Hand injury prevention in India: Are we doing enough?

History and Metamorphosis of Hand Surgery India

The advent of hand surgery in India reads like a fortuitous saga, a continuum of the hand deformity correction on leprosy patients pioneered by Dr. Paul Wilson Brand at the Christian Medical College (CMC) Vellore, Madras State (Tamil Nadu [TN]), in 1948. The "Hand Research Unit," established in 1951, became the largest repository for hand reconstructive surgeries and with its head-start drew in most hand dysfunctions in the country. Early industrialization and disorderly road traffic generated hand injuries that threatened workforce in India. Propitiously, a hand injury service was opened in 1971 at the Government Stanley Medical College Hospital, Chennai. The inexorable growth of hand surgery continued and incorporated the gamut of conditions that required hand care and rehabilitation, including brachial plexus injuries. Continuing Medical Education programs, Hand Surgery workshops, Indian Society for Surgery of the Hand meetings, Hand Fellowships, etc., increased the number of "hand surgery" practitioners, which drew the attention of the Medical Council of India to commence a postgraduate Hand Surgery program that it eventually gazetted. The sagacity of the members of the Board of Studies of TN Medical University honored the historical role of CMC Vellore in hand surgery and allowed it to commence the first Master of Chirurgiae Hand Surgery course in India in 2015. An intuitive understanding of 70 years of hand surgery accomplishments that redesigned and restored deformed and injured hands and protected livelihoods have made young surgeons increasingly take hand surgery as a career.

Epidemiology and Treatment Outcome of Blast Injuries to the Hand at a Tertiary Hospital of Kashmir Valley, India

Background: Blast injuries to hand can have disastrous consequences on account of loss of critical hand functions. This study was conducted to study the epidemiology and outcome of hand blast injuries reporting to emergency department of a tertiary care hospital.

Materials and Methods: All the blast injuries to hand admitted at our center between 2016 and 2020 were assessed at the time of injury and at 6 weeks after completion of primary management. The severity of injury and functional outcome was assessed using modified hand injury severity score (HISS) and quick disabilities of the arm, shoulder and hand (QuickDASH) scale, respectively. Descriptive statistics was calculated and correlation between HISS and DASH was assessed using Pearson's correlation coefficient.

Results: A total of 26 cases with a mean age of 23.12 ± 9.1 years were included. The subjects included 25 males and 22 subjects had injury to their dominant hand. The grade of injury was severe in 12 (46.15%) cases followed by moderate in 5 (19.2%) cases and major in 5 (19.2%) cases. The mean HISS score at injury was 67.46 ± 37.6. The mean QuickDASH score at follow-up was 37.24 ± 29.7. QuickDASH score at follow-up had a significant correlation with HISS score at baseline with a Pearson's correlation coefficient of (r = 0.67, p = 0.0012)

Conclusions: Blast injuries to hands are primarily seen in young males with low-grade explosives being the primary source of injury. Dominant hand is most commonly involved with many cases needing revascularization procedures. Higher severity of blast injuries to hand is associated with poor outcome at follow-up.

Advocacy and mass education in plastic surgery: Efforts and outcomes

Background:

Awareness of plastic surgery is lacking. Be it reconstructive surgery, or aesthetic surgery, public education and awareness regarding the spectrum is the need of the hour.

Materials and Methods:

We undertook a string of activities for patient awareness and education for burn prevention, occupational hand injuries prevention, skin banking awareness and various other conditions relevant to us as plastic surgeons. Use of social media helped us for increasing the reach of our projects.

Observation and Results:

Some of the projects we started, we are still pursuing with sincerity, and some never really picked up. A wide range and spectrum of activities were undertaken, and we would like to think that we have made some impact towards advocacy of plastic surgery; however, the measurable impact of these initiatives is questionable.

Conclusion:

Collective efforts for promotion of the speciality using innovative methods, use of celebrities for awareness and social media amongst other things must be undertaken to make a sustained and demonstrable impact towards advocacy of plastic surgery.