Plastic surgical operative workload in major trauma patients following establishment of the major trauma network in England: A retrospective cohort study

Hendrickson, Susan A.; Khan, Mansoor A.; Verjee, Liaquat Suleman; Rahman, K.M.A.; Simmons, Jonathan; Hettiaratchy, Shehan

doi:10.1016/j.bjps.2016.02.003

Cited by 13 publications

(14 citation statements)

References 15 publications

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“…The integral role of plastic surgeon at a Level 1 trauma centre, [2,8,9] and referral trauma centres [10,11] have been reported by several authors across the world. The findings of predominantly male and younger population being affected by road traffic injuries are comparable with the other Level 1 trauma centres.…”

Section: Discussionmentioning

confidence: 90%

“…Hand >head and neck -NA-Hendrickson et al [11] UK 132 1 Lower limb >hand -NA-Peterson et al [9] USA 1104 mutually exchanged, and resident in plastic surgery get to learn and implement the guidelines of advanced trauma life support, triage systems, resuscitation of victims with shock, etc., and necessary lifesaving skills such as airway, breathing and circulation stabilisation in the acute settings.…”

Section: Discussionmentioning

confidence: 99%

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

Singhal

Naalla

Dave

et al. 2018

Indian J Plast Surg

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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.

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

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

Singhal

Naalla

Dave

et al. 2018

Indian J Plast Surg

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“…One trust identified the increase in plastic surgical workload to be as high as seven times since the trauma network was introduced. 18 There is no directly comparative data with our study as this is a highly selective group with specific inclusion criteria. Unlike other published studies, our study is a longitudinal analysis conducted over a sevenyear period examining motorcyclists and pillion passengers with isolated open lower-limb fracture from 148 trauma receiving units in England.…”

Section: Discussionmentioning

confidence: 91%

“…In common with other studies, we have shown support for an orthoplastics service following the introduction of the trauma network. [12][13][14][15][16][17][18][19] Plastic surgical involvement is an integral factor in major trauma service planning and provision from postgraduate training to the provision of joint orthoplastics operating lists. The reduction we identified in the number of patients undergoing skeletal stabilisation and who later underwent soft-tissue coverage suggests a coordinated orthoplastic service.…”

Section: Discussionmentioning

confidence: 99%

Motorcyclists and pillion passengers with open lower-limb fractures: a study using TARN data 2007–2014

Hay-David

Stacey

Pallister

et al. 2018

annals

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Introduction We aimed to identify population demographics of motorcyclists and pillion passengers with isolated open lower-limb fractures, to ascertain the impact of the revised 2009 British Orthopaedic Association/British Association of Plastic Reconstructive and Aesthetic Surgeons joint standards for the management of open fractures of the lower limb (BOAST 4), in terms of time to skeletal stabilisation and soft-tissue coverage, and to observe any impact on patient movement. Methods Retrospective cohort data was collected by the Trauma Audit and Research Network (TARN). A longitudinal analysis was performed between two timeframes in England (pre-and post-BOAST 4 revision): 2007-2009 and 2010-2014. Results A total of 1564 motorcyclists and 64 pillion passengers were identified. Of these, 93% (1521/1628) were male. The median age for males was 30.5 years and 36.7 years for females. There was a statistically significant difference in the number of patients who underwent skeletal stabilisation (49% vs 65%, P < 0.0001), the time from injury to skeletal stabilisation (7.33 hours vs 14.3 hours, P < 0.0001) and the proportion receiving soft-tissue coverage (26% vs 43%, P < 0.0001). There was no difference in the time from injury to soft-tissue coverage (62.3 hours vs 63.7 hours, P = 0.726). The number of patients taken directly to a major trauma centre (or its equivalent) increased between the two timeframes (12.5% vs, 41%, P < 0.001). Conclusions Since the 2009 BOAST 4 revision, there has been no difference in the time taken from injury to soft-tissue coverage but the time from injury to skeletal stabilisation is longer. There has also been an increase in patient movement to centres offering joint orthopaedic and plastic care.

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“…With an orthoplastic approach, reconstruction has been as successful as 98.5 [3,11]. BOAST4 criteria specifies a need to start IV infusion of antibiotics within 3 hours of the accident when possible, in one study this occurred in 97% of patients who presented to a trauma centre and only 24% of patients presenting to A&E [3][4][5][6][7][8][9][10][11][12]. This shows the advantages of presenting to a trauma centre and the importance of geographical proximity in infection prophylaxis.…”

Section: Management Protocolmentioning

confidence: 99%

The geography of open fractures of the lower limb: Access to trauma care

Hawthorne¹,

Pillai²,

Alqubaisi³

2018

Res Rev Insights

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The aim of this paper is to develop an understanding of and document the geographical distribution of patients who suffered open fractures to the lower extremity between May 2013 and May 2015 and were treated at University Hospital of South Manchester (UHSM). To be able to recognise and explore any patterns in demographics and distances from home to hospital. This information will be used to review access to trauma care. Guidance to reduce trauma services in the region will be reviewed and any implications explored. On average the home to hospital distance was above the national average and would increase further if reconfiguration recommendations were followed. The reason for these higher values will be explored and the demographics of the two data sets compared to others in the literature. The data of orthoplastic patients and those only requiring orthopaedic care will be compared.

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Plastic surgical operative workload in major trauma patients following establishment of the major trauma network in England: A retrospective cohort study

Cited by 13 publications

References 15 publications

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

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

Motorcyclists and pillion passengers with open lower-limb fractures: a study using TARN data 2007–2014

The geography of open fractures of the lower limb: Access to trauma care

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