Posts

maxillary reconstruction TRAM Flap

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 35 year old diabetic male IDDM who suffered from mucormycosis two years ago ,he under went excision of maxilla,orbit and frontal lobe of brain. Part of nose was also excised , along palate . He had issues of palate which desired reconstruction ,sealing antero medial skull base ,orbital cavity reconstruction.  Patient had unregulated diabetes which needed control.  Patient was planned for surgery and TRAM flap was planned . After releasing all the contracture and facial vessels were prepared . TRAM flap was harvested and transferred ,palate was reconstructed ,orbital cavity and anterior skull base was sealed.                                 orbital and maxillary defect visible    palatal defect right side nose and nasal septum                                 ...

Post radiotherapy buccal mucosa cancer excision and reconstruction

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Recurrent tumor anterior view surgical team doing resection flap being insetted vessel anastomosis in contra lateral vessel before closure next day ICU reconstructive and onco surgeon in a team to serve patients in best possible way Me with Dr kaushal  post op day 3 A 40 year old male with recurrent squamous cell carcinoma . First surgery was done 5 years back and subsequently patient under went radiotherapy . Radiotherapy is very unforgiving to tissues it becomes hard and stiff. Vessel dissection becomes is difficult or hazardous . Patient was planned for surgery and tumor was excise with adequate margins . Anterior and lateral mandible was reconstructed free fibula flap . Paroneal vessel were connected to contra lateral neck vessels. Dr Adhishwar Sharma MBBS,MS  General Surgery PGIMER Chd Mch Plastic Surgery Fellowship in hand and microvascular surgery brahmanandclinic.com 8860650846

burnt hand release and groin flap

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pre operative and post operative photo showing improvement hand span .          Pre op deformity post operative photo 3 months note hand span pre operative dorsal photo Post operative dorsal view improvement in hand deformity and hand function as evident in these photo Release and groin flap cover groin flap during dressing hand function 26 year old male who suffered burn in childhood and developed hand contracture . It disabled him limiting span of hand and doing dexterous task. He was advised surgery, contracture release . Upon releasing contracture it was found that the all the tendon and and nerve were bare . So decision was taken to do groin flap. Groin flap was divided after 3 weeks . once the wound healed physiotherapy was started.  Dr Adhishwar Sharma MBBS,MS PGIMER Chd Mch Plastic Surgery Fellowship in microvascular and hand surgery Brahmanandclinic.com ,8860650846 adhishw...

Andy Bump deformity Anterior mandibular reconstruction

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Andy gump deformity is loss of anterior mandibular segment due to trauma ,infection or tumor resection. It is named after a famous cartoon character in USA . Best way to reconstruct is to do a microvascular reconstructive surgery. Osteocutaneous fibula is harvested on peroneal vessel , shaped into desired form and transferred. Microvascular anastomosis is done to local available  vessel. Flap is monitored for 5 days .Subsequently patient is discharged  . Tracheostomy if done is removed at day 5.                                                                                                                       At two weeks Fibula with blood vessel vasc...

hand replant

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hand dangling from skin tag hand with s viable hand at day 5 7 year old presents sharp cut injury to hand which lead to severe vessels , nerve ,tendons and bone. Immediately patient was planned for surgery both radial and ulnar artery were repaired after stabilization with K wire .  Next day patient was re explored and proximal row carpectomy done, hand fixed with two K wire radial snuff box artery was patent and ulnar artery was taken down end to end anastomosis was done. All flexor tendon were repaired and both nerve were repaired. All extensor tendon were repaired. Patient was shifted to ICU for monitoring . Hand survived and patient was discharged after 5 days Dr adhishwar Sharma MBBS,MS PGIMER Chd Mch Plastic Surgery Fellowship in hand and microvascular surgery 8860650846,adhishwar7@gmail.com