Plastic Surgery Rotation

Upon completion of the plastic surgery rotation, the neurosurgery resident shall be able to:

  1. Outline the mechanism of normal wound healing.
  2. Outline the factors that impair normal wound healing.
  3. Outline the different types of soft tissue wounds and their management, including lacerations, abrasions, contusions, avulsions, clean and contaminated wounds.
  4. Discuss the various types of skin infections and their management, including: cellulitis, erysipelas and necrotizing fasciitis.
  5. Outline the initial assessment, diagnosis, and classification of facial fractures.
  6. Perform the following skills:
    • Repair all types of skin/scalp lacerations.
    • Recognize the most appropriate closure for a given skin defect, including: primary closure, skin graft, flap, etc.

During the rotation, all residents should fulfill the Royal College’s CanMEDS Competencies.

COMMUNICATOR:

  1. Develop rapport, trust, and ethical therapeutic relationships with patients and families, be able to review/update day to day care with patients.
  2. Conduct, document and present pertinent history and physical exam in context of plastics surgery with particular attention to problems also seen also in neurosurgical patients – i.e. wound healing/flaps.
  3. With appropriate supervision discuss relevant information with patients and family in a compassionate way and be able to obtain consent for common procedures.
  4. Share and present information with other health care providers, with attention to communicating information to when organizing diagnostic tests and procedures.

COLLABORATOR:

  1. Work/collaborate effectively in an interdisciplinary team, including wound care nurses/service to coordinate patient care.
  2. Consult other services when appropriate in context of a complicated patient with multiple medical comorbidities – internal medicine/geriatrics/ICU.
  3. Take part in all educational activities and teaching afforded by the service during the rotation.
  4. Be able to share workload and duties appropriately with other residents and medical students
  5. Be able to teach medical students, other residents and patients.
  6. Describe the surgeon’s roles and responsibilities to other professionals; Describe the elements of a good consultation
  7. Work with other health professionals effectively to prevent, negotiate, and resolve conflict

MANAGER:

  1. Effectively utilize and allocate finite resources, prioritize tests and OR emergency cases.
  2. While on a busy surgical service manage own time, education and personal life for a balanced lifestyle.
  3. Work effectively and efficiently
  4. Triage patients being able to identify plastic surgery emergencies that require prompt and immediate management such as ischemic flap, wound debridement, burn patients.
  5. Demonstrate an understanding of the influences that affect the workings of the health care system at various levels
  6. Participate in discharge planning of a complex surgical patient.
  7. Participate in setting up appropriate expectations for patients requiring elective plastic procedures.

HEALTH ADVOCATE:

  1. Recognize and council patients on determinants of health in patients, especially with respect to surgical risks and wound healing such as smoking, DM and bmi.
  2. Contribute to overall patient well-being and outcome, though appropriate pre and post-operative care.
  3. Promote lifestyle which improves surgical risks, especially preoperatively in clinic setting.
  4. Facilitate return of patient to community/alternate care and help put care/support in place to reduce return to hospital for surgical care.
  5. Ensure consults and tests are done in an appropriate timely manner.

SCHOLAR:

  1. Participate in rounds and educational activities provided by the plastic surgery service.
  2. Identify and seek out personal learning needs, especially with conditions relevant to neurosurgical patients such as wound healing, scalp flaps, tissue handling, blood supply of tissues/skin, appropriate incisions to minimize cosmetic impact of incisions.
  3. Apply principles of critical appraisal to medical information.
  4. Participate in patient, student and peer learning
  5. Contribute to development of new knowledge and be involved in appropriate research projects as available.

PROFESSIONAL:

  1. Demonstrate a commitment to their patients, profession, and society through ethical practice
  2. Exhibit appropriate professional behaviors in practice, including honesty, integrity, commitment, compassion, respect and altruism
  3. Maintain appropriate relations with patients and other health care providers.
  4. Show appropriate respect for opinions of other health care providers
  5. Be able to appraise and identify own limits with respect to knowledge and patient care, and when to ask for assistance and consult effectively