Neropathic ulcer

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ulcer









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Pseudo bursa following abdominoplasty

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breast recon and breast reduction

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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
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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
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