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Volume 23 Supplement 2

London Trauma Conference 2014

  • Oral presentation
  • Open Access

Changing landscapes for plastic surgery: the effect of the Major Trauma Network on emergency operative workload

  • 1,
  • 1Email author,
  • 1,
  • 1 and
  • 1
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine201523 (Suppl 2) :O1

  • Published:


  • Service Design
  • Postgraduate Training
  • Sevenfold Increase
  • General Extremity
  • Major Trauma Centre


The advent of major trauma centres (MTCs) in the UK in 2010 has led to a concentration of complex, polytrauma cases in these centres. The role plastic surgeons play in trauma has increased and evolved over time [1], and currently plastic surgeons input into a wide variety of trauma [2]. Our study aimed to analyse the effect of MTC status on plastic surgery activity at our centre.


All trauma patients admitted to a London MTC in 2013 who underwent an operation were identified using Trauma Audit & Research Network data. Operative procedure(s) and operating specialty were recorded. This was compared to local historical data from pre-MTC go-live (2008–2010).


Of the 2606 trauma calls in 2013, 416 patients required surgical intervention. 29.3% of these patients (n = 122) were operated on by plastics (either as sole operating team or part of multi-specialty team). 76.2% (n = 93) involved lower limb trauma and 30.3% (n = 37) upper limb trauma. Emergency general extremity referrals increased from an average of 65/year to 484/year in the period 2011 to 2013, whilst plastics operative workload increased from an average of 53 cases/year to 407/year in the same period. This represents a more than sevenfold increase in the plastic surgery operative workload at our centre.


There has been a dramatic increase in emergency plastic surgery activity following designation of major trauma centre status at our centre. Understanding the epidemiology of plastic surgery is vital to improve service design, postgraduate training in the specialty, and workforce provision [1].

Authors’ Affiliations

Major Trauma Centre, St. Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK


  1. Khan A, Yeates D, Goodacre T, Goldacre M: Trends over time and geographical variation in admission rates for plastic surgery in England. J Plast Reconstr Aesthet Surg. 2010, 63: 1962-1971. 10.1016/j.bjps.2010.02.030.View ArticlePubMedGoogle Scholar
  2. Jalali M, Loughnane F, Winterton R: Trauma management within UK plastic surgery units. J Plast Reconstr Aesthet Surg. 2011, 64 (4): 558-559. 10.1016/j.bjps.2010.08.019.View ArticlePubMedGoogle Scholar


© Hendrickson et al. 2015

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.