10/14 (71.0%)*1/10 (10%)*NA
Uemura et al (2015)64 Duang-Kaew FoundationThailand, Vietnam, Myanmar, Laos, Cambodia, China, Sri Lanka, Bhutan and India1988–200868321 month5412/6832 (79.2%)186/5412 (3.4%)NA
Uetani et al (2006)65 Japanese Cleft Palate FoundationVietnam1993–2003790NANANANA
Wes et al (2017)66 Changing Children's Lives Int.Thailand201356<1.5 years30/56 (53.6%)0/30 (0%)Self-reported improvement: social interactions 83,3%; confidence 83.3%; school performance 75%
Post-burn contracture
Borghese et al (2005)31 NACambodia, Bangladesh2002, 2003200NANA14/200 (7.0%)NA
El Ezzi et al (2017)35 Terre des HommesBenin and Togo2002–2011503.6 years50/50 (100%)28/50 (56.0%)NA
Fuzaylov et al (2015)38 Doctors Collaborating to Help ChildrenUkraine2011–201339NANA1/39 (2.6%)NA
Kim et al (2012)45 Operation ReStore, Operation Smile and Cents of ReliefIndia201038NANA9/60 (15.0%)NA
Sinha et al (2016)63 Operation ReStoreIndia20123184 days31/39 (79.5%)9/31 (29.0%)SF-36 QoL : improvement of 5.8 points
WPI: 13.7% mean improvement
Bouman et al (2010)32 Facing Africa and Dutch Noma FoundationEthiopia, Nigeria2007, 20086335 days74/74 (100%)d 47/74 (63.5%)d Excellent results 36%
Satisfactory 23%
Mediocre 16%
Poor 11%
Very poor 14%
Marck et al (2010)50 Facing AfricaEthiopia2007, 20087735 days77/77 (100%)54/77 (70.1%)Good results 30.7%
Acceptable 34.6%
Mediocre 17.9%
Poor 7.7%
Very poor 9.0%
McGurk and Marck (2010)52 Project HararEthiopia2007–20099535 days89/95 (94%)57/89 (64.0%)Simple surgery group: good or acceptable results 90%
Complex surgery group: good or acceptable results 40%
Overall, poor results 6%
Overall, very poor results 6%
Rodgers et al (2015)59 Facing Africa and Dutch Noma FoundationEthiopia2008–20143436 daysNA17/34 (50.0%)NA
General reconstructive missions
Baran et al (2007)29 Physicians for Peace and InterplastMultiple countries1985–20044736NANANANA
Figus et al (2009)37 Interplast ItalyMultiple countries1988–20085235NANANANA
McClenaghan et al (2013)51 Project HararEthiopia20124021 days30/30 (100%)7/30 (23.3%)NA
Merrel et al (2007)54 Operation SmileVietnam1990–2004266NANA6/266 (2.3%)NA
  • Authors were contacted when data were missing for follow-up. Of note, in several studies (indicated with an *), the follow-up rate or complications rate were calculated over different subgroups; therefore, columns may not add up or correlate. aWhen available, this review reports the number of patients who received surgery; when not available, the number of procedures was used; when not available, the number of diagnosis was used. bWhen studies reported a range of follow-up intervals, the shortest length of follow-up was used for calculations. cWhen the total number of patients who completed follow-up was not available, the total number of patients included was used (in line with the cited articles). dThe complication rate cited was calculated over the total number of procedures.

  • CFDF, Cleft & Facial Deformity Foundation; DALY, disability-adjusted life year; NA, not available; SF-36 QoL, 36-Item Short Form Health Survey on Quality of Life; WPI, Whole Person Impairment questionnaire.