Department of Plastic and Reconstructive Surgery, Ajou University Hospital, Suwon-si, Republic of Korea.
Medicine (Baltimore). 2021 Feb 5;100(5):e24357. doi: 10.1097/MD.0000000000024357.
Although it is well recognized that other surgical specialties perform various procedures related to trauma care, there is a lack of analyses focusing on the role of plastic surgical management in trauma centers. This retrospective study was designed to investigate the scope of plastic surgery services in acute trauma care, using clinical data obtained from a single, regional, level I trauma center.This study included patients who presented to a single, regional, level I trauma center between March 1, 2016 and February 28, 2018. Patients with acute trauma to the facial soft tissue and skeleton, soft tissue of the upper and lower limbs, trunk and perineum, and other areas requiring plastic surgical procedures were included in the analysis. Cases requiring consultation for the correction of posttraumatic deformity or secondary deformity and trauma sequelae, such as scars, were excluded. Data on patients' demographics and detailed surgical procedures were acquired from electronic medical records. The reviewed cases were categorized by the primary anatomical region requiring surgery and the primary procedure performed.A total of 1544 patients underwent surgery, and 2217 procedures were recorded during the 2-year study period. In 2016, 1062 procedures on 690 patients, and, in 2017, 1155 procedures on 787 patients were registered. The average age of the patients who underwent plastic surgical procedure due to a trauma-related cause was 38.4 years (range, 2 days to 91 years), and 1148 patients (77.7%) were male. The head and neck region was the most commonly observed anatomical area that was operated on. The facial bone requiring the largest degree of surgical intervention was the mandible, followed by the zygomatic bone, nasal bones, orbital floor, and maxilla. Microsurgical procedures, such as flap surgery and microsurgery, were performed in 121 cases. The most commonly elevated free flap was the ALT flap (n = 69).Plastic surgeons play various roles in level I trauma centers, such as in the management of facial injury, performing limb-saving free tissue transfers, and complex wound reconstruction with flaps or skin grafts. Thus, plastic surgeons are an essential part of trauma centers.
虽然人们普遍认识到其他外科专业也会进行各种与创伤护理相关的手术，但缺乏专门针对创伤中心中整形外科技能的分析。本回顾性研究旨在探讨整形手术在急性创伤护理中的应用范围，其数据来自于一家单区域一级创伤中心。
本研究纳入了 2016 年 3 月 1 日至 2018 年 2 月 28 日期间在单区域一级创伤中心就诊的急性创伤患者。分析纳入了面部软组织和骨骼、上下肢软组织、躯干和会阴以及其他需要整形手术的区域发生急性创伤的患者。排除了需要会诊以矫正创伤后畸形或继发性畸形以及创伤后遗症（如疤痕）的患者。从电子病历中获取患者人口统计学和详细手术过程的数据。回顾性病例根据需要手术的主要解剖区域和实施的主要手术进行分类。
在 2 年的研究期间，共有 1544 名患者接受了手术，记录了 2217 例手术。2016 年登记了 690 名患者的 1062 例手术，2017 年登记了 787 名患者的 1155 例手术。因创伤相关原因接受整形手术的患者的平均年龄为 38.4 岁（范围：2 天至 91 岁），1148 名患者（77.7%）为男性。头颈部是最常见的手术部位。需要最大程度手术干预的面部骨骼是下颌骨，其次是颧骨、鼻骨、眶底和上颌骨。121 例患者接受了显微外科手术，如皮瓣手术和显微手术。最常使用的游离皮瓣是 ALT 皮瓣（n=69）。
在一级创伤中心，整形医生扮演着多种角色，如面部损伤的管理、进行保肢游离组织转移以及使用皮瓣或皮片进行复杂创面重建。因此，整形医生是创伤中心的重要组成部分。
