“SPECTRUM OF TRAUMA‑RELATED PLASTIC SURGERY CASES PRESENTING TO THE EMERGENCY DEPARTMENT OF A TERTIARY CARE CENTRE”

Abstract

Trauma represents a leading cause of morbidity and mortality, with a growing subset of patients requiring specialized plastic surgical intervention for complex soft tissue, skeletal, and neurovascular injuries. Early involvement of plastic surgeons in the emergency department is critical for restoring function, preventing complications, and optimizing aesthetic outcomes. This study aims to characterize the spectrum, management, and short-term outcomes of trauma-related plastic surgery cases in a tertiary care Indian centre.

Methods: This prospective observational study was conducted at the Department of Plastic Surgery, Government Kilpauk Medical College, Chennai, India, over 12 months. Forty consecutive patients presenting with acute trauma requiring plastic surgery intervention were enrolled. Data collected included demographics, mechanism and anatomical site of injury, type and complexity of trauma, surgical interventions, time to surgery, and short-term clinical outcomes. Descriptive statistics were used to analyze categorical variables.

Results: Of 40 patients, 77.5% were male and 55% aged 18–45 years. Road traffic accidents were the most common mechanism (60%). Hand and wrist injuries predominated (45%), followed by facial trauma (37.5%). Surgical management included complex primary closures (35%), tendon/nerve repairs (25%), facial fracture fixation (15%), skin grafting (12.5%), local/regional flaps (7.5%), and microvascular revascularization (5%). Most patients (87.5%) underwent surgery within 24 hours. Short-term outcomes were favorable, with 85% achieving primary wound healing, 10% experiencing surgical site infection, and 7.5% requiring secondary revision.

Conclusion: Trauma-related plastic surgery in the emergency setting predominantly involves young adult males with hand and facial injuries, frequently resulting from road traffic accidents. Early, specialized intervention following the reconstructive ladder ensures high rates of primary wound healing, minimizes complications, and supports functional and aesthetic recovery. These findings highlight the essential role of plastic surgery in multidisciplinary trauma care and underscore the need for timely referral and resource planning in tertiary centres.