Referral procedure
- Only patients with a PSTC appointment and completed referral form will be reviewed at the PSTC
- All referrals must be discussed with and accepted by the Plastic Surgery Doctor on call. Contact via switch CUH (021 4922000)
- Please consult the Plastic Surgery referral guidelines for a list of appropriate referrals
- Appropriate referrals not requiring hospital admission will be given an appointment for the Plastic Surgery Trauma Clinic at CUH (usually the following day)
Appropriate referrals
Facial Trauma
- Complex wounds with skin loss
- Possible involvement of facial nerve or parotid duct
- Significant wounds involving the lip vermilion
- Isolated fracture nasal bones
Upper limb Trauma
- Replantation/Revascularisation of finger/hand
- Compartment syndrome without bony injury
- High-pressure injection injury of the fingers/hand
- Complex wound with skin loss
- Isolated large haematoma without bony injury
- Any upper limb nerve injury
- Tendon injury of forearm or hand
- Ligamentous injury of digits
- Complex fingertip injuries e.g. bone exposed
- Open fractures/dislocations of digits/metacarpals
Lower limb trauma
- Below knee amputation (excl. individual toes)
- Complex wounds involving skin loss
- Isolated large haematoma without bony injury
- Possible associated major nerve injuries i.e. not digital nerve injuries (except big toe)
- Paediatric lower limb wounds requiring GA
Cellulitis
- Of the face / upper limb
Abscess/encrotising fasciitis
- Abscess of Face, Upper Limb
- Necrotising Fasciitis of Face, Upper or Lower Limb
Foreign bodies
- Face and upper limb (when readily palpable)
Burn trauma
- Separate burn protocol
Inappropriate referrals
Facial trauma
- Simple wounds, not lip vermilion →EM
- Eyelid injury →Opthlalmology
- Eye globe or tear duct injury →Ophth
- Isolated scalp wounds (no tissue loss) →EM
- # facial bones (exc. nasal bones) →MaxFax
- Intra-oral trauma →MaxFax
Upper limb trauma
- Simple superficial skin wounds →EM
- Simple fingertip injuries →EM
- Isolated vascular injury →Vascular
- Closed fractures of the hand →Ortho
- Wrist, forearm & arm dislocations/# →Ortho
- Compartment synd. with bony inj. →Ortho
Neck trauma
- Penetrating neck wounds →Gen Surg (± Vasc./ENT)
- Simple superficial skin wounds →EM
Lower limb trauma
- Compartment syndrome →Ortho
- Isolated vascular injury →Vascular
- Wounds over anterior knee or achilles tendon →Ortho
- Non-complex wounds → EM
- Tendon injury →Ortho
- Toes: Nailbed / digital nerve injury (except hallux) → EM
- Amputated toes →Ortho
Cellulitis
- Cellulitis elsewhere →EM or ID
Abscess/Necrotising fasciitis
- Abscess of Trunk/Perineum/Lower Limb →Gen Surg
- Abscess of Breast →Breast Surgery
- Abscess Intra-oral/dental →Max Fax
- Nec Fasc of Trunk and Perineum →Gen Surg
- Fournier’s Gangrene →Urology
Foreign bodies
- Impalpable foreign bodies →EM
- Palpable Foreign bodies:
- Lower Limb →Ortho
- Neck/Trunk (excluding breast)/Perineum →Gen Surg
- Breast →Breast Surgery
Others
*Infections: The Reconstructive Plastic Surgery Department is not a generalised debridement service. We provide a reconstruction service. We are happy to consult on complex wounds or to provide assistance with debridement where required.
Wound advice: CUH employs wound care nurse specialists to review inpatient wounds & will advise with the plastic surgery service.
Pressure sores: Admit under medical team on call, who should then arrange review by the rehabilitation consultant, Dr McFarland ± ID, Plastic Surgery, Ortho, Gen Surg, Urology, Neurology, Occupational Therapy, Physiotherapy, Dietetics, Social Work.
Links
- Wound management
- Wound dressings
- Tetanus Prophylaxis
- Burns
- Plastic Surgery Trauma Clinic CUH Referral Criteria
- Plastic Surgery Trauma Clinic CUH Referral Form