Spectrum analysis and outcomes of Plastic Surgery in rural government teaching hospital

Abstract

Background: Scarcity of plastic surgeons, financial burden, social taboo, negligence and glory of plastic surgery forbids a common man to consult a plastic surgeon! Shri Bhausaheb Hire Government Medical collegeDhule is a government tertiary care referral centre in the north Maharashtra. Aim and objectives:The aim of this study was to characterize the spectrum of disease, operative procedures, understand the challenges and contextual relevance for training at a government teaching hospital.Methods: We analyzed the data of the patients requiring plastic surgery expertise in the department of surgery from 1st October 2019 to 31st March 2021.Evaluation of patients biodata, procedures, complications and outcomes was carried out.Results:Resources like equipments,personnel,perioperative services and infrastructure were insufficient. This resource gap makes the situation a “checkmate”The most common diagnoses for the 397 patients evaluated were burns (57.17%). Congenital abnormalities were noted in 1% of the patients. Of the 232 procedures performed, the majority were skin excisions (62), skin grafts (25) and major debridement for burns (24). Other plastic surgeries were soft tissue repairs in major trauma (17), cosmetic surgery (13),tendon repairs(6),major flap surgeries(12),malignancy surgeries (5), A-V fistula for dialysis(2),vascular repair (1) syndyctaly (2), cleft lip (2),brachial plexus injury (1) and post dog bite facial wounds management (3). Out of 227 burns patients 28 died due to sepsis from burns (12.33%).Conclusion: We observed a large burden of burns and plastic surgery procedures at district level. General surgeons should lead this to meet the escalating society demands. Basic techniques and art of plastic surgery should be a part in training of general surgery residents so that our minimum services should be universally available to anyone, anytime and anywhere.