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Catastrophic incidents would necessitate the intervention of multiple specializations with plastic surgery (PS) as an indispensable area of expertise. In view of PS, prognostic assessment of trauma patients should be focused on the qualitative value rather than mortality because plastic surgeons rarely handled patients' vital signs in actual. Thus, we explored the association between the involvement of the PS department and qualitative prognoses for severe trauma patients. From November 2014 to December 2019, we enrolled total 529 trauma patients with an injury severity score (ISS) over 15 points. We set the prognostic factors that the rate of admission in intensive care unit (ICU), total or ICU duration of hospitalization, post-discharge progress and disability diagnosis which were regarded as qualitative prognoses. The analysis was performed with logistic regression analysis or regression analysis adjusted for age, sex, past medical history, cause of trauma, and frequency of operation. Among total of 529 patients, 290 patients in PS group and 239 patients in non-PS group were analyzed. In both groups, the under-65-year ages and male patients were significantly predominant. The rate of going home showed 2.082 times higher in PS group than non-PS group after adjusting for covariates, while there was no significant difference in diagnosis of disability. Meanwhile, overall prognoses were highly correlated with either higher ISS or lower Glasgow Coma Scale (GCS). In conclusion, higher severity generally affected to the severe trauma patient's prognoses, and the PS treatment only contributes to discharge disposition to home., Competing Interests: The authors have no funding and conflicts of interest to disclose., (Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.)

Purpose: While plastic surgeons have been historically indispensable in reconstruction of posttraumatic defects, their role in Level I trauma centers around the world has not yet been clearly approved. This study aims to assess the contribution of plastic surgeons in major trauma care by evaluating the characteristics of trauma patients underwent plastic surgery at a Level I trauma center., Method: From November 2014 to October 2020, we conducted a retrospective review of our hospital's Trauma Registry System for patients with an Injury Severity Score (ISS) of 9 or higher. Of all of 7174 patients, the plastic surgery (PS) department treated 870 patients; the 6304 patients not treated by the PS were classified as the Non-PS. Then, we performed propensity score matching to reduce the statistical bias, after the death in the emergency room and the missing value were considered exclusion criteria., Result: The mean ISS showed no significant difference between two groups (16.29 ± 7.04 in the PS vs. 16.68 ± 9.16 in the Non-PS, p = 0.3221). According to investigate the Abbreviated Injury Scale, both head and neck (65.0%) and face (46.4%) categories showed significantly higher in the PS group than the Non-PS group (p < 0.0001), and its contribution ratio was 2.151 and 21.822 times, respectively., Conclusion: This study revealed the specialty of plastic surgery was face area in trauma care. We thus argue that plastic surgical care is imperative for trauma patients, and expect to be implicated in trauma system planning., Competing Interests: The author has declared that no competing interests exist.

Purpose: The global trend of resident work-hour restrictions requires a more time efficient way of resident training. Among many training programs for learning the facial anatomy, the cadaver is the most similar to live patients. A cadaver should be used as efficiently as possible due to human dignity as well as the consideration of cost. The authors designed an effective cadaver dissection method in learning facial anatomy using the plastic surgery approach., Method: A 51-year-old male cadaver was used for dissection. The program was proceeded 6 times over 6 weeks, and 4 to 8 hours each day. We used standard surgical instruments with magnifying loupes. The results were analyzed through a numerical scale survey., Result: We planned to dissect the face from medial to lateral, cephalic to caudal, and superficial to deep portion. The overall knowledge and confidence level of the face were increased in all 7 participants. The mean knowledge level before and after the seminar was 3.00 and 4.03, respectively. Confidence level also increased through the seminar from 1.86 to 2.86., Conclusion: The authors believe this cadaver dissection program could optimize learning anatomical knowledge and improve resident's surgical confidence through a wide range of procedures.