The operative trauma workload in a plastic surgery tertiary referral centre in Scotland

Abstract

The trauma workload in plastic surgery is not well documented in the literature. The authors wished to investigate the operative trauma caseload in a tertiary referral plastic surgery centre to determine the demographics, mechanisms of injury, sites of injury and procedures performed. This study was conducted using a prospectively tabulated comprehensive database in which details of every trauma operation performed at the Canniesburn Plastic Surgery Unit (Glasgow, Scotland) are logged. The data from an 8-year study period (2003–2010) were collected for patient demographics, site of injury and operative procedures performed. The data from a shorter study period (April 2006–December 2010) were collected separately to investigate the mechanisms of injury. Data analysis was undertaken using Mintab 15 Statistical Software English. Analysis of 21,929 operative procedures on 8,880 patients was undertaken. There was a predominance of young male patients. More than 75% of trauma affected the limbs. The mechanism of injury was predominantly accidents (31%) including RTAs. The second most common mechanism was violent crime (17%), of which more than a quarter involved a knife. Notably, alcohol was a contributing factor in 3.4% of all trauma cases. Plastic surgery trauma involves injury to all sites of the body and the mechanisms are variable. However, certain mechanisms are arguably preventable through public health initiatives and legislative change in order to reduce the unnecessary economic burden on the health service. There is a significant operative caseload with a requirement for a varying complexity of reconstruction, ranging from debridements to microvascular free tissue transfer. Arguably, the plastic surgeon must be an integral part of any trauma centre.