brahmanand clinic

wound with bone and tendon exposed lateral aspect of wound gracillis muscle  graciillis muscle with pedicle flap being insetted A very bad crush injury of  ankle occurred while patient was going on motorbike. Heel bone {calcaneaum} was badly crushed, orthopedic surgeon put wires into calcanaeum and  tried to fix it. A big wound remained with exposed Tendo Achillies which needed cover . It was infected and dirty wound so VAC therapy was put on the wound to reduce infection and it was planned to cover it with a flap once it improves. Debate of muscle versus skin flaps will be always be there in plastic surgery . Muscle flaps have inherent advantages in these conditions . So decision was taken to do gracillis flap which was connected to posterior tibial vessels. Artery was connected end to side and a single vein was done. Post op was eventful, flap was monitored for vascularity for five days and then patient being discharged. Patient was skin grafted

                                                      degloving injury initial injury photo Immediate post op                                               at two weeks healed flap at three weeks At three weeks skin grafted donor site skin grafted thigh degloving injury finally healed flap at two months final hand function Degloving injury occurred to 21 years old male while coming from religious pilgrimage . Patient had total degloving of forearm skin , with extensive crushing of muscles. Patient had small liver injury as well as degloving of right thigh as well.   Pt was investigated and planne for debridement. After debridement patient was taken up for flap cover.    ALT myocutaneous was harvested and transferred ,after inset flap was vessels were connected ,artery to radial artery end to side. Vein was connected to superficial vein.    Post operative day patient was taken for haematoma evacuation,