The role of plastic and reconstructive surgeon in trauma care: Perspectives from a Level 1 trauma centre in India

Abstract

Background:As the morbidity and mortality due to trauma are ever increasing, there is proportionally growing need of trauma care facilities across the country. In the context of expanding designated trauma care facilities, the role of plastic and reconstructive surgeon needs to be analysed and defined at least at a Level 1 trauma centre.Materials and Methods:We included the patients who were operated under the department of plastic, reconstructive & burns surgery at a Level 1 urban trauma centre between January 2016 and December 2017. We analysed the demographic data and categorised operative data according to anatomical areas and interacting specialties.Results:A total of 1539 procedures were performed under the division of plastic reconstructive and burn surgery. Amongst them, 81% were male, and 19% were female. Mean age was 27.3 years (range: 3–90 years). The anatomical locations treated were upper limb (49%), lower limb (35%), head and neck (8%) and trunk (8%). Interdepartmental cases were 600 and majority of them were in collaboration with orthopaedics (n = 298), general surgery (n = 163), neurosurgery (79) and maxillofacial surgery (60).Conclusion:There is a significant role of plastic surgeon at a Level 1 trauma centre in India. The plastic surgeon's interventions are limb saving and sometimes lifesaving, many at times morbidity of post-traumatic sequelae are either prevented or treated. Along with other core specialties involved in the management of trauma, plastic surgeons play an integral role in a Level 1 trauma centre. The policymakers should take note to augment the number of plastic surgeons at a Level 1 apex trauma centre on par with other specialties, as the workload is heavy and is steadily on an increasing trend.

The use of machine learning for investigating the role of plastic surgeons in anatomical injuries: A retrospective observational study

“…[18–20] A report on Level I trauma centers in India indicated that plastic surgeons treated various anatomical areas, including the upper limb (49%), lower limb (35%), head and neck (8%), and trunk (8%). [21] Further, another study demonstrated a wide range of reconstructions in plastic surgery, including significant injuries in the extremities (40%), general wound care (36.4%), and craniofacial surgery (16.4%). [8] According to Fox et al, procedures performed by plastic surgeons include delayed primary suturing, tangential excision of necrotic tissue, skin graft or flap coverage, and release of secondary scar contractures to manage soft tissue injuries.…”

Its Not about the Destination, Its about the Journey—Plotting 50 Years of Changing Clinical Trends in Plastic Surgery in a Public Sector Teaching Hospital

“…Singhal et al 7 noted the essential role of plastic surgeons in trauma care centers, working in collaboration with other departments, thereby saving limbs and lives, and reducing morbidity. Records show that in 2019, we received referrals from 16 clinical departments, emphasizing our role as a “problem-solving specialty” in the hospital.…”

Multistep reconstruction of a post-traumatic defect in the lower limb with AV loop and free myocutaneous latissimus dorsi flap combined with a perforator monitor skin island after loss of ALT flap

“…Extensive soft tissue injury combined with open fractures is associated with higher infection rates and limited osteosynthesis options. This effect is amplified without an interdisciplinary approach involving plastic surgical soft tissue management and soft tissue expertise [ 4 ]. Prompt involvement of the department of plastic surgery ensures the early development of a reconstructive plan and enhanced soft tissue management.…”