title: Role of plastic surgery on the treatment complex wounds.
abstract: OBJECTIVE
  To report the performance of plastic surgery in the treatment of complex wounds in a tertiary hospital, analyzing its characteristics, types of injuries and approaches adopted, with emphasis on surgical treatment.
  
  
  METHODS
  We conducted a etrospective analysis of patients with complex wounds treated by plastic surgery in a tertiary hospital in a period of five years (2006 to 2010). Data collection was obtained from visits made, serial assessments and records of the medical charts.
  
  
  RESULTS
  There were 1927 patients treated (32 queries/month), mean age 46.3 years, predominantly male (62%). The surgical specialties requested 1076 consultations (56%), and the clinical, 851 (44%). The distribution by type of wound showed predominance of pressure ulcers (635/33%), traumatic wounds (570/30%), complicated surgical wounds (305/16%) and necrotizing wounds (196/10%), with the remainder represented by vasculitis (83/4%), venous ulcers (79/4%), diabetes (41/2%) and post-radiation (18/1%). The treatment was surgical in 1382 patients (72%) and non-operative in 545 cases (28%). There were 3029 operations, predominantly debridement (1988/65%) and skin grafting (619/21%) associated or not with negative pressure therapy (vacuum), followed by pedicle flaps (237/8 %), digital reimplantation (81/3%), microsurgical flaps (66/2%) and other (38/1%).
  
  
  CONCLUSIONS
  The plastic surgeon played an important role in the treatment of complex wounds by adopting early surgical treatment, contributing to the effective resolution of cases.
authors.affiliation: Department of Plastic Surgery, Faculty of Medicine, Universidade de São Paulo (USP), São Paulo, Brazil. pscoltro@hotmail.com
authors.forename: Pedro Soler
authors.initials: PS
authors.lastname: Coltro
authors.forename: Marcus Castro
authors.initials: MC
authors.lastname: Ferreira
authors.forename: Bernardo Pinheiro de Senna Nogueira
authors.initials: BP
authors.lastname: Batista
authors.forename: Hugo Alberto
authors.initials: HA
authors.lastname: Nakamoto
authors.forename: Dimas André
authors.initials: DA
authors.lastname: Milcheski
authors.forename: Paulo
authors.initials: P
authors.lastname: Tuma Júnior
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies; D014947:Wounds and Injuries / Q000601:surgery*; D055815:Young Adult