The Role of Internal Medicine or Hospitalist Co-Management in Surgical Specialties: Implications for Adult and Elderly Plastic Surgery Patients.

Background and

Objectives

Patients admitted to plastic surgery units increasingly present with multimorbidity, advanced age, diabetes, cardiovascular disease, chronic wounds, and complex metabolic requirements. In several surgical specialties, internal medicine specialist (IMS) co-management has been associated with improved clinical outcomes, yet its potential role in plastic surgery remains unexplored. Materials and

Methods

A narrative scoping review conducted using systematic search principles was conducted using MEDLINE, Web of Science, Scopus, and Google Scholar from inception to 1 December 2025. Search terms combined "internal medicine," "co-management," and "surgery." Studies assessing outcomes of IMS involvement in surgical inpatient care were included. Data on population, intervention characteristics, and outcomes were extracted and summarized. PRISMA recommendations were used to report the study selection process. The review focuses on adult and elderly surgical inpatients, as the available evidence is not applicable for pediatric populations.

Results

Twenty-two articles met the inclusion criteria. IMS co-management demonstrated consistent benefits across multiple surgical specialties, including reduced length of stay, lower complication rates, improved metabolic and cardiovascular stabilization, enhanced perioperative optimization, and decreased costs. Despite the growing complexity of plastic surgery inpatients, no studies specifically evaluated IMS co-management in this field.

Conclusions

Evidence from other surgical specialties suggests that structured IMS co-management may offer substantial benefits for plastic surgery patients, particularly those with multimorbidity, diabetes, severe burns, chronic wounds, or undergoing microsurgical reconstruction. Prospective studies are needed to determine its impact on patient outcomes, resource utilization, and clinical workflows within plastic surgery.