brahmanand clinic

EXPOSED BONE  Wound excision PERFORATOR INDENTIFIED Flap insetted Donor site skin grafted 21  year old young man met with a accident . He suffered severe head injuries ,abdominal injuries and  fracture leg . He was treated conservatively for head injuries and splenic injuries . Leg fracture was with a small wound. It was debrided and VAC therapy was applied for one week . After one week patient was taken up for ORIF and nailing was done. And wound was covered with a VAC After one week patient was planned for flap cover as the wound was bigger. Decision to do gastrocnemius was taken , doppler was done to identify perforator for skin paddle. Skin paddle was marked and elevated along with a muscle and transferred. Flap was insetted and donor site was skin grafted . Dr Adhishwar Sharma MBBS,MS Gen Surgery PGIMER Chd Mch Plastic Surgery Fellowship in Hand and Microvascular Surgery brachialplexus7.blogspot.com brahmanandclinic.com 886...

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...

pre op mouth opening mouth opening Temporal fascia raised Superficial temporal fascia interposed to prevent  re ankylosis mouth opening Superficial temporal fascia A 58 year old female who developed post traumatic TM joint ankylosis , was operated upon . Ankylosis was released and superficial temporal fascia interposition arthroplasty was done to prevent re ankylosis. Dr Adhishwar Sharma MB,BS, MS General Surgery PGIMER Mch Plastic Surgery Fellowship in Hand and Microvascular Surgery 8860650846 brahmanandclinic.com brachialplexus7.blogspot,com one week after video of patient showing excellent mouth  opening ,no pain .

                                                                  case 1 inferiorly based ear avulsion  after wash and repair two weeks after from behind case 2 superiorly based ear laceration immediately following repair  after one week Ear avulsion is a common injury following motorcycle accident . Ear has robust blood supply and if handled properly it survive easily.   Both superior based or inferior based flap survive as illustrated by these two index cases. Through wash with saline , betadine and hydrogen peroxide is mandated. Removal of all foreign particle , debris and non vitalised tissue is also necessary.Care repair with correct approximation of anatomical structure is mandated to get good results. Dr Adhishwar Sharma MBBS,MS...

pre op wound digital artery flap raised flap insetted checking bleeding before closure viable flap after two days after two days                                        suture removed after two weeks                                         Finger tip amputation are common emergency faced by plastic surgeons. Replantation is ideal but often not feasible. Cross finger flap and Thenar flap is usually  done to cover the stump.But these procedure are two stage with considerable morbidity. Digital artery perforator flap are single stage procedure with little or no morbidity. It is fast easy and has excellent results. Dr Adhishwar Sharma MBBS, MS General surgery PGIMER Chandigarh Mch Plastic Surgery Fellowship i...

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