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The Importance of Plastic Surgery in Multidisciplinary Teams: A Systematic Review and Meta-analysis of Comparative
Abdulaziz Elemosho1, Ramiz Kardan2, Edward M Reece3
1From the Department of Plastic and Reconstructive Surgery, College of Medicine, The Ohio State University Wexner Medical Center, Columbus, OH.
Background:
Multidisciplinary team (MDT) care facilitates coordinated expertise that leads to improved patient safety and outcomes. Yet, no prior study has quantified reported benefits from plastic surgery-inclusive MDTs across several procedures. We thereby hypothesized that plastic surgery-inclusive MDTs would lead to better surgical outcomes following cranioplasty, spine surgery, abdominoperineal resection, abdominal wall reconstruction, and extremity reconstruction, compared with the primary specialties acting alone.
Methods:
Following Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines, we searched PubMed, Embase, Scopus, and Web of Science for comparative studies comparing outcomes of care provided by plastic surgery-inclusive MDT and non-plastic surgery-inclusive MDT.
Results:
Thirty studies with a total of 9614 patients were included. Plastic surgery-inclusive MDT care was associated with reduced odds of wound complications in abdominoperineal resection (odds ratio [OR] = 0.65; 95% confidence interval [CI], 0.47-0.90) and spine procedures (OR = 0.57; 95% CI, 0.33-0.97). In addition, plastic surgery-inclusive MDT care for extremity reconstruction and abdominal wall reconstruction was associated with lower odds of wound complications ([OR = 0.24; 95% CI, 0.12-0.46] [OR = 0.33; 95% CI, 0.12-0.90]), reoperation ([OR = 0.13; 95% CI, 0.04-0.49] [OR = 0.26; 95% CI, 0.03-2.39]), and shorter length of stay (mean difference, -19.5 and -0.62, respectively).
Conclusions:
Plastic surgery-inclusive MDT care significantly reduces wound complication and reoperation rates across complex surgical procedures. These findings support the formal integration of plastic surgeons within MDTs to improve patient outcomes and surgical safety.
