Sushrutha Institute of Plastic Reconstructive & Aesthetic...

27
Sushrutha Institute of Plastic Reconstructive & Aesthetic Surgery Elite Mission Hospital Thrissur,Kerala Activity Report 2007-’10 Department of Plastic, Cosmetic, Hand, Reconstructive Microsurgery & Burns Surgery Activity Report 2007-’10 1

Transcript of Sushrutha Institute of Plastic Reconstructive & Aesthetic...

Page 1: Sushrutha Institute of Plastic Reconstructive & Aesthetic ...thrissurplasticsurgery.com/pdf/Annual-report1.pdf · Sushrutha Institute of Plastic Reconstructive & Aesthetic Surgery

Sushrutha Institute of Plastic

Reconstructive & Aesthetic Surgery

Elite Mission HospitalThrissur,Kerala

Activity Report 2007-’10Department of

Plastic, Cosmetic, Hand, Reconstructive Microsurgery

& Burns Surgery

Activity Report 2007-’10 1

Page 2: Sushrutha Institute of Plastic Reconstructive & Aesthetic ...thrissurplasticsurgery.com/pdf/Annual-report1.pdf · Sushrutha Institute of Plastic Reconstructive & Aesthetic Surgery

“To transform the quality of life is the highest of arts”

Sushrutha Institute of Plastic

Reconstructive & Aesthetic Surgery

Thrissur,Kerala

Activity Report 2007-’10

Department of Plastic, Cosmetic,Hand,

Reconstructive Microsurgery & Burns Surgery

Then...

Now...

Page 3: Sushrutha Institute of Plastic Reconstructive & Aesthetic ...thrissurplasticsurgery.com/pdf/Annual-report1.pdf · Sushrutha Institute of Plastic Reconstructive & Aesthetic Surgery

In this millennium we are witnessing an explosion in changes in all facets of Health Care Service. Science and Technology has made earlier creations obsolete. Acceptance levels of performance all over are increasing and the concept of professionalism is now a major norm. The shift from ISI to ISO’s

makes this evident.

In such a scenario created by people, options are limited and there cannot be a compromise on quality and performance. Our institution strongly believe in this concept and stands for a set of values and principles apart from its busi-ness purpose.

Elite Mission Hospital has been in the forefront of Health Care Services since its inception in 1979. Started with minimal facilities, it has grown up steadily and reached the present stage. Today Elite Mission is a 350 bedded Multi Super Speciality Hospital with all Basic departments and Major Super Specialities.

Sushrutha Institute of Plastic, Reconstructive and Aesthetic Surgery was start-ed in the year 2007, Within a short span of time Sushrutha became very popu-lar with five consultants viz. Dr. Aniljith, Dr. Anto Francis, Dr. Pradeep Kumar, Dr. Shaji Mathew, and Dr. Pradeoth working together as a TEAM. The success of this team is the sincerity, dedication, competency and hard work. On behalf of the institution I have great pleasure to complement the entire TEAM for bringing up Sushrutha Institute as a Tertiary Referral Centre.

I am very happy to note that Sushrutha Institute is bringing out an activity re-port during the 4th Annual Conference, which is organized in association with the Annual Conference of Kerala State Plastic Surgery Association. Your ideas and suggestions for the improvement will be highly appreciated.

Dr. K. K. MOHANDAS Med. Supdt. & Mg. Partner ELITE MISSION HOSPITAL

Creation ofSushrutha Institute

Mes

sage

Inauguration of our Institute (01.10.2007)

The urge to form partnerships, to link up in

collaborative arrangements, is perhaps the oldest,

strongest & most fundamental force in nature

—“Lewis Thomas” We, our Sushrutha team …

Activity Report 2007-’102 Activity Report 2007-’10 3

Page 4: Sushrutha Institute of Plastic Reconstructive & Aesthetic ...thrissurplasticsurgery.com/pdf/Annual-report1.pdf · Sushrutha Institute of Plastic Reconstructive & Aesthetic Surgery

We thank the

Management of Elite Mission

Hospital, Thrissur...

...for being the driving force

behind setting up of our

institute and our success

Dr. K. K. MohandasMedical Superintendent & Managing Partner, Elite Mission Hospital

Dr. K. C. PrakasanManaging Partner, Elite Mission Hospital

Sushrutha Institute of Plastic, Reconstructive & Aesthetic Surgery is a part of Elite Mission Hospital, Thrissur, Kerala, which is an ISO 9001 institution having a varied heritage of 31 years of glorified service. Our goal is to develop “Sushrutha In-stitute” as a centre of excellence providing the highest standard of quality care & service to every patient.

Realization of our goalsBy providing best service & most appropriate treatment available at afford-

able cost

By ensuring that staff in the hospital is specially trained to take care of the kind of patients it serves

By making re-habilitation and post operative care a key to ensure speedy & perfect recovery

We ensure the feedbacks with photographs to the referring doctors there by maintaining a close co-operation and better follow-up for patients

By being part of Elite Mission Hospital, which means being able to share resources and service of other super speciality services, helping to put the cost of treatment within reach

Sushrutha institute has been accredited by National Board of Examina-tions to conduct the post-graduate course in plastic surgery leading to the award of the degree DNB in plastic surgery

To keep in pace with the latest surgical practices and procedures, we have a well kept library, subscription to various journals and Wi-Fi internet facili-ties to access the journals online

We consider plastic surgery as an art with inspiration from the quotes of Aristotle – “Art indeed consists in the conception of the result to be pro-duced before its realization in the material.”

