High-energy traumas commonly lead to multiple organ injuries related to transmittance of high level of energy to victims. Injury patterns caused by high energy traumas are usually different when compared to other commonly encountered traumas due to the level of energy. Etiologically, high energy traumas include high-impact gunshot wounds, high-speed road accidents and falls from heights. Patients who subjected to high-energy traumas usually have injuries in maxillofacial region, hands, and upper and lower limbs. Injuries in these regions are diagnosed and treated by plastic and reconstructive surgeons. Those patients may have large composite soft tissue loses or avulsions, segmental bone loses, multiple fractures, major vascular injuries, multiple peripheral nerve injuries, amputations, compartment syndromes, massive hemorrhages, and burns. These injuries may be encountered either alone, or in combinations with each other.

More patients are exposed to high energy traumas when compared to previous decades due to increase of road accidents, lack of implementation of occupational safety regulations, or terror attacks. Plastic surgeons usually play an active and efficient role in the management of the patients who have injuries in maxillofacial region, hands, extremities and trunk related to high-energy traumas. Moreover, accurate and correct interventions conducted by plastic surgeons in these anatomic regions would lead to decrease in morbidities and increase of the success of future treatment strategies.

General approaches of plastic and reconstructive surgery for the patients who have injuries related to high energy traumas are outlined in the presented article. Diagnostic tests and treatment options for injuries in maxillofacial region, hand and upper extremity, lower extremity and trunk are summarized separately.

Keywords: high energy trauma, blast injuries, emergency plastic surgery