Journal of Trauma and Injury

Original Articles

Changes in patterns of plastic surgery emergencies at a level I trauma center in India during the COVID-19 pandemic: Veena Singh, Ansarul Haq, Sarsij Sharma, Sanjeev Kumar, Aditya Kumar, Amarjeet Kumar, Neeraj Kumar, Anil Kumar; J Trauma Inj. 2022;35(2):108-114. Published online May 11, 2022; DOI: https://doi.org/10.20408/jti.2021.0015

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Abstract PDF: Purpose
The coronavirus disease 2019 (COVID-19) pandemic has had major effects worldwide, including sudden and forceful setbacks to the healthcare system. The COVID-19 pandemic has also led to changes in the plastic and reconstructive management of emergency cases, including those due to road traffic accidents. This study analyzed changes in patterns of plastic surgery emergencies and modifications in consultation policies to minimize the exposure of healthcare workers.
Methods
Data on plastic surgery emergency calls received from the trauma and emergency department were collected for a period of 2 months before and during lockdown. The data were then analyzed with respect to the cause, mechanism, and site of the injury, as well as other variables.
Results
During lockdown, there was a 40.4% overall decrease in the plastic surgery emergency case volume (168 vs. 100). The average daily number of consultations before lockdown was 2.8 as compared to 1.6 during lockdown. Road traffic accidents remained the most common mechanism of injury in both groups (45.8% vs. 39.0%) but decreased in number during the lockdown (77 vs. 39). Household accidents, including burns, were the second most common cause of injury in both phases (7.7% vs. 20.0%), but their proportion increased significantly from 7.7.% to 20.0% in the lockdown phase (P=0.003). The percentage of minor procedures done in the emergency department increased from 53.5% to 72.0% during lockdown (P=0.002). Procedures in the operating room decreased by 73.1% during lockdown (67 vs. 18, P=0.001).
Conclusions
The COVID-19 pandemic and lockdown orders in India greatly influenced trends in traumatic emergencies as observed by the plastic surgery team at our tertiary care center. Amidst all the chaos and limitations of the pandemic period, providing safe and prompt care to the patients presenting to the emergency room was our foremost priority.; Summary

Plastic surgery in a trauma center: a multidisciplinary approach for polytrauma patients: Kyung-Chul Moon, Yu-Kyeong Yun; J Trauma Inj. 2022;35(4):261-267. Published online December 10, 2021; DOI: https://doi.org/10.20408/jti.2021.0086

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Purpose
With the increasing number of polytrauma patients treated at high-level trauma centers, plastic surgery has entered the specialty of traumatology. Plastic surgeons specialize in the simultaneous surgical care of patients with facial or hand trauma and soft tissue injuries requiring microsurgery. The purpose of this study was to introduce the role of plastic surgery in a high-level trauma center.
Methods
Between January 2020 and December 2020, 5,712 patients with traumatic injuries were admitted to the emergency department of a tertiary hospital. Of these 5,712 patients, 1,578 patients were hospitalized for surgical treatment and/or critical care. Among the 1,578 hospitalized trauma patients, 551 patients (35%) required at least one plastic surgery procedure. The patient variables included age, sex, etiology, the injured area, and injury characteristics. We also retrospectively investigated surgical data such as the duration of the operation, hospital stay, length of time from injury to surgery, and collaboration with other departments.
Results
The most common injury referred to plastic surgery was facial trauma (41%), followed by hand trauma (36%), and soft tissue injuries requiring microsurgery in various parts of the body other than the hand (7%). The majority of facial and hand traumas were concomitant injuries. Sixteen percent of patients underwent collaborative surgical management for polytrauma involving both plastic surgery and another department.
Conclusions
The role of plastic surgery in multidisciplinary teams at high-level trauma centers has become increasingly important. The results of this study may help in the development of multidisciplinary trauma team strategies and future workforce planning.

Summary

Citations

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Interdisziplinäres Extremitäten-Board in der Behandlung von Komplexverletzungen
T. Omar Pacha, P. Mommsen, V. Brauckmann, G. Aktas, M. Krempec, B. Wilhelmi, J.-D. Clausen, V. März, N. Krezdorn, P. M. Vogt, S. Sehmisch, J. B. Hinrichs, J. Ernst
Die Unfallchirurgie.2023; 126(3): 175. CrossRef

Current Status of Intraosseous Infusion Technique Use at Emergency Departments in Korea: Sang Cheon Choi, Hyun Soo Park, Jae Woo Kim; J Korean Soc Traumatol. 2007;20(1):6-11.

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Abstract PDF: PURPOSE
Gaining vascular access is difficult and time-consuming in critically ill children, so nowdays, in many countries, intraosseous vascular access is frequently used for rapid vascular access in critically ill children. Its pharmacokinetics is close to that of the peripheral intravenous route, but its infusion flow rate is faster. The purpose of this study was to determine how widely the intraosseous infusion technique was being used in Korean emergency departments.
METHODS
We telephoned forty-two (42) randomly selected university-affiliated hospitals. We asked physicians if they use the intraosseous infusion technique. Responders were emergency and pediatric residents and emergency faculty. If they responded that they were not using the intraosseous infusion technique, we asked the reason. Also, we asked about their experiences with the intraosseous infusion technique.
RESULTS
Forty-two (42) hospitals were enrolled in this study. No hospital used the intraosseous infusion technique on a regular basis. However, 8 hospitals used the intraosseous infusion technique occasionally. None of the responders had experience with the intraosseous infusion technique.
CONCLUSION
The intraosseous infusion technique is currently underrepresented at emergency departments in Korea.; Summary

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