Our journey 2007 to 2010

Activity Report 2007-’10 5Activity Report 2007-’104

Page 5: Sushrutha Institute of Plastic Reconstructive & Aesthetic ...thrissurplasticsurgery.com/pdf/Annual-report1.pdf · Sushrutha Institute of Plastic Reconstructive & Aesthetic Surgery

You all will agree with us when we say that even a small injury to the finger-tip can lead a great amount of disability in the present competitive world.

This department caters to all types of hand injuries from all of central Kerala mostly on a referral basis; in fact it accounts to 2/3rd of our total

trauma work. The variety encompasses from simple crush injury tip to multilevel amputations, blasts and burn injuries. We insist on the best treatment for the injury at hand without considering any other bias.

We have state of the art facilities for handling whatever type of hand injuries that come to us. We have access to fully fledged operation theaters with Microscopes (Leica, Carlzeiss), Pneumatic Micro Drills, Titanium small fragment fixation system and an enthusiastic hand Physio unit.

Apart from trauma, we treat large number of congenital hand anomalies of varying magnitude. We also have good number of primary and secondary procedures done for post nerve injury hand as well as for hand infections.

We consider ourselves humbled to see such a large amount of patients suffering from chronic renal failure and whenever called upon to create an Arterio-Venous Fistula for the purpose of Haemodialysis, we always extend a helping hand not only as a Surgeon but also with our charity.

We have initiated a programme to educate patients and workers about the need of proper hand care in the industries and common man regarding blast injuries and other home injuries to hand through our “Hand Friendly Society”. The alarming observation of young children having their hands injured by unsupervised use of crackers and non-skilled laborers working on unprotected machinery was disheart-ening to see.

The magnitude of loss of part and function of this important organ of the body and the relief we have provided in these instances is depicted below with few examples.

Patient with congenital thumb hypoplasia (underdeveloped). Hypoplastic thumb was removed and index finger was used to create the thumb as thumb bears 50% of hand functions.

Han

d S

urge

ryHand Surgery

Facial Surgery

Cosmetic Surgery

SushruthaInstitute

The problem solving centre

SushruthaInstitute

The problem solving centre

Brachial Plexus Surgery

Microvascular & Microneural surgery

Cancer Reconstruction

Burns

“The patient is the centre of the medical universe around

which all our works revolve and towards which all our

efforts trend.”

- J.B Murphy

Our AimTo provide best quality care and service with an aim of pursuing the functional as well as aesthetic perfection to patients who entrust their care to our team

Our VisionTo be recognized by our patients and referring doctors as the best in the provi-sion of service within our field of expertise. Our standard will be to provide service of a comprehensive, sensitive & professional nature. We aspire to be the best by providing the best.

Activity Report 2007-’10 7

Page 6: Sushrutha Institute of Plastic Reconstructive & Aesthetic ...thrissurplasticsurgery.com/pdf/Annual-report1.pdf · Sushrutha Institute of Plastic Reconstructive & Aesthetic Surgery

Patient with traumatic loss of right thumb. Second toe from the left foot utilized to create the thumb.

Functional restriction of movements occur due to thickening of tissue beneath the palmar skin (dupuytrens contracture) for which the thickened fascia is removed and function is restored.

Vascular malformation Hand

Groin flap for Right hand defect

FDMA flap for thumb defect

Blast injury, its consequences and treatment

Han

d S

urge

ry

Activity Report 2007-’10 Activity Report 2007-’108 9

Page 7: Sushrutha Institute of Plastic Reconstructive & Aesthetic ...thrissurplasticsurgery.com/pdf/Annual-report1.pdf · Sushrutha Institute of Plastic Reconstructive & Aesthetic Surgery

Sushrutha Institute microsurgery unit is a purpose built facility to manage and treat all range of microsurgical problems. It is facilitated by the team of plastic surgeons, anaesthesiologist and availability of dedicated opera-tion theaters. The assistance of a very skilled orthopedic service is also

available for the management of major bony injuries. Three operation theatres are available round the clock and it enables us to reduce the waiting time for the pro-cedures.

Microsurgery is a surgical technique with a various application from head to foot reconstruction that uses microscopic assistance to repair and treat structures (artery, vein, nerves etc.) that are small to naked eye with perfection.

Patient with loss of hair bearing tissue over the head due to trauma for which the entire tissue was reconstructed with omental tissue was taken from abdomen.

Traumatic loss of tissue from left upper limb. Rectus muscle and skin tissue was taken as separate unit for both function and cover of the lost tissue in the upper limb

Reconstructive Microsurgery

Traumatic loss of tissue over the forehead region was recon-structed with radial forearm flap. Later hair transplantation was done to recreate eyebrow.

