| Reconstructive Surgery |
NOSE RECONSTRUCTION
This lady lost her tip of nose and part of right alae.This was reconstructed using naso labial flap.
Part of right alae was cut off. This was reconstructed using naso labial flap.
This lady had complete loss of nose. One stage reconstruction of nose, columella and nasal lining done using fore head flap.
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LID RECONSTRCTION---COMPOSITE LID GRAFT / Lid replant
Total loss of upper lid. Lid was implanted back after excising muscles .Conjuctiva to conjuctiva, then levator palpabaris muscle was dissected and sutured to tarsal plate of amputed lid. Patient showed excellent lid function.
This patient had severe post burn ectropion. Release of lid and skin grafting done. |
CLEFT LIP
CLEFT LIP
65 yrs, Female, Bil. CL. Single stage repair.
Unilateral cleft lip. Modified Mellard’s repair.
BILATERAL CLEFT LIP
Bilateral cleft lip. Single stage repair.
CLEFT PALATE
Bilateral cleft palate. Palatoplasty
PRE OPERATIVE POST OPERATIVE
CLEFT PALATE
Unilateral cleft palate. Palatoplasty done. |
BED SORE / PRESSURE SORE---
Large Ulcer over Ischeal tuberocity.Wide excision,Gluteous Maximus Myocutaneous inferiorly based flap done.
CASE---Large sacral pressure sore in a young paraplegic patient. Treated with bilateral Gluteous maximus myocutaneous flap.Ucer healed uneventfully without any donor side defect.
This man of post traumatic paraplegia had multiple (sacral, bilateral tronchatric, heel) deep pressure sore. Previously his large sacral sore was covered with bilateral gluteius myocutaneous flap. Negligence caused to recurrence of pressure sore. His trochantric sore were covered by biceps femoris myocutaneous flap and sacral sore covered by very large local rotation flap. His all wounds healed and went home well.
DIABETIC FOOT ULCER / TROPHIC ULCER / NON HEALING ULCER
CASE I----- Patient of diabetes having ulcer foot for 8 yrs. After control of diabetes, and infection, wide excision of margins and floor including removal of dead Bone .Then local instep flap based on planter vessel was done to cover the ulcer.
CASE II----- Patient with diabetes for 20 yrs, was on Insulin. Ulcer in feet for 10 yrs. Treated with Instep flap based on Medial planter vessels.
CASE III----- Patient with leprosy. Amputation was planed because of fowl smell from wound. But after control of infection, flap done and foot was salvaged successfully.
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CASE IV----- Diabetic Ulcer foot. Wide excision and rotation flap.
CASE V----- Patient of diabetes with large injection abscess in gluteal region. Treated with Gluteus maximus myocutaneous flap. |
SALGAGE OF SEVERLY CRUSHED LIMBS
Near total amputation at elbow. Repair of neurovascular structures. Return of function after one year.
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CASE I----- This young boy forearm got badly crushed in ganna machine.
Shortening of bone, fixation of bone vascular graft, nerve repair, abdominal flap, bone grafting, tendon grafting, he attained very good function. He can write and he can button his shirt.
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CASE II----- His had got badly crushed in a machine. Thumb was reconstructed using radial artery fore arm flap, rest of proximal phalynx were covered by groin flap. Then in three stages proximal phalynx were separated. Now this boy can do his entire required job.
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CASE III----- He sustained near total amputation at arm level by a machine.
Crushed mid arm segment was excised and replant was done. He recovered with good function but intrinsic minus hand. He refused surgery for this and he is back to his job and able to do all required functions.
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REPLANT / MICROVASCULAR SURGERY
CASE I—Amputation of thumb in printing machine. Replant done after 16 hrs of cold Ischemia.Patient had venous Congestion. Leech were used for 4 days to reduce venous Ischemia.Patient did well with good movement at IP joint.
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This young man had amputation of upper limb at mid arm level while working in factory. After 3 hrs of amputation replant surgery was started.
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AFTER SUCESSFUL REPLANT FUNCTIOS RETURN.After one year of replant Good elbow ,wrist flesion and extension,Lateral pinch and flesion power was average with some clawing.Patient did not return for followup and refused for further surgery for clawing
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CASE ---- This young man had bilateral hand amputation .His both hands were chopped off in assault Patient did not return after discharge from hospital
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CASE —---- Amputation of index at middle phalynx level. Replant after 10 hrs of Ischemia. Repair of Neurovascular structures and tendons done.He did not come for followup.
