brahmanand clinic

wound on lateral side anterior wound showing exposed bone and surrounding slough Healed leg  Healed leg lateral view Post op photo of flap in ICU with monitoring bleed Healed flap flap being insetted Laxmi is a 25 year old female married who lives in a small town Palwal Haryana India. On ocassion of bhaiduj a Indian festival she got injured while travelling in the bus.Her brother know orthopedic surgeon Dr I K Bansal who works in Apex hospital palwal. Initial mangement was done by Dr I K bansal , extensive loss of skin and soft tissue loss led to need of a plastic surgeon. Apex hospital is a modern hospital setup by Dr Abhisek Jain a ENT surgeon and his wife Dr Twinkle Jain.  Extensive degloving injury are difficult to manage . In view of extensive tissue loss a decision to do free flap was taken and conveyed to Dr I K Bansal. On 31/10/2017  we did the gracillis free flap . After anesthesia we did through debridement of leg

Peroneal tendon identified   Add caption both tendon brought out Paroneal tendon laid out Paroneal tendon brought subcutaneous to skin Fixed to bone via sutures cast applied to foot foot paralysis is debilitating condition. It results in high stepping gait. It alters gait ,reduces walking speed. Some people adapt very well to it. Foot goes into inversion and excessive pronation. There is always instability of foot . Climbing stairs is difficult . Patient has a high stepping gait. Walking speed is reduced. Causes Spinal cord injuries both traumatic and iatrogenic Nerve injuries traumatic and various neuropathy Loss of muscle due trauma and myopathy Treatment As presentation is variable due to various causes, treatment is tailored according to it. Splints and physiotherapy Splints help in keep joints mobile and prevent developing contracture. It certainly help patient to walk better. Posterior tibialis tendon transfer It is helpful whe

Angiogram of vascular anomaly pre operative photo Post operative photo It is a story of 19 year old girl who was suffering from vascular malformation .She had red colored nevus since birth. It was stable non growing as she went into teens it started troubling her . Pain , discomfort ,impairment in activity of daily life, fatigue were main complaints.Sh e went to local doctors and were investigated. Angio gram done shown to be a large Arteriovenous( AVM) malformation.It had large multiple feeders coming into anomaly from Iliac artery as shown in angiogram. Her father was searching for hospital and doctor to cure her daughter. Search in Iraq proved futile . Then they turned  to  India, and landed in Fortis Faridabad in year 2015. I operated her in December 2015 and excised entire anomaly.  Large vessels coming out were caught and ligated. drain was also placed.Wound closure was achieve by mobilizing skin flaps . Post operative was uneventful, drain was removed on post ope

It is a story of barber who was injured in a road side accident in 2013 near Palwal haryana India. Palwal in s small town with primitive health facilities but it is developing  gradually. He was operated at local nursing home by a orthopedic doctor who fixed the fracture.. Fracture failed to unite and there was bone gap, resulting shortening of limb.  I often go to Palwal to operate at Sheetal hospital where I talked about vascularized fibula done for gap non union of bone mainly femur .Dr Sunil requested to do this surgery for this patient so we decided to do pedicled fibula for him. We operated him in 2015 march . We dissected out fibula based on intact paroneal vessels lower third of fibula was selected rest was used as bone graft.Window in muscle was created to  Surgery was fine I don't have intra op photo, fibula was fixed by a single screw and rail road fixator . Both ends of fibula were sharpened and medullary cavity were reamed to open up marrow cavity.Lower end o

Mustafa Zaiden was a college student in Iraq in year 2016 , once while going to college he met with a accident involving road side bomb blast. He's initial treatment was in Iraq, he underwent laparotomy and ileostomy for abdominal injury.External fixator was applied for femur. Foot injury   refused to heal it gradually developing into a osteomyletic wound  for which amputation was advised. Femur was refusing to unite and doctors treating were not giving any hope.  In desperation they looked out side and contacted many people in India, in February they landed in India .Patient was bed ridden because of foot wound ,external fixator on the thigh. After seeing patient I decided to debride the foot wound and apply VAC. I also took opinion of orthopedic surgeon about thigh wound ,they advised to excise the wound and put a flap and may then they will remove external fixator. Patient had a ileostomy and it was decided to contact  Dr AK Kriplani head MABGIS team for the same. Patient

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