brahmanand clinic 2

Vascular malformation are of 3 types . Arterial venous malformations , venous malformations and capillary malformations. Venous malformations are bunch of jumbled up veins that can affect any part of body . Pain ,swelling sudden painful enlargement are main symptoms. Sometimes lymphatic symptoms are also involved. pre op photo medial view Posterior view Anterior view venous malformation  after complete excision Skin necrosis of skin flaps a common complication 5 year old boy presents with swelling in thigh ,which  was present since birth. It was soft , non tender compressible . Dilated veins were present all over left thigh. MRI  scan was ordered and it showed lymphovenous malformation .  Dr  Adhishwar Sharma Dr Adhishwar Sharma MBBS,MS General Surgery PGIMER Chd Mch Plastic Surgery Fellowship in hand and microvascular surgery 8860650846, adhishwar7@gmail.com

Finger tip injuries are common, and many flaps are designed and none them is  perfect. Thenar Flap is common flap used to treat these injuries. Thenar flap is taken from thenar eminence and donor site is usually skin grafted . Flap division takes place after two weeks ,it is a pedicle flap. Finger stiffness can be seen in elderly patient. Dr Adhishwar Sharma MBBS, MS General Surgery PGIMER Chd Mch Plastic Surgery Fellowship in Hand and Microvascular Surgery Brahmanandclinic.com 8860650846, adhishwar7@gmail.com

Sub glottic stenosis is very disabling condition . Patient presents with breathlessness ,loss of voice, in case of complete stenosis patient may need permanent tracheotomy to live. This is a story of young boy aged 12 years ,4 years back he suffered road side accident resulting loss of speech and  permanent tracheostomy. When the patient come fiberoptic bronchoscopy was done to ascertain level of level of block. CT scan was done to visualise the anatomy. patient was taken up for surgery and planned for excision of stenosis and lyrngeotraceeal reconstruction. Flap raising intense fibrosis Thyrotomy done and site of anastomosis exposed Proximal end of anastomosis  Distal end of anastomosis Two ends separated  Posterior wall sutures taken over ET tube closed with Sternocleidomastoid muscle over it.  Sternocleidomastoid muscle flap strap muscle closed 7 day post op video showing ability of boy speak after gap of 4 year