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CASE —---- Amputation of four fingers by paper cutting machine. Replant of three fingers done. Repair of digital vessels for each finger done with tendon repair. I do Bone fixation in digit replant using stainless steel wire no 26 by box fixation technique. Fixing bone by K wire causes more damage to tissue and micro movement over repair site of vessels. Replant failure following dressing is largely because of movement over repair site. I lost three digital replant after doing dressing.
CASE —---- Amputation at wrist in a jeep accident. More element of crushing at amputation level.Replant done. Patient achieved good flexion . Waiting for tendon graft for extensors.
CASE —---- While working on wood cutting machine, his wrist joint got amputed with loss of tendons and avulsion of median and ulnar nerves. Replant of joint done. Followed by tendon grafts, sural nerve cable graft for median and ulnar nerve. Patient achieved good protective sensations and average flexion and extension. He is back to job and refused for further surgery.
CASE —---- This is a boy of 11 yrs of age. His trouser got trapped in fan of generator. His distal half of penis got imputed along with skin of rest of penis. His skin of upper thigh also got avulsed. Dissection of deep dorsal vein with artery and nerve was done. Catheter was passed through amputed penis. First repair of urethra was done followed by repair of c. spongiosum and c. cavernosa.Then artery ,vein and nerve were repaired. Patient underwent skin grafting of shaft of penis and thigh. Patient passed urine successfully with a very fine ventral fistula.
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UPPER LIMB
UPPER LIMB
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UPPER LIMB
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UPPER LIMB
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LOWER LIMB RECONSTRUCTION
MICROVASCULAR FREE VASTUS LATERALIS MUSCLE TRANSFER
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SALVAGE OF BELOW KNEE STUMP
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| GENITOURINARY RECONSTRUCTION |
PSEUDO HERMAPH PHRODITE
Phallus construction / aphalia /penis construction
This is a boy without penis. Investigated and treated by endocrinologist for 5 yrs before penis construction. Then his phallus was constructed using micro vascular free radial artery flap. His sensation was restored by joining lateral cutaneous nerve of forearm to dorsal nerve of penis. His testis are functioning. Two year after surgery penile implant will be inserted and then he can have his normal sexual life.
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CASE IV
MICROPHALLUS
This young boy had very small penis. He was investigated and treated by endocrinologist before penis construction. Then his phallus was constructed using micro vascular free radial artery flap. His sensation was restored by joining lateral cutaneous nerve of forearm to dorsal nerve of penis. His testis are functioning. Two year after surgery penile implant will be inserted and then he can have his normal sexual life.
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MIRACULUS SURGERY
CASE I
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CASE II
Wrist joint Replant
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CASE III
Bilateral hand replant
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Phallus construction / aphalia /penis construction
This is a boy without penis. Investigated and treated by endocrinologist for 5 yrs before penis construction. Then his phallus was constructed using micro vascular free radial artery flap. His sensation was restored by joining lateral cutaneous nerve of forearm to dorsal nerve of penis. His testis are functioning. Two year after surgery penile implant will be inserted and then he can have his normal sexual life.
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MICROPHALLUS
CASE IV
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Cosmetic Surgery
LIP
This young boy had bulky lips. His lower lip was trimmed by wedge excision and tightening of orbiculis muscle.
This patient had bilateral cleft lip and palate. Large defect of vermilion, Anterior palatal fistula, vellopharyngeal incompetence. All defects were treated in one stage. To correct vermilion defect, bilateral vermilion advancement flap was used.
This patient had vermillion defect i.e. whistle deformity
Post operative pictures shows complete correction. I use vermilion advancement flap to correct defects. |
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NOSE
SUPRA TIP NASAL DEPRESSION ----- Nasal septal cartilage used
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Severe saddle nose deformity. Augmentation using iliac crest bone graft.
SHORT COLUMELLA
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Absent columella with flaired alae.
Long nasal tip with supra tip depression .
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Congenital cleft nostril .Correction using Conchal cartilage
