Plastic Surgery Response to the 2023 Kahramanmaraş Earthquake: Injury Patterns, Surgical Spectrum, and Departmental Organization.

BACKGROUND

The February 6, 2023, Kahramanmaraş earthquakes caused catastrophic damage in Turkey and Syria, resulting in mass casualties and disrupted health care. This study aims to describe the experience of a plastic and reconstructive surgery department during the acute disaster response period.

METHODS

A retrospective study was conducted, including 145 patients hospitalized in the Department of Plastic, Reconstructive, and Aesthetic Surgery at a tertiary referral center between February 6 and February 21, 2023. Demographic characteristics, anatomic distribution of injuries, injury types, and surgical procedures were analyzed.

RESULTS

The cohort included 88 females and 57 males with a mean age of 33.3±19.6 years. A total of 264 injuries were documented, mostly consisting of crush injuries in the extremities and associated fasciotomy defects. Surgical interventions included 77 debridements, 47 split-thickness skin grafts (STSG), 31 primary closures, and 20 maxillofacial reconstructions. 23 primary fasciotomies were performed, along with 15 fasciotomy extensions for inadequate prior decompressions. 14 microvascular free flap reconstructions and 7 locoregional flaps were carried out, with 1 free flap failure.

CONCLUSIONS

In a mass-casualty earthquake setting, strict adherence to traditional stepwise reconstructive algorithms is often impractical. A flexible, elevator-based reconstructive approach allows surgeons to achieve definitive reconstruction earlier, shorten hospital stays, and use limited surgical capacity more efficiently under resource-constrained conditions. Inadequate fasciotomies performed at referring centers were frequently encountered, highlighting the need for systematic decompression protocols in disaster triage. Early integration of plastic and reconstructive surgeons into disaster response planning is strongly recommended.

LEVEL OF EVIDENCE: Level IV-retrospective case series.