Procedures - Trauma & Reconstructive Surgery
Trauma & Reconstructive Surgery
Accidental injuries and trauma can occur in many places, commonly at work (motorised saws, kitchen and industrial equipment) and at home (garage, garden and kitchen appliances).
Lacerations (skin repairs/Skin Grafts)
These can occur to yourself, your young child at home (playground trauma), and even to your elderly relatives (accidental falls and trauma). Due to their frail skin it is also not uncommon for them to require skin graft as part of their repair.
Hand & Upper Limb Injuries
You may have sustained a closed or open hand injury from either a sports or work/industrial trauma, which is very common. Closed fractures are bony breaks which do not contain any open wounds. An open fracture, on the other hand, is associated with an open wound overlying the bony break. In these situations you may also have deeper tendon, nerve and arterial injuries at the same time from a more traumatic mechanism of injury. Repair of these structures will be complex and often require metalware fixation for the fracture, and microsurgery to repair nerve and arterial vessel structures.
Selected Lower Limb Injuries
These are commonly results of motor vehicle accidents. It is not uncommon for you to require treatment in conjunction with other specialists (such as an orthopaedic surgeon) especially if you have a concurrent long bone fracture. In situations where skin coverage is an issue, usage of skin grafts and tissue flaps may be required to reconstruct your leg. Once again, microsurgery may be required to achieve these complex reconstructions depending on how severe your injury is.
Having trained previously at the Victorian burns unit (Alfred Health), I have a great deal of experience in dealing with burn injuries. You may require admission and treatment at a tertiary institution if it is a severe burn involving a large area(s) of your body. Flame (including petrol), scald and chemical (including concrete) burns are very common in the community. If the burn you have sustained is simple, it may require special dressings only. A deeper burn means that you may require surgical excision and reconstruction with skin grafts, with regular dressings support after you are discharged home. The scaring process can be quite debilitating depending on the site and degree of your burn. You will be referred to a specialised hand therapist and physiotherapist to ensure adequate rehabilitation of your scars and mobilisation of joints to prevent contractures.
It is extremely likely that your injury would have been seen to by a general practitioner or by an emergency physician. As soon as the referral has been received by myself, urgent arrangements will be made for me to see, assess, treat and manage your injury at an appropriate centre. It is important to ensure that you are fasted for at least 6 hours before any surgeries can be done in order to avoid unnecessary anaesthetic complications.
How long your operation takes will depend on how much injury is needing to be repaired and the extent of the damage. This can range from a simple 20-30 mins procedure to a much longer operation time. Especially if your injury is complex, common with hand, upper limb and lower limb injuries.
Every surgery carries some degree of risk, and you will be briefed on these during your initial consultation if you are wanting to proceed with surgery. Some of the possible general complications may include:
- Wound infection or breakdown (requiring dressings and/or antibiotics)
- Pain and discomfort around the wound sites
- Haematoma (blood clot which may require evacuation)
- Bleeding (which may necessitate blood transfusion)
- Deep vein thrombosis (a blood clot in the leg, which in rare occasions, may travel to the lungs and become life threatening)
- Hypertrophic, stretched or keloid scar
- Anaesthetic complications (which will be addressed by your anaesthetist)
The time it takes for you to return to usual home, work and leisure activities will depend on the site of surgery, what was repaired (fracture/tendon/nerve etc), and your usual occupation and nature of daily work. These will all be discussed and addressed thoroughly at the time of your initial consultation to ensure a safe return to normal duties as efficiently as possible. If you have suffered an upper limb or hand injury, you will most likely need to see a hand therapist post-operatively (and similarly a physiotherapist for a lower limb injury) as part of your rehabilitation process. We have access privately to these allied health staff members to facilitate your recovery process. Immediately before you are discharged from the hospital, a post-operative information sheet will be given to you to ensure written information is available about how to look after your wounds and dressings in the immediate week prior to being seen in your first post-operative appointment