Plan for plastic surgeons to participate in trauma teams at regional trauma and emergency centers

임, 남규; 강, 동희

doi:10.5124/jkma.2018.61.12.710

Cited by 3 publications

(15 citation statements)

References 12 publications

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“…In another advanced country in terms of trauma treatment, the United Kingdom, the overall trauma mortality decreased significantly after the introduction of major trauma centers [5]. In contrast, the proportion of preventable deaths in South Korea was 35% in 2010, which was more than twice that of other advanced countries in the field of trauma [1]. Furthermore, the number of trauma patients has steadily increased, and the mortality of trauma patients rose from 1.87% in 2007 to 2.71% in 2011 [3].…”

Section: Discussionmentioning

confidence: 99%

“…Plastic surgeons play a major role in managing trauma patients. Because traumatic damage usually involves soft tissue injuries of the body, facial bone fractures, hand injuries, and neurovascular injuries, plastic surgeons play a highly important role in the treatment of these patients 1 6 . For example, after the terrible bomb attack in the 2013 Boston Marathon, plastic surgeons played a substantial role in treating the victims 7 .…”

Section: Discussionmentioning

confidence: 99%

“…The activation team was deployed when severe trauma patients presented to the emergency room. In general, physiological and anatomical considerations, as well as the mechanism of the injury, were used to determine whether a trauma patient was severe [1]. The Injury Severity Score (ISS) was also used to assess the severity of patients' trauma.…”

Section: Methodsmentioning

confidence: 99%

“…The laws regulating emergency medical services were amended in 2012, as a consequence of which regional trauma centers were established by the government to reduce preventable deaths in South Korea. In 2010, when discussions about establishing these centers were in full swing, the proportion of pre-ventable deaths in South Korea was 35%, which was more than twice that of other advanced countries in the field of trauma [1]. Trauma centers were established in each province, so that patients could reach a trauma center anywhere in the country within an hour, and the trauma center models of advanced countries such as the United States and United Kingdom were benchmarked [2].…”

Section: Introductionmentioning

confidence: 99%

“…The role of plastic surgeons in treating trauma patients was overlooked when this legal framework was established. In fact, in the field of emergency medicine, plastic surgeons specialize in the simultaneous surgical care of patients with facial trauma, burns, and complicated wounds [1].…”

Section: Introductionmentioning

confidence: 99%

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Epidemiology of severe trauma patients treated by plastic surgeons: A 7-year study at a single regional trauma center in South Korea

2020

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Background After the laws regulating emergency medicine were amended in 2012, regional trauma centers were established in South Korea. Plastic surgeons specialize in the simultaneous surgical care of patients with facial trauma, burns, and complicated wounds. The objective of this study was to evaluate the role of the plastic surgery department in treating severe trauma patients.Methods From January 2012 to December 2018, we enrolled 366 severe trauma patients with an Injury Severity Score (ISS) over 15 who received treatment by specialists in the plastic surgery department. Of these patients, 298 (81.4%) were male, and their mean age was 51.35 years (range, 6–91 years). The average ISS was 22.01 points (range, 16–75 points).Results The most common diagnosis was facial trauma (95.1%), and facial bone fracture (65.9%) was most common injury within this subgroup. Patients were referred to 1.8 departments on average, with the neurosurgery department accounting for a high proportion of collaborations (37.0%). The most common cause of trauma was traffic accidents (62.3%), and the average length of stay in the general ward and intensive care unit was 36.90 and 8.01 days, respectively. Most patients were discharged home (62.0%) without additional transfer or readmission.Conclusions Through this study, we scoped out the role of the specialty of plastic surgery in the multidisciplinary team at regional trauma centers. These results may have implications for trauma system planning.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Epidemiology of severe trauma patients treated by plastic surgeons: A 7-year study at a single regional trauma center in South Korea

2020

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

Lim

Park

2022

Medicine

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While plastic surgeons have been historically indispensable in the reconstruction of posttraumatic defects, their role in trauma centers worldwide has not been clearly defined. Therefore, we aimed to investigate the contribution of plastic surgeons in trauma care using machine learning from an anatomic injury viewpoint. We conducted a retrospective study reviewing the data for all trauma patients of our hospital from March 2019 to February 2021. In total, 4809 patients were classified in duplicate according to the 17 trauma-related departments while conducting the initial treatment. We evaluated several covariates, including age, sex, cause of trauma, treatment outcomes, surgical data, and severity indices, such as the Injury Severity Score and Abbreviated Injury Scale (AIS). A random forest algorithm was used to rank the relevance of 17 trauma-related departments in each category for the AIS and outcomes. Additionally, t test and chi-square test were performed to compare two groups, which were based on whether the patients had received initial treatment in the trauma bay from the plastic surgery department (PS group) or not (non-PS group), in each AIS category. The department of PS was ranked first in the face and external categories after analyzing the relevance of the 17 trauma-related departments in six categories of AIS, through the random forest algorithm. Of the 1108 patients in the face category of AIS, the PS group was not correlated with all outcomes, except for the rate of discharge to home (P < .0001). Upon re-verifying the results using random forest, we found that PS did not affect the outcomes. In the external category in AIS, there were 30 patients in the PS group and 56 patients in the non-PS group, and there was no statistically significant difference between the two groups when comparing the outcomes. PS has contributed considerably to the face and external regions among the six AIS categories; however, there was no correlation between plastic surgical treatment and the outcome of trauma patients. We investigated the plastic surgeons' role based on anatomical injury, using machine learning for the first time in the field of trauma care.

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A quantitative analysis of trauma patients having undergone plastic surgery

Lim

Yoon

2022

PLoS ONE

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Purpose While plastic surgeons have been historically indispensable in reconstruction of posttraumatic defects, their role in Level I trauma centers around the world has not yet been clearly approved. This study aims to assess the contribution of plastic surgeons in major trauma care by evaluating the characteristics of trauma patients underwent plastic surgery at a Level I trauma center. Method From November 2014 to October 2020, we conducted a retrospective review of our hospital’s Trauma Registry System for patients with an Injury Severity Score (ISS) of 9 or higher. Of all of 7174 patients, the plastic surgery (PS) department treated 870 patients; the 6304 patients not treated by the PS were classified as the Non-PS. Then, we performed propensity score matching to reduce the statistical bias, after the death in the emergency room and the missing value were considered exclusion criteria. Result The mean ISS showed no significant difference between two groups (16.29 ± 7.04 in the PS vs. 16.68 ± 9.16 in the Non-PS, p = 0.3221). According to investigate the Abbreviated Injury Scale, both head and neck (65.0%) and face (46.4%) categories showed significantly higher in the PS group than the Non-PS group (p < 0.0001), and its contribution ratio was 2.151 and 21.822 times, respectively. Conclusion This study revealed the specialty of plastic surgery was face area in trauma care. We thus argue that plastic surgical care is imperative for trauma patients, and expect to be implicated in trauma system planning.

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Plan for plastic surgeons to participate in trauma teams at regional trauma and emergency centers

Cited by 3 publications

References 12 publications

Epidemiology of severe trauma patients treated by plastic surgeons: A 7-year study at a single regional trauma center in South Korea

Epidemiology of severe trauma patients treated by plastic surgeons: A 7-year study at a single regional trauma center in South Korea

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

A quantitative analysis of trauma patients having undergone plastic surgery

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