The Role of Plastic and Reconstructive Surgery at a United States Level One Trauma Center: A Retrospective Review of Trauma Activations from 2011-2013
Katherine Billue, MD, Michael Parker, MD, Ryan Lucero, MD, Ann Salvator, MS, Robert Marley, MD.
Akron General Medical Center, Akron, OH, USA.
Trauma is a multidisciplinary undertaking with plastic and reconstructive surgery (PRS) playing a significant role in the care of this patient population. The objective of this study was to describe the role of PRS and types of injuries encountered for trauma activations (TAs) at a level 1-trauma center.
Data from 2011-2013 was retrospectively collected from a trauma database on patients who presented as TAs and had PRS consultations. Patients were evaluated regarding demographics, injury, and treatment.
There was a total of 275 PRS consults out of 1,927 TAs (14.3%). The mean age was 46.34 ±22 and 73.5% were male. 13.1% of patients had positive toxicology screens and 29.1% had positive blood alcohol levels. Motor vehicle collisions (48%) were the most common (MC) mechanism of injury followed by falls (26.9%). The MC reason for consultation was facial fractures (FF) (N=196, 71.2%). Multiple FF was the MC injury (N=98). Nasal bone fracture (N=33) was the MC isolated FF followed by orbital wall fractures (N=23) and mandible fractures (N=23). 67 FF needed operative repair during the same admission with open reduction and internal fixation (N=48) representing the MC procedure. The second MC reason for consultation was lacerations (N=65, 23.3%). The face was the MC area affected (N=56) with 14 lacerations requiring operative repair.
Craniofacial trauma represents the largest number of PRS consultations and injuries requiring operative intervention for TAs. This differed from previous studies that showed the majority of the trauma workload for PRS was upper extremity injuries.
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