Activity Report 2007-’10 Activity Report 2007-’1010 11

Page 8: Sushrutha Institute of Plastic Reconstructive & Aesthetic ...thrissurplasticsurgery.com/pdf/Annual-report1.pdf · Sushrutha Institute of Plastic Reconstructive & Aesthetic Surgery

Sushrutha Institute has been in forefront for treatment of brachial plexus injuries. We use advanced microsurgical techniques (including nerves and muscle transfers) to repair damaged brachial plexus nerves, muscles and tendons. A panel of surgical specialties including orthopaedic surgeons,

neurosurgeons, neurologist and physical medicine specialist work together to repair the damage and to restore as much functions as possible.

OverviewBrachial plexus is a network of nerves that starts in our spinal cord and controls muscle movements in our shoulder, arm and hand and provides sensation to these areas. Brachial plexus injuries most commonly occur after an accident, sports injury or during child birth can leave the limb without function/ sensation.

Adult brachial plexus injuryPatient with traumatic injury subclavian vessels and brachial plexus injury. Managed initially by vascular repair, subsequently by combination of peripheral nerve trans-fers and nerve grafts.

Obstetric Brachial Plexus InjuryWe provide pamplets to parents of children who are suffering from brachial plexus birth palsy to educate their mother about the care and physiotherapy required before and after surgery.

Brachial Plexus Surgery

Peripheral nerve surgeries encompass acute nerve injuries, entrapment neuropathies and nerve tumors. Multidisciplinary care for patients with peripheral nerve disorders makes Sushrutha Institute the obvious choice for peripheral nerve surgeries.

A case of peripheral nerve sheath tumor arising from the branch of median nerve – excision done in toto

Peripheral Nerve Surgery

Case of late obstetric brachial plexus palsy with Gilbert III shoulder. Managed by L-episcopo procedure. Latissimus Dorsi and Teres major muscle transfer with sub-scapular muscle release.

Activity Report 2007-’10 Activity Report 2007-’1012 13

Page 9: Sushrutha Institute of Plastic Reconstructive & Aesthetic ...thrissurplasticsurgery.com/pdf/Annual-report1.pdf · Sushrutha Institute of Plastic Reconstructive & Aesthetic Surgery

Filariasis is the commonest cause of lymphoedema in our part of the world. According to WHO, filariasis is the most common cause after leprosy, of long term disability.

Patients with lymphoedema often have recurrent infections leading to further fibrosis and increase in oedema. Most of the patients with lymphoedema can be managed conservatively with advice for limb elevation , use of pressure bandages , massage etc.

Although lymphoedema is not curable, a lot of improvement can be achieved in the quality of life of these unfortunate patients by proper treatment and incidence of infection can be considerably reduced.

Surgery in the form of debulking procedures is reserved for advanced cases. After surgery patients are advised to continue use of pressure garments or pressure bandages to prevent recurrence of oedema.

We in our unit give focus for proper identification of the disease process and plan the line of action accordingly. All patients are given proper education regarding the conservative line of management. Surgery is done on a selective basis followed by continuation of conservative line of management.

Clefts of lip, alveolus and palate are the most common congenital anomalies of orofacial region. The ultimate goal in cleft lip and palate management is achievement of normal appearance and normal speech. Surgical techniques are aimed at restoring normal anatomy with

emphasis on muscular reconstruction of lip and soft palate.

Surgery for lip and palate patients are done free of charges, including medications and hospital stay.

Following primary surgery, regular follow up by multidisciplinary team is essential.

Elite hospital is fully equipped with all modern facilities to provide state of the art treatment for cleft patients with the help of our multidisciplinary team comprising Paediatricians, ENT Surgeons, Orthodontists, Prosthodontists, Speech Therapists, Oral & Maxillofacial Surgeons in addition to the team of Plastic Surgeons.

After primary surgery, subsequent surgeries like pharyngoplasty, alveolar bone grafting, secondary correction of lip & nasal deformities and orthognathic surgery for jaw deformities are undertaken according to requirement.

Free surgery for cleft lip & palate patients

Complete unilateral cleft lip – lip repair done

Cleft palate – palatoplasty done

Lymphoedema

Filarial lymphaedema correction in right leg and scrotum

Activity Report 2007-’10 Activity Report 2007-’1014 15

Page 10: Sushrutha Institute of Plastic Reconstructive & Aesthetic ...thrissurplasticsurgery.com/pdf/Annual-report1.pdf · Sushrutha Institute of Plastic Reconstructive & Aesthetic Surgery

Aesthetic plastic surgery involves technique intended for enhancement of appearance through surgery and medical techniques and is specifi-cally concerned with maintaining normal appearance and restoring or enhancing at or beyond the average level towards the aesthetic ideal.

The demand for cosmetic surgery is on the rise every day, the improved appear-ance has a positive effect on self confidence. In this modern era cosmetic surgery has become a necessity rather than a luxury because any physical disfigurement /unattractiveness whether from birth or acquired later, leaves behind a mental and emotional scar in one’s life. Our department caters to all types of cosmet-ic surgeries like liposuction, abdominoplasty, breast augmentation and reduc-tion, rhinoplasty, gynaecomastia, lip reduction, otoplasty, eyelid correction, hair transplantation, body contouring, chin and cheek augmentation, scar revision, dim-ple creation, fat injection. Apart from above, we also have solution for ACNE scars, wrinkles, unwanted hair growth removal (using VPL Energiest system, UK). We also handle chemical peeling, microdermabrasion, photorejuvenation, botox injection.

