Journal of Trauma and Injury

  • 제35권4호
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  • Pages.261-267
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  • 2022
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  • 2799-4317(pISSN)
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  • 2287-1683(eISSN)
대한외상학회 (The Korean Society of Traumatology)
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Plastic surgery in a trauma center: a multidisciplinary approach for polytrauma patients

  • Kyung-Chul, Moon (Department of Plastic Surgery, Korea University Guro Hospital) ;
  • Yu-Kyeong, Yun (Department of Plastic Surgery, Korea University Guro Hospital)
  • 투고 : 2021.10.26
  • 심사 : 2021.11.29
  • 발행 : 2022.12.31
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초록

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.

키워드

과제정보

This research was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education and Korea University Guro Hospital (No. 2021M3E-5D1A01015189).

참고문헌

  1. Staruch RM, Lloyd-Hughes H, Shiatis A, Hettiaratchy SP. Evidence for the formal development of trauma subspecialty within plastic surgery in the United Kingdom. J Plast Reconstr Aesthet Surg 2018;71:e8-9. https://doi.org/10.1016/j.bjps.2017.10.027
  2. Brown JB, Watson GA, Forsythe RM, et al. American College of Surgeons trauma center verification versus state designation: are level II centers slipping through the cracks. J Trauma Acute Care Surg 2013;75:44-9. https://doi.org/10.1097/TA.0b013e3182988729
  3. Peterson SL, Moore EE. The integral role of the plastic surgeon at a level I trauma center. Plast Reconstr Surg 2003;112:1371-5. https://doi.org/10.1097/01.PRS.0000082815.79881.51
  4. Hacikerim Karsidag S, Ozkaya O, Ugurlu K, Bas L. The practice of plastic surgery in emergency trauma surgery: a retrospective glance at 10,732 patients. Ulus Travma Acil Cerrahi Derg 2011;17:33-40. https://doi.org/10.5505/tjtes.2011.99083
  5. Hendrickson SA, Young K, Gardiner MD, et al. The role of plastic surgery in major trauma in the United Kingdom and workforce recommendations. J Plast Reconstr Aesthet Surg 2021;74:1071-6. https://doi.org/10.1016/j.bjps.2020.10.061
  6. Florence C, Haegerich T, Simon T, Zhou C, Luo F. Estimated lifetime medical and work-loss costs of emergency department-treated nonfatal injuries: United States, 2013. MMWR Morb Mortal Wkly Rep 2015;64:1078-82. https://doi.org/10.15585/mmwr.mm6438a5
  7. Herrera-Escobar JP, Seshadri AJ, Stanek E, et al. Mental health burden after injury: it's about more than just posttraumatic stress disorder. Ann Surg 2021;274:e1162-9. https://doi.org/10.1097/SLA.0000000000003780
  8. Haider AH, Herrera-Escobar JP, Al Rafai SS, et al. Factors associated with long-term outcomes after injury: results of the Functional Outcomes and Recovery after Trauma Emergencies (FORTE) multicenter cohort study. Ann Surg 2020;271:1165-73. https://doi.org/10.1097/SLA.0000000000003101
  9. McCarty JC, Herrera-Escobar JP, Gadkaree SK, et al. Longterm functional outcomes of trauma patients with facial injuries. J Craniofac Surg 2021;32:2584-7. https://doi.org/10.1097/SCS.0000000000007818
  10. Rumsey N, Harcourt D. Body image and disfigurement: issues and interventions. Body Image 2004;1:83-97. https://doi.org/10.1016/S1740-1445(03)00005-6
  11. Sargazi N, El-Gawad A, Narayan B, et al. A full time regional ortho-plastic unit; initial results. J Plast Reconstr Aesthet Surg 2016;69:572-3. https://doi.org/10.1016/j.bjps.2015.12.005
  12. MacKenzie EJ, Bosse MJ, Pollak AN, et al. Long-term persistence of disability following severe lower-limb trauma. Results of a seven-year follow-up. J Bone Joint Surg Am 2005;87:1801-9.
  13. Boriani F, Ul Haq A, Baldini T, et al. Orthoplastic surgical collaboration is required to optimise the treatment of severe limb injuries: a multi-centre, prospective cohort study. J Plast Reconstr Aesthet Surg 2017;70:715-22.