“PATTERNS AND OUTCOMES OF RECONSTRUCTIVE PLASTIC SURGERY IN A TEACHING HOSPITAL: A PROSPECTIVE OBSERVATIONAL STUDY”

Abstract

Reconstructive plastic surgery is integral to modern healthcare, particularly in teaching hospitals where complex trauma, oncologic defects, burns, congenital anomalies, and chronic wounds converge. These procedures restore function and aesthetics, improve quality of life, and reduce morbidity, while teaching institutions simultaneously provide training and innovate in surgical techniques. Understanding the patterns, outcomes, and complications of reconstructive cases in such settings is crucial for service planning and resource allocation.

Methods: A prospective observational study was conducted at the Department of Plastic Surgery, Government Kilpauk Medical College, Chennai, India, from January 2021 to December 2023. Thirty-five consecutive patients undergoing reconstructive procedures across trauma, oncology, burns, congenital anomalies, and chronic wounds were enrolled. Data collected included demographics, etiology, anatomical site, surgical procedure, intraoperative and postoperative complications, and functional and aesthetic outcomes. Follow-up assessments were performed at 1 week, 1 month, 3 months, and 6 months, with complications graded per Clavien-Dindo and functional/aesthetic outcomes measured via validated tools.

Results: The cohort included predominantly adults (62.9%), with a slight male predominance (54.3%). Post-traumatic (42.9%) and post-oncological (28.6%) cases were most common. Head and neck (34.3%) and upper limb/hand (28.6%) reconstructions predominated. Skin grafting (40%) was the most frequent procedure, complemented by local/regional flaps (45.7%) and free microvascular flaps (5.7%). Uneventful healing occurred in 77.1%, with minor complications in 17.1% and major complications in 5.7%. At six months, functional restoration was achieved in 80% and overall patient satisfaction was 85.7%.

Conclusion: Reconstructive plastic surgery in a teaching hospital setting effectively addresses complex functional and aesthetic needs, with high rates of healing, functional restoration, and patient satisfaction. The findings highlight the critical role of teaching institutions in managing diverse reconstructive challenges, training future surgeons, and providing patient-centered care.