Demand for plastic surgery services via inpatient referrals in a Nigerian Teaching Hospital

Abstract

Background: Plastic surgery is one of the most collaborative surgical specialties and is also considered the most consulted service in a hospital. Plastic surgeons respond to many medical consults or inpatient referrals, and the comprehensive impact of these services, when they are nonoperative, often goes unnoticed. Objectives: The objectives of the study were to assess the nature of demands of plastic surgery services for admitted patients in a teaching hospital and the specialties and types of patients that benefit from them. Materials and Methods: Clinical records of inpatients evaluated by plastic surgeons were retrieved using a compendium of consults received from other specialties within the hospital over a period of 1 year period. Results: The plastic surgeons received a total of 151 hand-written consults from surgeons, physicians, gynecologists, and pediatricians. The vast majority came from physicians (45.7%) and surgeons (40.4%). Among the physicians, endocrinologists sent the highest number of consults (42.5%). Ulcers constituted the commonest reason for inpatient referrals (66.2%). Over 29% of consults were for patients with primary diagnosis of diabetes mellitus, whereas 13.9% were for head injuries. Conclusions: The demands for the services of plastic surgeons come from virtually all the clinical specialties in a tertiary hospital. The commonest reason for such referral is for their review and management of ulcers. There is a need to utilize telemedicine in reducing the burden of reviewing these patients, especially in large tertiary hospitals.