The role of plastic surgery in major trauma in the United Kingdom and workforce recommendations

Hendrickson, Susan A.; Young, Katie; Gardiner, Matthew; Phillips, Georgina; Wallace, David; Hettiaratchy, Shehan; Giblin, Anna‐Victoria

doi:10.1016/j.bjps.2020.10.061

Cited by 4 publications

(5 citation statements)

References 9 publications

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“…The role of plastic surgery was wound management, including irrigation and debridement; the infection was properly controlled and patients' limbs were salvaged. In addition, another study explored the subspecialty of full-time consultant plastic surgeons and the plastic surgical workload relating to major trauma 14 . However, there were not enough plastic surgeons who could manage extremity trauma in Level 1 trauma centers.…”

Section: Discussionmentioning

confidence: 99%

Current status of plastic surgery department interaction from interhospital transfer in a regional trauma center

Kim,

Cho,

Lim

et al. 2024

Preprint

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Background The incidence of multiple trauma has been on a rise recently, and there is a consensus on the importance of initial treatment to prevent death. Notably, the government has initiated a well-organized trauma system in South Korea. Thus, depending on the treatment purpose, there exists an active interhospital transfer. In the present study, we analyzed the clinical outcome of patients who transferred to a regional trauma center and the plastic surgeon’s interaction in their treatment. Methods We performed a retrospective chart review of major trauma patients transferred to Ajou regional trauma center from January 2020 to February 2022. We evaluated injury severity score (ISS), initial resuscitation, post-transfer treatment, and plastic surgery-related procedure. Results In total, 92 patients were evaluated; of these, 41.1% were from certified tertiary hospitals, 16.30% were pre-transfer resuscitation cases, 18.47% were in the intensive care unit, and 17.39% were admitted for an emergency operation. At transfer, 63.04% (58 patients) had an initial open wound and 34.78% were referred to a plastic surgery department. In addition, 20.65% of patients with initially detected wounds underwent plastic surgery operation and required an average 1.76 ± 0.46 of debridement and 12.75 ± 3.45 of aseptic dressing. Conclusion Increasing the current status of interhospital transfers to regional trauma centers required an active interaction with the plastic surgery department. Most major trauma patients have multiple wounds that needs specialized reconstruction. Therefore, a dynamic consultation system is one of the essential facilities in a trauma center.

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Section: Discussionmentioning

confidence: 99%

Current status of plastic surgery department interaction from interhospital transfer in a regional trauma center

Kim,

Cho,

Lim

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

“…The authors suggest that each plastic surgery department serving in an REMC should include surgeons with skills relevant to the types of injuries presented, including head and neck surgeons, extremity trauma surgeons, and access to reconstructive surgeons. Because of the necessarily multi-disciplinary nature of most major trauma work, plastic surgeons supporting major trauma centers should also be familiar and comfortable with working closely with related surgical and medical specialties, as well as allied healthcare professionals [5].…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have reported the role of plastic surgery in trauma centers specifically and individually [3,4]. However, limited studies have included every field of plastic surgery practice in traumatology [5]. The present study introduces the field of plastic surgery as practiced at a high-level trauma center of a tertiary hospital, equivalent to a level I trauma center in the US.…”

Section: Introductionmentioning

confidence: 99%

Plastic surgery in a trauma center: a multidisciplinary approach for polytrauma patients

Moon

Yun

2022

J Trauma Inj

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Purpose: With the increasing number of polytrauma patients treated at high-level trauma centers, plastic surgery has entered the specialty of traumatology. Plastic surgeons specialize in the simultaneous surgical care of patients with facial or hand trauma and soft tissue injuries requiring microsurgery. The purpose of this study was to introduce the role of plastic surgery in a high-level trauma center. methods: Between January 2020 and December 2020, 5,712 patients with traumatic injuries were admitted to the emergency department of a tertiary hospital. Of these 5,712 patients, 1,578 patients were hospitalized for surgical treatment and/or critical care. Among the 1,578 hospitalized trauma patients, 551 patients (35%) required at least one plastic surgery procedure. The patient variables included age, sex, etiology, the injured area, and injury characteristics. We also retrospectively investigated surgical data such as the duration of the operation, hospital stay, length of time from injury to surgery, and collaboration with other departments. results: The most common injury referred to plastic surgery was facial trauma (41%), followed by hand trauma (36%), and soft tissue injuries requiring microsurgery in various parts of the body other than the hand (7%). The majority of facial and hand traumas were concomitant injuries. Sixteen percent of patients underwent collaborative surgical management for polytrauma involving both plastic surgery and another department.Conclusions: The role of plastic surgery in multidisciplinary teams at high-level trauma centers has become increasingly important. The results of this study may help in the development of multidisciplinary trauma team strategies and future workforce planning.

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“…For instance, while our hospital mainly treats patients with facial bone fractures, in England, lower extremity trauma is dominant. [ 6 , 14 ] Nevertheless, a major strength of this study was the analysis of the characteristics and qualitative indicators of prognosis in patients with PS involvement among severe trauma patients, and these differences were recognized through a comparison with controls.…”

Section: Discussionmentioning

confidence: 99%

Association between the participation of the plastic surgery department and qualitative prognoses in severe trauma patients: A retrospective observational study

et al. 2022

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Catastrophic incidents would necessitate the intervention of multiple specializations with plastic surgery (PS) as an indispensable area of expertise. In view of PS, prognostic assessment of trauma patients should be focused on the qualitative value rather than mortality because plastic surgeons rarely handled patients’ vital signs in actual. Thus, we explored the association between the involvement of the PS department and qualitative prognoses for severe trauma patients. From November 2014 to December 2019, we enrolled total 529 trauma patients with an injury severity score (ISS) over 15 points. We set the prognostic factors that the rate of admission in intensive care unit (ICU), total or ICU duration of hospitalization, post-discharge progress and disability diagnosis which were regarded as qualitative prognoses. The analysis was performed with logistic regression analysis or regression analysis adjusted for age, sex, past medical history, cause of trauma, and frequency of operation. Among total of 529 patients, 290 patients in PS group and 239 patients in non-PS group were analyzed. In both groups, the under-65-year ages and male patients were significantly predominant. The rate of going home showed 2.082 times higher in PS group than non-PS group after adjusting for covariates, while there was no significant difference in diagnosis of disability. Meanwhile, overall prognoses were highly correlated with either higher ISS or lower Glasgow Coma Scale (GCS). In conclusion, higher severity generally affected to the severe trauma patient’s prognoses, and the PS treatment only contributes to discharge disposition to home.

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The role of plastic surgery in major trauma in the United Kingdom and workforce recommendations

Cited by 4 publications

References 9 publications

Current status of plastic surgery department interaction from interhospital transfer in a regional trauma center

Current status of plastic surgery department interaction from interhospital transfer in a regional trauma center

Plastic surgery in a trauma center: a multidisciplinary approach for polytrauma patients

Association between the participation of the plastic surgery department and qualitative prognoses in severe trauma patients: A retrospective observational study

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