Polytrauma is a situation where the patient has an injury of one or more extremities/systems/body cavities or a combination of injuries that require thorough examination, assessment, and priority of management. A plastic surgeon is the best person to deal with facial lacerations, facial bone fractures, soft injuries of the hand, fractures of hand and foot bones, crush injuries, or difficult soft tissue injuries of leg and foot and multiple such injuries involving skin, muscles, nerves, blood vessels, bones, and ligaments.
However, there are incidences of other injuries either singly or in combination in a patient of polytrauma like long bone fractures, rib fractures, hemothorax, pneumothorax, intraabdominal injuries, or head injury. Because of the background of his general surgical training and vast experience of treating accidental injuries, plastic surgeon effectively prioritizes the management of trauma patients and starts the treatment without delay. Other specialists whose services might be needed in the treatment of polytrauma patients include neurosurgeons, thoracic surgeons, general surgeons, orthopedic surgeons intensivists.
Polytrauma is an unfortunate incidence of injury wherein a patient has sustained multiple injuries, some of which might be critical and life-threatening. The majority of cases of polytrauma happen due to vehicular accidents. Whatever may be the cause, urgent primary care during transportation and shifting the patient to a well-equipped hospital with facilities for resuscitation and emergency surgery of all kinds (including neurosurgery, thoracic surgery, plastic surgery, orthopedic surgery, and general surgery) is the rule. The slightest delay in shifting the polytrauma patient or shifting to an ill-equipped hospital can cost a patient his limb or life. The team transporting the patient of polytrauma and the team receiving the patient must have proper communication and coordination to deal with the critical situation. Concerned specialists must be aware of the arrival of the polytrauma patient and a critical care specialist in trauma patient management must be available at the base who can coordinate with all specialists.
The most frequent cause of polytrauma injuries is vehicular accidents. Though four-wheeler accidents account for majority of road traffic accidents leading to polytrauma injury, dreaded polytrauma injuries do happen in two-wheeler accidents also. Apart from vehicular accidents; industrial accidents, railway accidents, warfare injuries, earthquakes, the collapse of the building, construction site accidents, and other weird causes also account for a small but definite number of polytrauma injuries.0
Symptoms of polytrauma range over a wide spectrum. Obviously, visible symptoms on the surface are abrasions, lacerations, crush injuries, bleeding from the avulsed tissues, deformity and pain due to fractures, and altered level of consciousness, and pain. However, invisible yet grievous signs of injury include hypotension, and respiratory depression. Shock etc. Because the patient of polytrauma may have associated blunt injury of the abdomen, hemopneumothorax, retroperitoneal bleeding/hematoma, liver or splenic injury, mesenteric tear or visceral injury, extradural or subdural hematoma, cervical spine injury; examining and treating only the visible injuries can be lethal.
Treatment of polytrauma patients starts from the site of the accident itself. To have an expert team of paramedics and nursing staff trained for airway maintenance, hypovolemic shock management, and cardiopulmonary resuscitation is the best approach to attend and shift these patients. The rule of the golden hour of trauma must be remembered and followed during the transportation of such critically injured patients.
Patients must be transferred efficiently and quickly to a hospital with facilities of I.C.U. back up, well-equipped operation theatre, and availability of critical care specialists and surgical team who can handle emergency procedures like endotracheal intubation, tracheostomy, intercostal drainage tube insertion, hemostasis of bleeding wounds, central venous and arterial line insertion and cardiopulmonary resuscitation. Apart from all these, the availability of super specialist surgeons (plastic surgeon, neurosurgeon, cardiothoracic surgeon) must be ensured and operation theatre must be made ready and available before the arrival of the patient.
Complications of polytrauma can be disastrous. The most disastrous complication is, of course, death. However, effective and efficient primary treatment and immediate shifting of the patient at the proper place (hospital) can not only save the life of a patient, it can drastically change the quality of life of the patient also. Especially in head injury and chest injury patients, correction of their breathing problems and improvement of oxygenation of blood helps to prevent permanent brain damage. Apart from these, early stabilization and fixation of fractures of the cervical, dorsal, or lumbar spine, femur, and other long bones, stabilization of mandible and maxilla fractures, and management of open injuries by proper dressing and subsequent surgeries also help in improving the general condition and overall recovery of the patient.
The best way to prevent polytrauma injury is to strictly follow the traffic rules and avoid road traffic accidents. However, it is not possible always to prevent road traffic accidents. In that situation, urgent and best primary treatment at the site of the accident and shifting the patient to well-equipped hospital is the best treatment.
Results of treatment of polytrauma are excellent if the treatment is carried out by an experienced team of doctors and without wasting time. As the majority of polytrauma injuries happen to young individuals, the results are good and rehabilitation of these patients is faster and better.
For polytrauma injuries that do not involve internal organ injuries, critical head injuries, or patients who require endotracheal intubation, Cutis Hospital is the best hospital for management. At Cutis Hospital, all these patients are primarily examined and treated by an experienced plastic surgeon and his team. The team includes experienced orthopedic surgeons, physician,s and physiotherapists. For such limited polytrauma injuries, Cutis Hospital is the best option for treatment.
The golden hour in polytrauma injuries is the first 60 minutes after the accident happens.
Golden hour is an extremely important and life-saving period for polytrauma injury patients. Because major complications responsible for the early death of these patients can be stopped from progressing and the patient’s general condition can be stabilized during the initial 60 minutes after the accident,. These complications include airway obstruction, bleeding, spinal cord injury due to vertebral fractures, pneumothorax, etc.
The importance of first aid treatment in polytrauma injuries is immense. In fact, it can never be underestimated, because the team giving first aid treatment has the best and only chance to save some of these patients.
Compound, comminuted fractures of multiple facial bones with internal oral bleeding or a head injury can lead to choking of the patient due to blood collection inside the throat. Emergency tracheostomy (making a hole in the trachea and inserting a curved tube for breathing) is a life-saving procedure in such patients, and it should be done immediately.
We provide effective surgical and non-surgical treatments for all parts of the body. At Cutis Hospital, our cosmetic and plastic surgery team is committed to giving patients safe and high-quality care.
