INTRODUCTION:

With the advent of industrial revolution, the cause-effect scenario of trauma has changed drastically over the last few decades. With increasing high-velocity and high impact traumas, involving high speed machinery, the need for Plastic and reconstructive surgeon at primary trauma management level is undeniable. A plastic surgeons role is usually limb and life saving, limiting major disabilities later.

PROCEDURE:

HEAD NECK AND FACE:

Involves from debridement and suturing of small lacerations with minimal skin loss on one end of the spectrum to major reconstructions with free tissue transfer, facial bone reconstructions with Maxillo-facial surgeons.

Procedures for head and face post traumatic reconstructions include-

1. Suturing of lacerations
2. Local flap covers for soft tissue defects
3. Scalp replant or revascularization for traumatic avulsion of the scalp
4. Free tissue transfer for major soft tissue loss
5. Eyelid reconstructions
6. Exploration of facial nerve and its branches in suspected penetrating injuries around the parotid region.
7. Ear reconstruction with local flaps
8. Ear reconstruction with costal cartilage graft for cartilage loss
9. Primary Rhinoplasty
10. Lip alignment and suturing

Procedures for lower extremity trauma:

All reconstructions follow the dictum of a thorough debridement as a rule. Most secondary complications and infections can be avoided if the wound is thoroughly explored and debrided at the first setting, giving the surgeon a perspective of the tissue losses and extent and nature if injuries. This may be in conjunction with orthopedic surgeons in cases of associated long bone fractures.

1. Debridement in itself and negative pressure wound therapy
2. Skin grafting
3. Local flaps- myocutaneous, fasciocutaneous, muscle flaps
4. Free tissue transfer
5. Tendon reconstructions with or without tendon graft
6. Primary tendon transfers
7. Primary Nerve repair
8. Fixation of small phalanges of foot
9. Tendoachilles repair

Procedures for upper extremity trauma:

1. Replantation
2. Revascularization of digits/forearm/ arm
3. K-wire fixation of fractures of small bones
4. Osteoplastic reconstruction for maintaining length of phalanges
5. Local flap cover
6. Pedicled distant flaps
7. Nerve repair
8. Nerve reconstruction with nerve graft
9. Tendon repairs
10. Tendon reconstruction with tendon graft
11. Primary tendon grafts
12. Nail bed surgeries