Lajjo Devi and knee

-
Lajjo Devi was 45 old women from Mohna village of dist Faridabad Haryana. She was born in a village near Palwal. She was married at age of 20 ,after her first child she suffered from a osteoclastoma of knee. She was operated in safdurjung hospital , where excision of tumor and arthrodesis of knee was done. Her wound disrupted and skin necrosed , exposing her bone upper tibia. She was referred to plastic surgery department Safdurjung hospital where plastic surgeons tried a microvascular LD flap which stared bleeding from anastomotis site  third post op day resulting in flap failure.
Suddenly the life of young women changed she was laden with a disability and young child . She was taken to many private practitioner but to no avail. Slowly hope waned and enthusiasm was replaced by a eerie acceptance,  Her relationship with in-laws and husband deteriorated and she was living with her brother. They were regularly consulting all available orthopedic surgeons but no was giving any hope. Then they decided to get medical insurance to enable them to afford treatment at private hospitals.
Dr Sunil Goyal runs a private hospital in palwal , it is pretty popular with in the city. Lajjo Devi along with  her brother consulted Dr Sunil for the same , he referred them to me. Her brother along with her come to see me, I advised CT angio and MRI leg to get certain information after history and examination. After reviewing reports I came to conclusion that  she needs medial gastrocnemius  flap cover, I informed them that it can be done in palwal. They refused they said that they want surgery under medical insurance and at good corporate hospital. I offered them FMRI which they readily agreed , following which I put paper in FMRI for approval,. Approval came in due course of time and on 8/9/2017 she was admitted for surgery. I did patellectomy and gastrocnemius flap cover . She was discharged after two days . Rest of her follow up was in clinic , sutures removed after one month . She was very happy and relieved , her son was her main care giver along her brother. So after 24 years she got rid of her wound.
original wound

original wound


intra op photo




healed flap

After six months


After six months












Dr Adhishwar Sharma
MS Gen Surgery PGIMER  Chd
Mch Plastic Surgery
Fellowship in Hand and Microvascular Surgery
brahmanandclinic.com
8860650846







Comments

Post a Comment

Popular posts from this blog

Pseudo bursa following abdominoplasty

-
Image
At six months post op Six months Post op six months Bursa fluid Final closure MRI Scan MRI Scan showing pseudobursa pre op pre op photo pre op wound A young Tanzanian doctor who was ENT surgeon by training went to Korea for training and decided to get abdominoplasty done in 2015. Post operative he was fine . In 2016 he noticed swelling in abdomen which was increasing in size. It made breathing difficult, it was pain ful and interfere in daily activities.  In 2017 he came to us in India and requested a solution to his problem. A physical examination was done, and a MRI scan was ordered. MRI scan showed a cystic swelling in the abdominal wall .  Patient was taken up for surgery and that pseudo bursa was excised. Post op was uneventful, at six months patient was showing normal profile. Dr Adhishwar Sharma MBBS ,MS General Surgery PGIMER Chd Mch Plastic Surgery Fellowship in Hand
Read more

breast recon and breast reduction

-
Image
marking for breast reduction Partial mastectomy scar Tram flap marked out internal mammary vessel dissected out Microvascular anastomosis done primary closure and lateral muscle mass Lie of vascular pedicle before final closure final closure  both breast shape 40 year old female developed right breast cancer which was excised partilly . Hence completion mastectomy and right axillary dissection was done . Right breast was reconstructed with muscle sparing tram flap and left breast was reduced by lejour method. Lejour method is superior pedicle reduction technique which results in linear scar well accepted by patients. Tram flap was raised by sparing lateral muscle and including only medial component . Inferior epigastric artery of flap was connected to internal mammary vessels .  Drains were placed and flap was monitored for vascularity for 5 days and patient discharged there of. Nipple reconstruction and any other revision are d
Read more

TKR

-
Image
Patient was a 75 years old lady from Iraq who under went joint replacement surgery in India. She developed post operative wound dehiscence which resulted in exposed implant.For two months orthopedic surgeon and plastic surgeon for some reason or another kept the wound open did took no decision to close it .Patient under went one debridement and VAC therapy. Then I received a call from interpreter and I saw the patient.We decided that few days of VAC therapy and in consultation with ortho surgeon we decided date of surgery. We operated and after debridement I did a medial gatrocnemius flap cover and skin grafting. Post operative patient had fever for two days and dressing was soaked. We had placed a drain which did not worked ,so we removed drain and started daily dressing and betadine, hydrogen peroxide irrigation of the wound. Wound culture showed klebsiella P sensitive to meropenam . I told patient where to purchase generic meropenam and  we also instilled meropenam in the wound. Gr
Read more