DO YOU KNOW A PLASTIC SURGEON..........
When a doctor introduces himself as a plastic surgeon, momentarily beautiful faces of Bollywood starlets flash in front of one’s eyes and the image of a jet setting doctor sets in. Over the last few decades the plastic surgeon has become synonymous with a cosmetic surgeon. My kid had a fall and sustained a cut wound over the eye; I would rush to the nearest hospital and ask for a Plastic Surgeon! My belief, there is no scarring in the hands of the plastic surgeon. You may be able to relate to many such parents. My friend is overweight and wants to go figure size zero; who do we consult, the Plastic Surgeon. My mother spilt scalding hot milk on her hand; whom to consult, the Plastic Surgeon.
Is the speciality of Plastic Surgery limited to making scars disappear or make people look young and beautiful? Is this field limited to slowing the natural process of ageing? Is this field limited to the glamorous world of actors and models? Is this field affordable only by the super- rich? Hair Transplant found the fancy of the masses seeing their on screen balding actors suddenly supporting wavy locks of hair. Face transplant has been a fantasy of many since Poonam Dhillon changed to Tina Munim in a blockbuster Bollywood movie in the 1980s. Skin rejuvenation and tightening with botox & lasers has vaporized a decade of wrinkles. This brings us to the core issue of DO YOU KNOW A PLASTIC SURGEON.... does much more than just hair transplants, nose jobs, tummy tucks.........
The locale of a plastic surgeon is not limited by anatomical barriers on the human body, nor is confined to one single organ system; but encompasses all medical and surgical specialities. It was in 300BC, when Sushruta laid down the foundation of Plastic Surgery in India by performing forehead flaps for reconstructing the nose. His techniques are embalmed in his literature entitled, “Sushruta Samhita” and are still followed around the globe. Rhinoplasty commonly known as Nose Job, both as a cosmetic and reconstructive procedure has been our heritage.
It was Dr. Capt. Balakrishnan, in India who brought the services of the Plastic Surgeon to the masses by envisaging the first Dept. of Plastic and Reconstructive Surgery in Nagpur and PGIMER, Chandigarh in India. It was his ideology that a child should not grow up with the deformity of a cleft lip & palate, a child should not be disabled due to birth defects of hands and feet, a labourer not left in the lurch to fend for himself with burns contractures, a skilled labourer left impoverished due to hand injury involving tendon and nerve, a housewife facing a decision to have her limb amputated due to crush injury, a youngster be left with terrifying scars of faciomaxillary injury sustained in a road traffic accident. He was a teacher of teachers and his ideologies still reverberate through those hallowed halls.
The words Trauma and Trauma Surgeon are synonymous with a Plastic Surgeon. It may be a small laceration on the face or a gaping hole in the leg with multiple fractures and bleeding vessels; No wound, be it small or big is out of the preview of the Plastic Surgeon. According to a survey there are 14 deaths per hour due to road traffic accidents involving trucks and two wheelers on Indian Roads. Shattering the myths, the maximum number of accidents occur in the afternoons and evenings. In the absence of stringent laws and non- cooperative drivers who shun the protective equipment like helmets and safety belts, these numbers continue to grow. Split open faces with shattered facial bones are a common sight in the casualty being examined by a Plastic Surgeon. The neurosurgeon and the plastic surgeon are usually the first ones to operate on such a patient as these injuries are in >45% of times associated with head injury.
Glass cut injuries over the wrist or hand by suicidal or homicidal intent not only cuts the arteries as is glorified in the movies but also disrupts the tendons moving the fingers, the nerves providing sensation to the hand. Such gashes though look docile on the outside are amongst the most challenging for the plastic surgeon to restore the structures to their functional state. Repairing the tendon, the nerve and the blood vessel requires skill, patience and persistence for desired results.
In patients who sustain fractures of limbs due to violent accidents with bone ends jutting out of the skin usually require a team of orthopedicians and plastic surgeons to fix the bone and cover the splintered bone with healthy skin, so that the person may be able to walk at the earliest. Many a times this bone becomes non viable and requires transplant of healthy bone from other parts of the body to be placed in the fracture site to help close the fracture. Many times these fractures have associated injury to the blood vessel which may lead to fatal blood loss or loss of the limb if not repaired within 6-8 hours. This repair of the peripheral vessels is a component of the armamentarium of the plastic surgeon.
Human rage respects no boundaries and sometimes we are faced with a sword wielding felon intent on chopping off one’s head or limb; and unfortunately do succeed in some instances. In the 80’s & 90’s when the Toka machines were in vogue in the heartlands of Punjab and Harayana, trauma surgeons were faced with the unique dilemma of witnessing numerous amputations on hands, arms even avulsion injury of scalp which got caught in the wheel of the infamous Toka Machine. It was during those times the Plastic Surgeons took upon themselves to restore these limbs by reimplanting them. Surgical techniques and equipment has seen revolutionary change since the turn of the century with the Plastic Surgeon at the helm of all affairs. State of the art equipment is available in the premier institutes like S.P.S. Apollo Hospital, Ludhiana and other tertiary care centres along with availability of Plastic Surgeons trained to perform these surgeries akin to heroic acts seen on the silver screen.
This all brings us back to the same pertinent question; “DO YOU KNOW A PLASTIC SURGEON...........” does much more than just trauma surgery?
DR. ASHISH GUPTA (ASSOCIATE CONSULTANT)
DEPT. OF PLASTIC & MICROVASCULAR SURGERY
S.P.S. APOLLO HOSPITAL, LUDHIANA
EMAIL: docashish2001@gmail.com
