brahmanand clinic

5 year old girl had a glass cut injury on the medial aspect of arm ( inner side) . Due to resultant bleeding patient was rushed into emergency she was operated upon as soon as possible. Brachial artery was repaired with reversed saphenous vein graft . Median and ulnar nerve nerve repair was done end to end .Biceps and triceps muscle were also repaired. Theses are common emergency situations in which plastic surgeons are involved , soft tissue trauma in any part of body and facial fractures are commonly dealt  by plastic surgeons apart from burns, Dr Adhishwar Sharma MB,BS MS (gen Surgery)PGIMER Chd Mch Plastic Surgery Fellowship in microvascular and Hand surgery brahmanandclinic.com 8860650846 adhishwar7@gmail.com

                                                   post operative patient walking ulcer with VAC dressing Gracillis flap insetted flap from dorsal to hind foot skin graftted wound before skin graftted fully healed foot healed foot dorm healed healed foot lateral view six months old 41 year male diabetic with hind foot ulcer for six months . He under went debridement and VAC therapy which removed and underwent flap cover. Microvascular gracilis muscle flap was done , flap artery connected to ant tibial artery. Post op was uneventful , distal part of flap was lost . After ten day he under went skin grafting . Patient had total graft take , pressure garments and silicone gel sheet was advised. He went back to his work. Dr Adhishwar Sharma MB,BS , MS (Gen Surg)PGIMER Chd Mch Plastic and Reconstructive surgery Fellowship in microvascular and hand surgery 8860650846, adhishwar7@gmail.com brahmanandclinic.com

pre op wound pre op wound dorsi flexion max Left foot impending wound shave osteotomy of !st MP joint 55 year old diabetic who had this ulcer for 3 years come treatment . Assesment showed tight TA tendon with restricted dorsiflexion on both limbs. plan was made to do 1) bilateral TA release 2)Shave osteotomy of first Metatarsal 3)Rotational flap and skin grafting 4)Tarsal tunnel release Left foot wound healed with TA release only, Right side have a infective episode which settled with VAC therapy . Patient had second surgery which settled the wound. Dr Adhishwar Sharma MB,BS ,MS (Gen Surg) PGIMER Mch Plastic Surgery Fellowship in microvascular and hand surgery 8860650846 ,adhishwar7@gmail.com  brahmanandclinic.com

pre op wound dorsal aspect flap marking dissected flap revesered and insetted connected to common digital artery lookis bad but bleed is bright red one week old 28 year old male with ring avulsion injury, refused option of groin flap. Patient was offered option of venous flap he accepted. A venous flap was designed and transferred . incoming vien to flap was connected to common digital artery and draining vein was connected to digital vien . Flap developed congestion first post op day , all sutures were removed flap improved . Subsequently it developed dusky appearance though bleeding was okay. I am waiting for one month to pass so that measures to reduce edema and proper shape can be given. 12/06/2018 Dr Adhishwar Sharma  MBBS, MS gen surgery PGIMER Mch Plastic surgery 8860650846 , adhishwar7@gmail.com brahmanand clinic.com