Defining orthoplastic limb salvage centers: a systematic review

Area of Science:

• Orthopedics
• Vascular Surgery
• Plastic Surgery
• Health Services Research

Background:

• Limb salvage centers are increasing but lack standardized criteria.
• Orthoplastic centers may represent a distinct model of care needing standardization.

Purpose of the Study:

• To assess organizational features of limb salvage centers.
• To determine if orthoplastic centers differ from vascular centers and benefit from standardization.

Main Methods:

• Systematic review of publications from major databases (MEDLINE, Embase, Web of Science, Cochrane) up to 2024.
• Quantified 26 organizational features across six care domains using a validated quality framework.
• Identified differentiating features and established a quality framework for orthoplastic centers.

Main Results:

• Orthoplastic centers more frequently reported plastic surgery consultation, surgical outcomes, and network integration.
• Vascular centers reported more team features and quality systems, reflecting chronic disease management.
• Six organizational features characterized orthoplastic centers, providing standardization priorities.

Conclusions:

• Orthoplastic limb salvage centers exhibit distinct care paradigms.
• Standardization of orthoplastic limb salvage centers is beneficial.
• Structural benchmarks are suggested for the development of standardized orthoplastic limb salvage centers.