Role of Plastic Reconstructive Surgery in the management of earthquake victims of Nepal in Tribhuvan University Teaching Hospital

Abstract

An earthquake of magnitude 7.8 richter on 25 April 2015 and its major aftershock on 12 May 2015 struck Nepal resulted inmassive destruction of Kathmandu valley and rural areas causingmore than 8800 mortalities and left more than 23000 injured. The casualties who were brought to the hospital were treated by various surgical specialties including plastic surgery. This is a cross sectional study in which the authors evaluated soft tissue injuries treated by the plastic surgery team in one month period after the earthquake. Information was gathered regarding pattern of soft tissue injuries and their treatment. There were total of 486 earthquakevictims admitted in the hospital and 532 major operations were performed. Total of 77 patients were admitted under plastic surgery and 115 operative procedures were perfonned for the 104 soft tissue injuries in these patients. Operations for soft tissue injuries accounted for 22% of the total operations performed. The most common operation was split thickness skin grafting (34%). Local and regional flaps were performed on ten cases (9%) and free flap was done in four cases (3.4%) ofinajor soft tissue defects requiring coverage of exposed bones. Complications occurred in 23 patients (29.87%) and included infection, skin necrosis, partial skin graft loss, Acute Kidney injury and sepsis. The authors conclude that the role of plastic surgeons is vital in disasters like earthquake and it helps in the appropriate and timely wound care and debridement and alsohelp to identify patients that would potentially benefit from limb salvage.