brahmanand clinic

Dr Adhishear Sharma MB,BS, MS Gen Surgery PGIMER  Chd Mch Plastic Surgery Fellowship in hand and microvascular surgery 8860650846 , adhishwar7@gmail.com brahmanandclinic.com

26 year old Iraqi male suffered fracture talus neck , he was seen by orthopedic surgeon who advised surgery. Surgeon exposed talus with fibular osteotomy , after fixing talus surgeon plated fibula. Wound breakdown occurred at the fibular osteotomy site exposing plate. Usually removal of plate is recommended but in this case that was not feasible. So decision to do muscle flap was taken , muscle flaps are good options in covering hardware. Gracilis muscle flap  was done ,flap was connected to anterior tibial vessels, skin graft were placed. Patient made uneventful recovery ,muscle took one month to cover up. Dr Adhishwar Sharma MB,BS,MS Gen Surgery,PGIMER Chd Mch Plastic Surgery Fellowship in microvascular surgery  8860650846 adhishwar7@gmail.com brahmanandclinic.com

preop pre op pre op Post op in ICU A 60 year old lady presented with a walking difficulty.She met with a accident two years ago , she under went above knee amputation right lower limb.and skin grafting on calcaneum bone. As the wounds healed problem of ambulation dawned on her ,she was given prosthesis, silicone soles and other things to improve ambulation. Nothing helped and she was largely wheel chair bound. For sole reconstruction a microvascular gracilis was planned for her from her amputated leg. And flap vessels were connected to posterior tibial vessels, artery was connected end to side and veins were connected end to end. Flap was insettted and old skin graft was excised prior to it. Skin graft was placed after 5 days. She was allowed weight bearing after two months Post op healing flap Patient when all is well with author All photos are with consent Dr Adhishwar Sharma    91  8860650846 adhishwar7@gmail.com

initial wound  Exposed bones Entire wound gracillis muscle with pedicle muscle with skin graft skin grafted wound healing wound 3 years post op patient back to his job                                  3 years post op patient is having ankle stiffness due to ankle injury A 48 year old male belonging to palwal district working in faridabad district electricity department suffered a crush injury foot following a motorcycle accident. He suffered extensive fractures of foot and ankle. He lost second toe along all the soft tissue and tendons. 2 and 3 metacarpal were exposed and fractured. Management Initial wound debridement was done and external fixator was placed .Once after all dead tissue was gone decision to do flap surgery was taken. Gracilis free flap was done to cover the wound ,flap vessel were connected to anterior tibial vessels. After 5 days skin graft was placed . Gradually in two months patients wou

flap bed irrigated with antibiotics flap before skin grafting flap before skin grafting After skin grafting inner view of wound after skin grafting After skin grafting LD and serratus flap flap wit slough on it six months after injuries After debridement total degloving from knee joint to annkle ankle wound  vessel dissection 22 year old hotel management graduate met with a road side accident, he was trying to climb DTC bus suffered a rollover injury. He suffered dislocation of ankle and total shin degloving of shin . He had ESIC panel insurance. He was taken to ESIC hospital in gurgaon from where he was referred to QRG central hospital Faridabad. Where he was taken up  for debridement and external fixator application first , after two days underwent LD and Serratus muscle transfer . Post operative he developed high grade fever which was man