Many people are surprised to learn that emergencies form a large part of most Plastic Surgeons workload, dealing with both acute injuries and also with the longer-term reconstruction following trauma. In particular Plastic Surgeons look after injuries of the face, the hands and burn injuries, but may also be asked to manage patients who have lost skin and soft tissue from other parts of the body, especially the legs. Injuries can have occurred for many reasons; falls, glass cuts, assaults, road traffic accidents or explosions.
The Plastic Surgeon must first ensure that the wound is made clean and healthy, then to close the wound, by suturing (stitching) if possible, or by reconstructing any missing tissue. Reconstruction may involve moving skin or other tissue from other areas of the body to restore what is lost. The area from where it is moved (donor site) must be able to spare it. Sometimes it is possible to do this reconstruction, relatively simply, using a skin graft but on some occasions a more complicated procedure is required. This could mean moving a flap of tissue, and its blood supply. which will keep this flap alive, may need to be joined by means of microsurgery (using a microscope to connect very tiny blood vessels and nerves).
When treating traumatic wounds the plastic surgeon will endeavour to repair all the wounds very carefully to try and minimise scars. Unfortunately once a skin injury has occurred there will be a scar. Initially the scar may be quite red and hard, but generally over 12-18 months the scar will mature and become paler and flatter. If the scar does not mature well, then the Plastic Surgeon will be able to advise on possible ways to improve such scars.