What is Plastic Surgery?
It is a usual belief among general public that the word plastic in plastic surgery means artificial, which is a misconception. The word is derived from the ancient Greek word plastikos, which means to shape or give form. Plastic surgery is a surgical specialty involved in the reconstruction of defects in the face and body tissue disorders due to illness, trauma, or birth.
Plastic surgery restores and improves function, as well as appearance. It can involve surgery on any part of the body, except the central nervous system, including, but not limited to, the following:
Defects at Birth (Congenital Anomalies)
Facial Skeleton (Maxillofacial)
Plastic surgery includes both reconstructive surgery and cosmetic procedures. Usually reconstructive surgery is carried out on abnormalities of the body that may be caused by the following:
Trauma or due to accidents
Disease and Infections
Congenital (present at birth) anomalies
The aim of this type of surgery is usually to improve function of the affected body part, but may also be performed to give a normal appearance to the patient.
Cosmetic or aesthetic plastic surgery is performed to repair or reshape normal parts of the body, usually to improve appearance.
History of the NHSL Plastic Surgical Unit
Plastic surgery unit at the General Hospital Colombo, as it was called then, was established in 1962, long after the establishment of the other general surgery units by Dr A. Wijesinghe, who was trained in the UK as the first plastic surgeon in Sri Lanka. The unit had humble beginnings and consisted of only two rooms which could only accommodate 3 beds each and plastic surgery was performed once a week. Since his retirement in 1981, Dr. Narendra Wijemanne was appointed to the unit and was instrumental developing the unit and in popularizing the field of plastic surgery. He also revolutionized treatment of cleft lips and palates.
Dr Dulip Perera was appointed to the unit in 1999 after the retirement of Dr. Narendra Wijemanne. Dr. Perera's contribution to the unit was immense and he has been able to expand the unit he took over with a capacity of 10 beds in the female ward and 5 beds in the male ward and a room for children to what it is today consisting of 3 consultant plastic surgeons operating in 3 operating theatres and 3 wards, male, female and paediatric, consisting of a bed capacity of 16, 15 and 5 in each ward respectively. He was also responsible for maintaining the high quality of training and popularizing the field of microsurgery which has resulted in providing specialized care for trauma patients. The unit also has a team of dedicated staff consisting of senior registrars, senior house officers, nurses, occupational therapists and junior staff members to assist in these services and provide round the clock services to all patients referred to the unit.
The plastic surgery unit at the National Hospital of Sri Lanka has been recognized as a centre of excellence for training plastic surgeons locally and is currently being considered to train plastic surgeons from Australia. The metamorphosis of the plastic surgery unit at the National Hospital of Sri Lanka has been truly remarkable and is a result of the dedication by every member of the staff who has served in the unit and thrived for its success during the past 52 years since its inception in 1962.
Clinics conducted under the specialty
- General plastic surgery clinic
Every Friday 8am onwards (except on public holidays)
- Cleft lip/palate clinic
Every 1st Thursday 8am onwards (except on public holidays)
- Brachial plexus clinic
Every 2nd Thursday 8am onwards (except on public holidays)
all above clinics are held at plastic surgery clinic room, near ward 04 (female), 2nd floor Bandaranaike building.
Dr. Dhammika Dissanayaka (consultant plastic surgeon) can only be consulted on Fridays.
How to register for clinics
Only a consultant should refer a patient to the plastic surgery clinic from other institutions either government or private sector.
Patients are registered at our plastic surgery clinic directly through OPD referrals or through room number 18 (general surgical clinic)
Services rendered by the unit
- Plastic & reconstructive surgeries
- Reconstruction of hand, foot & facial injuries.
- Surgical correction of congenital (birth) defects/injuries of limbs & face including ears, nose, lip, palate & genitalia.
- Breast reconstruction following cancer or similar problems.
- Also we are doing selected aesthetic (cosmetic) surgeries for teaching purposes.
- Occupational / scar therapy unit
Conducted by 3 occupational therapists
We are providing occupational & scar therapy at post & pre operative stages.
- Dressing room
Sterility maintained, well equipped dressing room conducted by trained staff which is always supervised by a medical officer.
How to obtain these services
Only for the patients who are registered at the clinic can obtain these services as ordered by the consultants or by another doctor.
Instruction on transferring patients to the unit
- Transferring between institutions
- Referrals between the units should be by the consultants at all times.
- During non working hours
- Consultants delegate this responsibility to a senior registrar (SR). The SR should keep the consultant informed that a patient has been transferred to the unit.
- In an emergency (eg: re-plant*)
- Always contact our on call team 0112691111 or 1959 (Ext 2204 or 2844)
- Please refer the following guidelines
Guidelines for accepting transferred patients
Prior to transferring a patient, a member of the on call team (SR/Reg./SHO) should be contacted and a brief history regarding the patient clearly explained.
If a possibility is available to e-mail or provide photos via MMS it will be of at most benefit to the oncall medical officer who would be accepting the patient to assess the necessity of transfer. A photocopy of the BHT will be mandatory for acceptance of the transfer.
The initial transfer form should be signed by the consultant and none other, including the designation, name, date and time are mandatory.
Prior to transfer if the oncall medical officer was not notified duely the transfer will not be accepted by the relevant unit and the patient will have to be admitted via the casualty surgical/ medical unit only.
During weekends when transferring patients between units only a mutual agreement among the consultants should permit such transfers.
When being transferred, the patient should be properly educated that re transfer back to the initial unit will not be compulsory by ambulance, and a transfer form by hand maybe issued and the patient will have to provide his/her own transport back to the unit, this may be due to the dire necessity of beds to be provided for urgent, complicated surgeries being perform in the unit and to accommodate these patients.
- During weekends only dire emergencies will be accepted.
- For internal tranferes please refer the following guidelines
Guidelines for accepting transferred patients
If the patient is internally warded, the in charge consultant should make sure a referral to the relevant on call consultant is written. (Since some units consists of several consultants the referral should be written to the consultant who is on call on this day).
If itâ€™s a referral made for the first time the referral should strictly be addressed to the consultant in charge of the unit and none other.(SR/Reg.).
Prior to accepting the transfer, the on call consultant should contact the ward staff and clarify the availability of beds. If none are available he should inform the unit regarding the unavailability of beds and agree to inform them in return once a bed falls vacant.
If the patient is accepted and surgery is performed following surgery once the patient is fit for transfer he/she should be taken over back by the unit from which the patient was transferred initially from and relevant legal documents including medical certificates, insurance forms and other should be provided by the unit from which the patient was transferred from.
If the patient is X-ward relevant documents of proof should be dually submitted.
To further improve hand, microsurgery and craniofacial services
To develop this unit as a premier training center for plastic surgery trainees in Sri Lanka as well as in the Asia Pacific Region
To facilitate research by all the members in the unit
To purchase computer and software facilities to register and preserve patient data in view of conducting 'Paperless clinics' in the future.