Lipoabdominoplasty

Cosmetic Surgery

Dimple creation

Rhinoplasty - Correction of deformity of nose by harvesting bone from hip region

We provide high quality reconstruction to our patients injured due to trauma or occupational hazards. We, at ‘Sushrutha’ try to integrate the latest techniques and practices refining common procedures, wide range of reconstructive surgery including microsurgery and con-

ventional plastic surgical procedures are employed which suits the patient condition and requirement.

Gynaecomastia correction by liposuction

Statistics Hand Injuries

Thumb replantation

Finger replantation Wrist replantation

Vascular injury right arm - Arterial segment reconstructed with reverse saphenous vein graft

Activity Report 2007-’10 Activity Report 2007-’1016 17

Page 11: Sushrutha Institute of Plastic Reconstructive & Aesthetic ...thrissurplasticsurgery.com/pdf/Annual-report1.pdf · Sushrutha Institute of Plastic Reconstructive & Aesthetic Surgery

Statistics

Hand Surgery 2007-2008 2008-2009 2009-2010

Hand injuries 680 890 936Blast injuries 18 24 29Local /free flap 117 110 169

Finger injuries 530 540 560

Suturing 280 258 312Nail bed repair 97 120 157Nail bed graft 3 2 8FTSG 12 15 21SSG 140 177 184Terminilisation 150 172 190Ray amputation 15 8 15Tumor excision 1 3 12I & D 12 15 17Hematoma evacuation 4 2 3

Replantations

Arm 1 2 3Forearm 3 2 4Hand / Wrist 3 4 8Thumb 2 6 15Fingers 9 12 20Ring Avulsion 2 3 12

Revascularisation

Digital Artery 18 26 54Ulnar artery 14 14 27Radial artery 18 24 28Brachial artery 3 4 8Axillary artery 1 4 6Femoral artery 4 4 8Popliteal artery 3 4 9Posterior tibial artery 3 5 8Anterior tibial artery 4 3 8Vein Graft 24 26 28

We, in collaboration with the Onco-Surgical team headed by Dr. Sreekumar Pillai and Dr. Anil S Krishna undertake oncoplastic procedures.

Head & Neck

Cancer growth over the left cheek involving both the skin and mucosal aspect. Radi-al forearm flap from the left hand folded to form both the layers for reconstruction

Traumatic injury right mandibular region managed by stabilization of mandible with plate and screws. Full thickness laceration repaired in layers.

Activity Report 2007-’10 Activity Report 2007-’1018 19

Page 12: Sushrutha Institute of Plastic Reconstructive & Aesthetic ...thrissurplasticsurgery.com/pdf/Annual-report1.pdf · Sushrutha Institute of Plastic Reconstructive & Aesthetic Surgery

Statistics

Facio-Maxillary Injury 2007-2008 2008-2009 2009-2010

Panfacial fractures 30 21 32

Nasal bone 17 12 19

Zygoma Fracture elevation 12 10 8

Wiring 7 7 12

Maxillary fracture 12 9 19

Mandible fracture 8 12 14

Blowout fractures 3 2 6

Osteotomy 2 3 3

Cancer growth over the left jaw bone involving both the skin and mucosal aspect. Free fibula flap with skin tissue used for reconstruction of mucosal aspect and jaw bone. Pectoralis musle with skin flap used for reconstruction of skin loss.

This patient - resident of Coimbatore had an electric shock over his forehead. Presented with loss of forehead tissue and bone. Bony deformity was corrected by harvesting bone from iliac bone and skin was reconstructed by radial forearm flap from the left forearm.

Statistics Head & Neck 2007-2008 2008-2009 2009-2010

Suturing 148 182 228SSG 3 5 12Local Flaps 7 8 11Free flaps 6 10 11

Naevus excision 8 12 18Tracheostomy 17 20 24Parotidectomy 13 12 14Facial nerve surgery 3 2 4Dermoid cyst 6 8 12Vascular malformations 3 7 14Ear lobe repair 28 36 42Biopsy 22 38 30Tongue tie release 2 2 4Sebaceous cyst/ Lipoma excision

8 6 12

Lower LimbS

ushrutha Institute has emerged in the past 4 years as a leading centre for trauma care and a tertiary trauma referral centre. Committed 24 hour surgical team has enabled to provide quality care and to ensure better results even in complicated trauma cases.

StatisticsLower Limb Trauma 2007-2008 2008-2009 2009-2010

Lower limb injuries 222 280 352

Major degloving injuries 98 112 116

SSG 110 168 212

Micro Surgical Flaps

Rectus abdominis 0 1 2

LD 8 9 18

Gracilis flap 9 12 15

Parascapular 4 8 5

ALT 12 22 38

Free Style 1 1 2

Lateral arm 2 2 4

Toe transfer 1 2 3

Activity Report 2007-’10 Activity Report 2007-’1020 21

Page 13: Sushrutha Institute of Plastic Reconstructive & Aesthetic ...thrissurplasticsurgery.com/pdf/Annual-report1.pdf · Sushrutha Institute of Plastic Reconstructive & Aesthetic Surgery

Mangled foot was stabilized with external fixator and latissimus dorsi muscle flap was used to cover the foot. Patient could carry out his day to day activities follow-ing recovery.

