KEY POINTS:
The number of violent assaults resulting in facial reconstructive surgery has rocketed up, now far outstripping motor accidents as the biggest cause of the surgery in New Zealand.
That has drawn a damning response from one of the country's leading plastic surgeons, Hutt Hospital's Swee Tan.
A member of the team responsible for the new findings, which looked at facial fractures from the country's central region over a two-year period to December 2007, Mr Tan said it was now time New Zealand stopped accepting violence as part of its culture.
Motor vehicle accidents were historically higher than violent assaults in the list of leading causes for the costly surgery. While the number of injuries attributed to traffic accidents had fallen, there was no doubt injuries from assaults, many drink-induced, had risen sharply, Mr Tan said.
And the injuries were serious. Broken noses, jaws and cheekbones could cause intense pain, make for long and costly surgery, require extensive rehabilitation and result in lengthy time away from work.
An average victim of assault with facial injuries would require:
* An initial GP or accident and emergency centre consultation.
* An x-ray, and usually a CT scan too.
* A referral to and assessment by a plastic surgery unit.
* A general anaesthetic.
* Several days' hospital admission.
* Surgery, which on top of taking up valuable theatre space and using expensive equipment and anaesthetic, needed an anaesthetist, anaesthetist registrar, anaesthetist technician, surgeon, trainee surgeon, scrub nurse, and circulating nurse.
The public health system was always constrained by resources, Mr Tan said. That made the significant cost of preventable facial injuries to the public health system "incredibly frustrating" for surgeons.
The country had previously mounted campaigns to decrease the rate of preventable injuries. He cited the compulsory wearing of bicycle helmets and the compulsory wearing of seatbelts in cars as two examples. It was now time to accept the same approach was needed with violence.
"We have failed to educate the public ... We need to make a stand against violence."
He believed it would take a centrally driven education campaign to make that change happen.
"We can carry on doing what we do - putting our ambulance at the bottom of the cliff - and we'll continue to struggle. Or we can say, 'There is a better way,' and we can decide to change."
Mr Tan said the cost breakdown of how much the violence-induced surgery was costing the country had not been done, but it would be in the tens of millions.
Leading causes:
'89 - '91
Violent assaults - 31%
Road accidents - 33%
Sports injuries - 18%
'05 - '07
Violent assaults - 42%
Road accidents - 7%
Sports injuries - 32%
