drsasikanthmicrosurgery

Patient accidentally placed his hand in a cutting machine in a tyre factory and as a result his hand got cut from rest of forearm at the level of wrist. Patient came to us after more than 10 hours but the cut hand was well preserved in saline bag placed in ice.  So the decision to replant in two stages was taken. In the first stage the bony fixation and the vascular repair was done and the circualation was reestablished and the skeletal stability was achieved by external fixator application. We waited for 24 hours and again took up the patient for completion of the surgery after the survival of the hand was sure.  Both the extensor tendons, flexor tendons were identified, tagged and repaired by modified Kesslers method and silverskoold technique. The ulnar nerve, median nerve and superficial radial nerve were identified and repaired. A small raw area was left for further skin grafting because of the tension free c

    This Patient lost his two fingers and tip of thumb in an industrial accident.  He wanted us to reconstruct his index finger so that he can switch off and on the machines in the factory he is working. He didn't had to problem in his other daily activities because of loss of the other finger and part of the tip of the thumb. After detailed discussion of the procedure and its outcomes with the patient in multiple visits the decision of microvascular transfer of 2nd toe to index finger with tendon reconstruction was taken.  Surgery was successfully performed and the post operative photograph is evident. 

12 year old child diagnosed with Parosteal osteosarcoma of lower end of knee. The tumor was excised and was replaced with fibula flap with skin paddle and fixed with plate and screws. Video shows child walking after the surgery.

15 year girl was diagnosed with osteosarcoma of lower end of femur. The tumor war removed and the remaining bone was irradiated with high dose irradiation. After radiation treatment the bone is refixed in its original place by plates and screws. Unfortunately the overlying skin was necrosed and the implant along with the bone was exposed. After proper debridement a free latissimus dorsi flap was harvested with its thoracodorsal vessels and the knee with exposed implant and the bone were covered thus salvaging the entire limb and covering the vital knee joint. Last picture shows well healed latissimus dorsi muscle flap with skin graft.