The ever increasing incidence of trauma and its associated multiple complex injuries has paved the way for an ortho-plastic approach to the management of such patients within the recently introduced "Major Trauma Centres" (MTCs). Unfortunately, many MTCs lack the presence of an on-site plastic surgical team, which may delay treatment in those requiring input for soft tissue coverage. The presence of plastic surgeons within a MTC or regional trauma units does not only improve the level of care

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... ovided in acute injuries but enables the establishment of multiple elective services for those with chronic bone and joint conditions. Patients and Materials: In this paper we describe the impact on the trauma and elective services provided by our regional trauma and orthopaedic unit at The Royal Liverpool University Hospital following the appointment of a full-time on-site consultant plastic surgeon. Results: The addition of a consultant plastic surgeon within our busy regional trauma and orthopaedic (T&O) unit and has resulted in a profound reduction in time to review and definitive soft tissue coverage in trauma patients in addition to a substantial reduction durations and cost of in-patient stay. Furthermore, we have been able to show a similar trend in our elective sarcoma and foot and ankle patients. Discussion: The constant availability of a plastic surgeon within out T&O unit has facilitated the creation of multiple new services including the foot and ankle MDT to enable a multidisciplinary approach to the management of such patients. Conclusion: This ortho-plastic model is one which should be considered and replicated in all large regional T&O units or MTCs.