Trauma and Burns
surgery is a surgical specialty that utilizes both operative and non-operative
management to treat traumatic injuries, typically in an acute setting. Trauma
surgeons generally complete residency training in General Surgery and often
fellowship training in trauma or surgical critical care. The trauma surgeon is
responsible for initially resuscitating and stabilizing and later evaluating
and managing the patient. The attending trauma surgeon also leads the trauma
team, which typically includes nurses and support staff as well as resident
physicians in teaching hospitals.
WHAT IS A TRAUMA
surgeons (also called critical care and acute care surgeons) specialize in
performing emergency surgeries on people who’ve had a critical injury or
illness. Trauma surgery requires extensive knowledge of surgical procedures and
how to manage different types of injuries. A trauma surgeon can help you pull
through a critical injury or an acute illness.
WHAT DOES A TRAUMA SURGEON TREAT?
surgeons are qualified to diagnose and surgically repair trauma caused by
injuries and illness. They must quickly evaluate a person’s condition and
determine what type of operation--if any--is necessary.
you see a trauma surgeon, it’s usually after you arrive at a hospital’s
emergency room. They come onto your care team if it’s possible that you’ll need
surgery to treat your illness or injury.
CONDITIONS A TRAUMA SURGEON MIGHT TREAT INCLUDE:
or Penetrating Trauma
trauma is any injury from a forceful impact. Common causes are motor vehicle
crashes, falls, or assaults. Penetrating trauma is an injury from an object
that pierces the skin and other tissues, including gunshot wounds, stab wounds
and farm equipment injuries.
may need a trauma surgeon to treat severe burns, such as thermal burns,
chemical burns, frostbite, and inhalation injury burns. Treatment options can
include emergency surgery, skin excision, and skin grafting procedures.
inhalation injury burns. Treatment options can include emergency surgery, skin
excision, and skin grafting procedures.
Care & Emergency General Surgery Conditions: -
people have unexpected medical emergencies that need immediate surgical
intervention. Trauma surgeons can treat appendicitis, diverticulitis,
cholecystitis, a perforated bowel, a perforated ulcer, abdominal abscesses,
incarcerated hernias, and bowel obstructions.
Critical Care Conditions: -
surgeons also perform surgical critical care procedures on patients who were
already in the hospital for another surgery or procedure. This includes people
with sepsis, respiratory failure, multi-organ failure, or coagulopathy.
surgery to treat burns
WHAT IS BURN SURGERY?
are two main categories of burn surgery: acute and reconstructive. Acute burn
care occurs immediately after the injury. It is delivered by a team of trauma
surgeons (General Surgeons) that specialize in acute burn care. Complex burns
often require consultation with plastic surgeons, who assist with the inpatient
and outpatient management of these cases. Large burns, or burns of critical
body areas, should be treated at a verified burn center, such as the Trauma
Burn Center here at the University of Michigan. Many smaller burns can be
treated with outpatient options. Some patients may need reconstructive burn
surgery after the initial burn wounds have healed. This type of care is usually
provided by a plastic surgeon. The goals of reconstructive burn surgery are to
improve both the function and the cosmetic appearance of burn scars. This
involves altering scar tissue, with both non-operative and operative treatment.
The relationship between the burn patient and the reconstructive burn surgeon
often lasts many years. Treatments for scar tissue often take several months to
be effective, and new scar contractures can appear long after these injuries,
especially in young patients who are still growing.
WHAT ARE THE BENEFITS OF RECONSTRUCTIVE BURN SURGERY?
will not be able to remove a patient’s burn scars entirely, but it will help
improve basic functions and make scars less noticeable. Scarring can limit the
normal motion of the neck, shoulder, hands, or legs. Often surgery to help
release this contracture can help a patient regain range of motion. Facial
scarring that leads to problems with the eyelids, lips, nose, or hair loss can
also be helped with reconstructive burn surgery. Scars that are abnormally
thick, wide, or discolored might also be improved by a variety of operative and
WHAT ARE THE OPTIONS FOR RECONSTRUCTIVE BURN TREATMENT?
therapies might involve scar massage, application of pressure garments, or
other topical therapies. An occupational therapist at the University of
Michigan can help fit patients with pressure garments. The team includes
specialty hand therapists who help with the rehabilitation of hand burns and
scars. Surgical options consist mainly of scar release procedures. The tight
scar tissue is released and the open area closed by a plastic surgeon. There
are a variety of ways to close these wounds depending on a patient’s needs.
Skin grafts, skin rearrangement (sometimes called Z-plasty), and more complex
skin donor flaps could be used, depending on the location of the scar and a
patient’s personal goals. Most minor procedures are performed as outpatient
surgery, but the larger grafts and flaps would likely require an inpatient
stay. Tissue expansion can also be used as an alternative to skin grafting.
Excellent results are commonly attained when performing tissue expansion to
regions of the face, neck, arms, hands, and legs.
IF YOU NEED RECONSTRUCTIVE BURN TREATMENT
first step is to schedule a personal consultation with a plastic surgeon.
Communication is crucial in reaching your goals. You will have the opportunity
to explain the results you'd like to see from therapy. Together, you and your
surgeon will reach an understanding of what you can expect from procedures and
the long-term benefits you will experience. Every patient is different, and
your surgeon will choose the surgical technique and treatment plan that is
right for you. During the initial consultation, you should expect:
provide a complete medical history, including information about previous
surgical procedures; past and present medical conditions; and any medications
or herbal supplements you are taking.
surgeon to conduct a complete physical examination.
discuss possible risks and complications of the procedure.
you choose to have surgery at U of M, you will be given a pre-operative
information packet that explains everything you should do and know before your
surgery date. Your procedure will take place at the University of Michigan
Hospital which provides state-of-the-art surgical suites and recovery areas.
The majority of these procedures are completed on an outpatient basis. Your
surgeon will give you specific instructions on how to prepare for surgery,
including guidelines on preoperative skin cleansing, eating and drinking,
smoking, and taking or avoiding certain vitamins and medications. Whether your
surgery is done on an outpatient or inpatient basis, you should arrange for
someone to drive you home after your surgery, and to help you out for a day or
two after you leave the hospital, if needed.
post-surgery instructions are important to heal and obtain the best possible
outcome, both in terms of function and physical appearance. You will have to
follow up appointments so your surgeon can assess your long-term results and
answer any questions or concerns you may have. Since a variety of procedures
can be performed, your individual postoperative instructions may vary. In
general, skin grafts require a kind of "bolster" dressing to keep
them in place for 3-5 days without any movement of the skin graft. The bolster
helps the skin graft "stick" to the wound and begin to heal. Smaller
operations (scar revisions, Z-plastics) might require only a small, soft
dressing afterward. After scar releases on the hand, your surgeon may place you
in a larger dressing that incorporates a plaster splint for support after
surgery. In general, follow-up visits are scheduled within two weeks of
surgery, and there may be stitches to remove at that time. Additional physical
therapy or occupational therapy may be required in the weeks and months
following surgery to ensure complete recovery of function. This may involve
splints or casts, as well as exercises you perform at your treatment visits and
on your own at home. Your surgeon and therapists will work together to develop
the plan that is best for you.nd stigmata associated with burn injuries.