As part of limb reconstruction in cases of high velocity trauma with bone loss, we do limb reconstruction with LRS and ilizarov systems.

StatisticsOther lower limb flaps 2007-2008 2008-2009 2009-2010

Sural artery flap 10 14 23Fasciocutaneous flap 38 52 66Gastrocnemius muscle flap 5 12 14Soleus muscle flap 2 5 6Abductor hallucis flap 3 2 2Adipo fascial flap 2 7 12

8 months old baby had come with an accidental injury to foot which was recon-structed with latissimus dorsi flap cover

Patient came with an injury over the right ankle region where the foot was dis-rupted from the leg. Blood supply to the foot was re-established with a vein graft. Tissue defect was reconstructed with gracilis free flap from thigh. Heel pad region was reconstructed by reverse sural artery flap from the leg.

Activity Report 2007-’10 Activity Report 2007-’1022 23

Page 14: Sushrutha Institute of Plastic Reconstructive & Aesthetic ...thrissurplasticsurgery.com/pdf/Annual-report1.pdf · Sushrutha Institute of Plastic Reconstructive & Aesthetic Surgery

Congenital problems provide a major challenge to the reconstructive sur-geon. To bring back the smile to the face of cleft lip child, to bring back function to the congenitally deformed hand remains our primary goal.

Statistics:Congenital problems 2007-2008 2008-2009 2009-2010

Cleft lip 8 14 21

Cleft palate 10 12 26

Radial Club hand 2 2 2

Pollicisation 2 2 3

Congenital trigger thumb, fin-ger release 8 10 12

Macrodactyly 1 1 2

Constriction Ring Syndrome 2 2 3

Syndactyly separation 3 4 9

Thumb duplication 1 0 1

Cleft hand 1 0 0

Polydactyly 2 4 3

Cleft lip secondary correc-tion 2 4 12

Hypospadias 1 2 5

Constriction bands over the bilateral leg was corrected by Z plasty and tendon lengthening

Congenital Deformity Correction

Cosmetic/ Aesthetic Surgery

Unilateral cleft lip repair Bilateral cleft lip repair

Failure of separation of fingers in utero may lead to syndactyly of fingers for which release is performed

The contemporary approach to restoring and enhancing the face and body is the signature of Sushrutha Institute. Our Plastic Surgeons are skilled in the state of the art surgical procedures.

Statistics

Cosmetic Surgery 2007-2008 2008-2009 2009-2010

Rhinoplasty 15 12 16

Secondary rhinoplasty 11 12 14

Tip Plasty 8 6 8

Activity Report 2007-’10 Activity Report 2007-’1024 25

Page 15: Sushrutha Institute of Plastic Reconstructive & Aesthetic ...thrissurplasticsurgery.com/pdf/Annual-report1.pdf · Sushrutha Institute of Plastic Reconstructive & Aesthetic Surgery

Reduction Mammoplasty 1 4 5

Liposuction 3 5 8

Abdominoplasty 11 15 24

Body Countouring 3 10 12

Fat Injection 16 19 25

Laser 72 70 75

Microdermabrasion 123 125 120

Chemical Peel 30 35 32

Brest augmentation 1 2 2

Hair transplant 2 3 8

Gynaecomastia 18 26 35

Genioplasty 1 1 2

Photo rejuvenation 57 53 45StatisticsBrachial Plexus Surgery 2007-2008 2008-2009 2009-2010

Oberlin’s transfer 8 12 15

Shoulder Arthrodesis 4 6 5

Muscle transfer 4 8 12

Obstetric brachial plexus palsy 8 10 14

Otoplasty - Correction of ear deformity

Reduction of abdomen with liposuction and abdominoplasty

Brachial Plexus Surgery

C5, 6/ C5, 6, 7 injuries managed by peripheral nerve transfers. Postoperatively pa-tients with good elbow flexion and external rotation

Activity Report 2007-’10 Activity Report 2007-’1026 27

Page 16: Sushrutha Institute of Plastic Reconstructive & Aesthetic ...thrissurplasticsurgery.com/pdf/Annual-report1.pdf · Sushrutha Institute of Plastic Reconstructive & Aesthetic Surgery

StatisticsPeripheral Nerve

Surgery 2007-2008 2008-2009 2009-2010

Digital Nerve 78 120 126

Medial Nerve 33 46 55

Ulnar nerve 34 35 56

Radial Nerve 25 24 36

Nerve Graft 24 23 33

Nerve transfers 6 12 18

Neurolysis 2 5 8

Peripheral Nerve Surgery

MiscellaneousStatistics

Miscellaneous 2007-2008 2008-2009 2009-2010

Pressure Sore

Sacral 38 54 62

Trochantric 12 13 14

Ischial 18 28 38

Heel 9 12 18

Peripheral nerve transfers

Ischial pressure ulcer reconstructed with I-GAP propeller flap

Statistics

Miscellaneous 2007-2008 2008-2009 2009-2010

Diabetic Foot 739 1200 1553OthersPenile replant 1 0 1Tubal reconstruction 1 1 2Chest tube drainage 8 12 16Varicose veins 18 12 22Embolectomy 4 3 8Aneurysm 18 38 23Implant removal 382 415 463Radical neck dissection 4 12 18Ingrowing toe nail 3 9 14AV fistula 360 420 469

