Rishabh Pant's car injury - what we need to be aware of - a plastic surgeon's perspective
Plastic surgery & plastic surgeons are more than what meets the eye – eye opening take on plastic surgery in RTA cases and more.
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Plastic surgery & plastic surgeons are more than what meets the eye – eye opening take on plastic surgery in RTA cases and more.
Rishabh was referred to a Tertiary care hospital at Dehradun, where the necessary scans were done to eliminate life-threatening injuries.
Once life-threatening injuries like solid organ injuries (liver/ spleen/ kidney/ pancreas/bowel/lung and brain) are ruled out, importance is then given to bony and soft tissue injuries on the face, body, and limbs.
This is where orthopedics and Plastic surgeons come into the scene for a timely intervention. As this is a plastic surgeon’s perspective, the focus will be on soft tissue injuries across the body and face and skeletal injuries of the maxillofacial region.
Once life-threatening injuries are ruled out, trauma surgeons, orthopedic and plastic surgeons work in tandem to fix and restore bony and soft tissue injuries, often in a single surgery.
Any plastic and reconstructive procedure aims to restore form and function so that the victim is rehabilitated in the safest and shortest possible manner.Maxillofacial injuries need special attention as the best time to address fractures of the jaws is immediately after the accident.
It is important to know that jaws have dentition and that any fractures may alter the ability to chew food properly.For this reason, plastic surgeons fix the broken jaws by wiring/plating the broken fragments and restoring teeth occlusion, enabling patients to return to their regular eating habits.
Orbital fractures may impair vision, and it is best to fix the fractured units at the earliest.
Soft tissue injuries are repaired at the earliest( possibly in the first 12-24 hours after the injury). Surgical toileting and wound cleansing go a long way in removing foreign debris and non-viable skin and soft tissues, thereby aiding in earlier wound healing. Skin and soft tissues are repaired either by simple fine suturing techniques.
Skin grafting, flap surgery, or complex microvascular reconstruction may be needed depending on the extent of the injury. Hand injuries usually require a skeletal fixation of underlying fractures and repair of the damaged nerves and vessels. Extremely mangled limbs are best managed with amputation, as complex reconstructions may be futile.
Burn injuries are seen in road traffic injury victims as a result of an explosion or due to friction. These victims must be assessed thoroughly, and initial fluid resuscitation is done to stabilize patients.
Burn injuries are then managed surgically to remove all the devitalized skin and cover the wounds with skin grafting or special dressings. Extensive burn injuries may need cadaver skin grafts and prolonged hospitalization before healing occurs. Timely intervention by plastic surgeons and orthopedic surgeons ensures healing and prepares the patient for earlier rehabilitation and restoration back into society.
The importance of preventing road traffic accidents should be addressed. Seat belts, helmets, avoiding drunken driving, ensuring adequate sleep before going on a long drive, and safety features in a car go a long way in averting major accidents, and the huge spending by governments in managing this menace of road traffic accidents.
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