Although it is well recognized that other surgical specialties perform various procedures related to
trauma care, there is a lack of analyses focusing on the role of
plastic surgical management in trauma centers. This retrospective study was designed to investigate the scope of plastic surgery services in acute
trauma care, using clinical data obtained from a single, regional, level I trauma center.This study included patients who presented to a single, regional, level I trauma center between March 1, 2016 and February 28, 2018. Patients with acute
trauma to the facial soft tissue and skeleton, soft tissue of the upper and lower limbs, trunk and perineum, and other areas requiring
plastic surgical procedures were included in the analysis. Cases requiring consultation for the correction of posttraumatic
deformity or secondary
deformity and
trauma sequelae, such as
scars, were excluded. Data on patients' demographics and detailed
surgical procedures were acquired from electronic medical records. The reviewed cases were categorized by the primary anatomical region requiring surgery and the primary procedure performed.A total of 1544 patients underwent surgery, and 2217 procedures were recorded during the 2-year study period. In 2016, 1062 procedures on 690 patients, and, in 2017, 1155 procedures on 787 patients were registered. The average age of the patients who underwent
plastic surgical procedure due to a
trauma-related cause was 38.4 years (range, 2 days to 91 years), and 1148 patients (77.7%) were male. The head and neck region was the most commonly observed anatomical area that was operated on. The facial bone requiring the largest degree of surgical intervention was the mandible, followed by the zygomatic bone, nasal bones, orbital floor, and maxilla. Microsurgical procedures, such as flap surgery and microsurgery, were performed in 121 cases. The most commonly elevated
free flap was the ALT flap (nā=ā69).
Plastic surgeons play various roles in level I trauma centers, such as in the management of
facial injury, performing limb-saving free tissue transfers, and complex
wound reconstruction with flaps or skin grafts. Thus,
plastic surgeons are an essential part of trauma centers.