Patient with bilateral varicose veins – multiple ligation and excision done

Diabetic ulcer reconstructed with gracilis free muscle flap and skin graft

Activity Report 2007-’10 Activity Report 2007-’1028 29

Page 17: Sushrutha Institute of Plastic Reconstructive & Aesthetic ...thrissurplasticsurgery.com/pdf/Annual-report1.pdf · Sushrutha Institute of Plastic Reconstructive & Aesthetic Surgery

Miscellaneous 2007-2008 2008-2009 2009-2010

Burns

Debridement 53 60 82

Contracture release 9 15 19

Tangential excision 5 6 8

Skin Grafting 18 26 38

Local Flap 15 23 32

Free Flaps 1 2 4

Post burn contracture of the neck reconstructed with parascapular flap

Post burn contracture causing difficulties in movement of both hands. Right hand reconstructed with free ALT flap harvested from the thigh. Left hand reconstructed by reverse radial forearm flap.

Elite Mission Hospital blood bank is recognized by Kerala Govt. as a regional blood bank. It supports the needs of Sushrutha Institute by providing blood and blood components as required. The staffs here are active in promoting

voluntary blood donations

Blood Bank Services

The Sushrutha Institute is supported by a team of dedicated physiotherapists. The team takes care of our patients and provide adequate instruction and rehabilitation required for normal movements and function after surgery.

Department of Physiotherapy & Hand Therapy

Activity Report 2007-’10 Activity Report 2007-’1030 31

Page 18: Sushrutha Institute of Plastic Reconstructive & Aesthetic ...thrissurplasticsurgery.com/pdf/Annual-report1.pdf · Sushrutha Institute of Plastic Reconstructive & Aesthetic Surgery

We have 10 bedded post –operative ICU which is equipped with multi para monitors. We also have 6 bedded ventilator ICU with state of the art ventilators, portable ultra sound, bronchoscopy and separate plastic

surgery ICU dedicated to post-op microsurgical patients.

Anaesthesia department headed by Dr. Thomas Kunnath and ably assisted by Dr. Jayasree Menon, Dr. Indu Regunath, Dr. Uma Devi & Dr. Renjith. They pro-vide 24 hours high quality anaesthesia support which is fundamental for the

delivery of the elective and emergency care services.

Statistics of 2009 – 2010Under GA & Regional Anaesthesia:

2009 – 3729 cases 2010 - 4272 cases

Department ofAnesthesiology

Department ofIntensive Care

Departmental Library & Journal

We have a well kept library with plastic surgery books & journals to keep in pace with the latest surgical practices and procedures. Journals sub-scribed include Clinics in plastic surgery, Hand clinics, Journal of hand

surgery, Plastic and reconstructive surgery.

A Wi-Fi internet facility to access the journals online is also made available at our institute.

Dr Pradeep Kumar and Dr Anto Francis with Dr PS Bhandari

Activity Report 2007-’10 Activity Report 2007-’1032 33

Page 19: Sushrutha Institute of Plastic Reconstructive & Aesthetic ...thrissurplasticsurgery.com/pdf/Annual-report1.pdf · Sushrutha Institute of Plastic Reconstructive & Aesthetic Surgery

The department of Plastic Surgery was accredited for super speciality train-ing in Plastic Surgery by NBE in 2011, every year one candidate is selected. During this period the candidates are taken through a structured training

programme which not only promotes educational activities but also better surgical techniques, care and services for our patients.

Diplomate of National Board (DNB) -Plastic Surgery

Dr. Vamsi Krishna Undavalli.

Dr. Aniljith. V. G

M.S. (Gen. Surgery) M.Ch (Plastic surgery)

Our Staff team

Lectures delivered (From Oct – 2007):• Invited lecture “Bed sore and its management” - Orthoclub, Thrissur 2009

• Invited lecture “Cosmetic surgery” – IMA, Thrissur 2010

Attended conferences (From Oct – 2007):• 1st annual conference SIPRAS –“ Trauma care” -Thrissur 2008

• Basic hand course – October 2008 Thrissur

• 15th KPSA instructional course – Aesthetic surgery – Trivandrum, 22nd August 2009

• 2nd annual conference SIPRAS – “Nerve con 2009” – Thrissur 2009

• Haircon 2009 – 1st annual conference of association of hair restroration sur-geons – India – Ahamedabad, 18th – 20th December 2009

• NABICON 2010 – Pondichery, January 2010

• ISAPS ( Indian Association of Aesthetic Plastic Surgery)- symposium – Port Blair, 2nd April 2010

• “AESURG” 2010 – Annual meeting of Indian association of Aesthetic Plastic Surgeons – Port Blair, Andamans – 2nd & 3rd April 2010

• 18th KPSA instructional course & 3rd annual conference SIPRAS “ Head & neck reconstruction” – Thrissur 2010

