brahmanand clinic

amputated part preserved in saline amputation stump successful revascularization of thumb  . Pink  thumb  16 year old girl under went replant of thumb for traumatic amputation thumb . She was taken up for surgery and long vein graft was placed to connect radial artery to ulnar digital artery of thumb. thumb pinked up and then two veins were repaired. Part survived then then the patient was transferred to ICU for monitoring . Subsequently patient underwent groin flap for wound coverage. Dr Adhishwar Sharma MBBS,MS General Surgery PGIMER Chd Mch Plastic Surgery Fellowship in hand and microvascular surgery 8860650846, adhishwar7@gmail.com

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 revis...

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...

                                                      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...

pre op wound after deridement gracillis muscle with pedicle muscle being insetted post op day 10 healthy muscle and graft taken up 42 year old iraqi male suffered electric contact burn ,which resulted in loss of skin ,tendons and exposed bone.. Wound was debrided and VAC was applied and culture was done . Antibiotics according to culture were given. After 10 days of VAC therapy decision to operate was taken. Bone was nibbled and gracillis flap was taken to cover it. Flap artery was connected end to side to anterior tibial artery and vein was connected end to end to venae comitantes. Patient was anticoagulated for 5 days and flap monitoring was done. After six days of surgery patient was discharged and put on ecosprin for one month. Regular dressing were done and flap epithelized rapidly . Microvascular surgery is difficult in high voltage electric burn injuries as in these case . Electric current travels through neurovascular bundles. Dead bone is a good...