RECOMMENDED GUIDELINES FOR OPTIMAL-DESIGN OF A PLASTIC-SURGERY SERVICE DURING MASS CASUALTY EVENTS

Objective: The objectives of the study were to evaluate the pattern of plastic surgery (PS) team intervention during the first 12 hours afte r a mass casualty blast. Methods: The records of 272 civilians injured from 1994 to 1997 in Tel Aviv were reviewed, Patients' injuries were classified according to the nature of their PS injury and the type of PS intervention. The procedure time and number of plastic surgeons inv olved were recorded in 20-minute intervals. The average and standard d eviation of the peak demand (PD) timing for PS intervention were calcu lated. Linear correlation between the PD and the total number of wound ed transferred to the Tel Aviv Sourasky Medical Center was evaluated b y the correlation coefficient. Results: A distinct ''double-peak'' and five phases pattern of PS team intervention were observed. A linear c orrelation and a 1:5 ratio were found between the total number of woun ded transferred to the Tel Aviv Sourasky Medical Center and the PD for PS intervention, Conclusions: PS involvement has a predicted pattern related to the patient volume. Guidelines based on the conclusions dra wn from this study can ensure an ordered, efficacious level of PS care during these events. A triple team plan is suggested, and adjustments in medical resources according to the specific nature of the event ar e described.