• 5th Annual conference of Indian Society of Facial plastic and reconstructive sur-gery - Kumarakom 2011

• Indian Society of Facial Plastic & Reconstructive Surgery, February 2011 - Kot-tayam

Conferences attended Papers presented & published:

Activity Report 2007-’10 Activity Report 2007-’1034 35

Page 20: Sushrutha Institute of Plastic Reconstructive & Aesthetic ...thrissurplasticsurgery.com/pdf/Annual-report1.pdf · Sushrutha Institute of Plastic Reconstructive & Aesthetic Surgery

Lectures delivered (From Oct – 2007)• “Diabetic foot” - Thrissur2007

• “External fixators” – Kannur, 2008

• “Hand infections”– (Basic Hand Course ) Kannur, 2008

• “ Pulp space infection, Flexor tendon sheath infection, skin graft”- Kannur, 2009

• “ Pediatric hand injuries & Splinting – Kannur, 2009

• “Dupuytren’s contracture” – Trivandrum. 2010

Attended Conferences (From Oct -2007)• Basic hand course – Kannur 2008

• 1st annual conference SIPRAS –“ Trauma care” – Thrissur 2008

• Basic hand course – Thrissur 2008

• Basic hand course – Bangalore 2009

• 2nd annual conference SIPRAS – “Nerve con 2009” – Thrissur 2009

• 8th Asian Pacific Federation of Societies for Surgery of Hand – Taiwan 2009

• 18th KPSA Instructional Course & 3rd Annual Conference SIPRAS “ Head & neck reconstruction” – Thrissur 2010

• Ganga International Wrist Course 2011

Lectures delivered (From Oct – 2007) • Invited lecture – ‘possibilities in plastic surgery’ IMA Thrissur , 2007

• Invited lecture – ‘possibilities in plastic surgery’ IMA Wadakkanchery, 2007

• Invited lecture – ‘possibilities in plastic surgery’ IMA Irinjalakuda, 2007

• Invited lecture – ‘possibilities in plastic surgery’ IMA Palakkad, 2007

• Invited lecture – ‘possibilities in plastic surgery’ IMA Kunnamkulam, 2007

• Invited lecture – ‘possibilities in plastic surgery’ IMA Thrissur surgical club, 2007

• Invited lecture – ‘possibilities in plastic surgery’ IMA West fort clinical meeting, 2007

• Invited lecture – ‘reconstructive microsurgery’ IMA Thrissur, 2007

• Invited lecture – ‘reconstructive microsurgery’ Thrissur surgical club, Thrissur, 2007

• Invited lecture VIDEO PRESENTATION – free radial artery forearm flap, KPSA instructional course, Trivandrum, 2007.

• Invited lecture – ‘reconstructive microsurgery’ Thrissur ortho club, Thrissur , 2008

Dr. Anto Francis

M.S. (Ortho) M.Ch (Plastic surgery)

Dr. K. Pradeep Kumar,

M.S. (Gen. Surgery) M.Ch (Plastic surgery)

• Invited lecture – ‘possibilities in resection & reconstruction of oral cavity and head and neck cancers’ Indian Dental Association, Thrissur , 2007

• Invited lecture – ‘Facial contouring’ Thrissur ENT club, Thrissur , 2008

• Invited lecture – ‘Adult brachial plexus injury’ Thrissur ortho club, Thrissur , 2008

• Invited lecture – ‘Adult brachial plexus injury’ Thrissur neuro club, Thrissur , 2008

• ‘’Experience with T-DAP’’ flaps’- Indian society of reconstructive microsurgery – biennial meeting Delhi, –feb 2008.

• Invited lecture , VIDEO PRESENTATION, ‘PMMC FLAP’’, 31st annual conference of ASI, Thrissur, 2008

• Invited lecture, aesthetic free tissue transfers in lower leg and foot defects, KPSA, Kottayam, 2008

• ‘’Experience with T-DAP’’ flaps’ , KPSA, Kottayam, 2008

• ‘’Reconstruction of abdominal & perineal defects with pedicled flaps’, KPSA, Kottayam, 2008

• Faculty, free fibula harvest, cadaver flap dissection workshop, Organised by AIMS, Kochi, 2008

• Invited lecture – ‘Adult brachial plexus injury’ Neuroyaan, state NSI conference, Thrissur, 2009

• Case presentation “Penis replant” “DIEP flap” “Toe transfer” – Clinical Meeting, Elite Mission Hospital, Thrissur – 19th March 2009

• Invited lecture – “Reperfusion injury” Critical care society, Thrissur, 27th March 2009

• Clinical case presentation – Surgical club, Thrissur on 22/04/2009

• Faculty, cadaver flap dissection workshop, Organised by AIMS, Kochi, 2008 & Anatomy, Thrissur Medical College – June 13th & 14th 2009

• Invited faculty – “Moderator on ALT & Pectoralis major flaps”- Head & Neck Oncology Conference- 2009, Amritha Institute Of Medical Sciences, Kochi

• Invited lecture – “Oncoplastic Breast Surgery”, Onco Club Kozhikode

• Clinical case presentation – Doctors club, Elite Mission Hospital

• Faculty, Live workshop on Oncoplastic Breast conservation– BCSCON- 2010 –Department Of Surgery Calicut Medical College On February 28th2010

