BACKGROUND Many medical disciplines, including emergency medicine, trauma surgery, dermatology, psychiatry, family practice, dentistry and nursing have all documented attempts at assessing their own level of bioterrorism preparedness. There is neither such an assessment nor an existing review of bioterrorism agents as they relate to plastic surgeons. The purpose of this paper is to prepare the plastic surgeon for a potential bioterrorism incident.

METHODS: A systematic review of peer-reviewed literature on bioterrorism agents as well as a review of the Center for Disease Control (CDC) online resources was conducted. “Category A” agents were identified. Specific attention is paid to management issues that plasticsurgeons may face for each agent.

RESULTS: Disease entities reviewed were Anthrax, Smallpox, Plague, Viral Hemorrhagic Fever, Tularemia, and Botulinum toxin. For each agent, pathophysiology, presentation, weaponization, medical management, vaccination, and surgical issues related to plastic surgery are presented.

CONCLUSIONS: This paper represents the first attempt at addressing bioterrorism preparedness amongst plastic surgeons. A brief glance at peer-reviewed resources indicates that many other fields have already started a similar process. Eventually, our leadership will be called upon to develop evidence-based consensus guidelines for the management of bioterrorism, and this paper is a first small step in that direction.
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