• Invited lecture - Spinal Accessory Nerve Injury- KPSACon-TVM. on April 2010

• Free Paper - Composite Chimeric Tissue Transfer- KPSACon-TVM. on April 2010

• Chair free paper Session - Brachial Plexus Injury- KPSACon,-Tvm. On April 2010

• Clinical case presentation on ‘Penetrating neck injuries’, Surgical club, Thrissur, 19th Aug 2010

• Clinical case presentation – Doctors club, Thrissur, 31st Aug 2010

• Faculty, cadaver flap dissection workshop, Organised by AIMS, Kochi, 4th July,2010

Activity Report 2007-’10 Activity Report 2007-’1036 37

Page 21: Sushrutha Institute of Plastic Reconstructive & Aesthetic ...thrissurplasticsurgery.com/pdf/Annual-report1.pdf · Sushrutha Institute of Plastic Reconstructive & Aesthetic Surgery

• Faculty - lecture “Reconstruction of tongue & floor of mouth defects” -18th KPSA in instructional course & 3rd annual conference of Sushrutha Institute of Plastic, Reconstructive & Aesthetic Surgery, Sept. 11th & 12th 2010

• Case presentation – “Disputed neurogenic thoracic outlet syndrome, Surgical club, Thrissur, 01st December 2010.

• Faculty, Panel discussion on congenital hand & brachial plexus, APLAST( plastic surgery tutorial), AIMS, Kochi, March 11th – 13th, 2011

• Faculty, Panel discussion on nerve injuries, tendon injury and replant, APLAST( plastic surgery tutorial), AIMS, Kochi, March 11th – 13th, 2011

• Invited lecture – “Brachial Plexopathy”. What a surgeon looks for in electro-diagnostics and what can be achieved” – Thrissur neurological society. March 2011.

CONFERENCES AND WORKSHOPS ATTENDED• Annual conference of KPSA , Kochi, 2007

• 1ST Instructional course in plastic surgery,TNPAPS ‘lower limb reconstruction’ Coimbatore, 2007.

• KPSA Instructional course in plastic surgery, head and neck reconstruction, Trivandrum, 2007

• Annual conference of APSI, Pune 2007

• Advanced head and neck cancers –symposium, Amritha institute, Kochi, 2008

• Indian society of reconstructive microsurgery – biennial meeting Delhi, –feb 2008.

• 2nd national workshop on Propellar flaps, Chennai, 2008.

• 31st annual conference of ASI, Thrissur, 2008

• 21st annual conference KPSA, Kottayam, 2008

• 12th international perforator flap course, Coimbatore 2008.

• 21st annual conference of ISSH & 2ND combined BSSH meet, Bangalore, 2008.

• 3rd biennial meeting , brachial plexus surgery group of India, Coimbatore,2009

• APSICON 2009, Mahabalipuram, Chennai.

• 2nd annual conference, “nervecon 2009” -Peripheral nerve / Brachial plexus Repair & Reconstruction , Sushrutha Institute Of Plastic, Reconstructive & Aes-thetic Surgery, Elite Mission Hospital, Thrissur

• C.M.E on Head & Neck surgery, I. M.A, Ernakulam

• Workshop Brachial plexus surgery, Chang Gung Memorial Hospital, Taiwan, 2009.

• 8th Asian Pacific Federation of Societies for Surgery of Hand, Kaohsiung, Taiwan, November 13 – 15, 2009.

• “KPSACon” - Tvm. April 2010

• Cadaver flap dissection workshop, Organised by AIMS, Kochi, 4th July, 2010

• 18th KPSA in instructional course & 3rd annual conference of Sushrutha Insti-tute of Plastic, Reconstructive & Aesthetic Surgery, Sept. 11th & 12th 2010

• APSICON – 2010, Goa

• 4th Biennial meeting of brachial plexus surgery group of India, February 16th,17th & 18th 2011, Bangalore

• APLAST( plastic surgery tutorial), AIMS, Kochi, March 11th – 13th, 2011

• “Neuro Update” state meet of - Kerala Neurological Society, 20th March 2011

MEMBERSHIPS• Life member: Indian Medical Association

• Life member: Association of plastic surgeons of India

• Life member: Indian society for surgery of hand

• Life member: Indian society of surgery for reconstructive microsurgery

• Life member: Indian association for facial, plastic & aesthetic surgery

• Life member: Kerala plastic surgeons association (K.P.S.A)

• Life member: Fellow of head & neck oncology

• Life member: Brachial Plexus Surgery Group of India

• Member: Thrissur surgical club.

Lectures Delivered (From November 2008)• Oman experience in Plastic Surgery – Elite Mission Hospital monthly meeting

- November 2008

• “Pressure sore management” Elite Mission Hospital Meet 2009

• “Lymphoedema management” IMA, Thrissur 2009

• “Embryology of hand & classification of congenital anomalies of hand” - Instruc-tional course – Thiruvananthapuram – April 23rd 2010

Attended conferences (From March 2008)• 1st Annual conference SIPRAS –“ Trauma care” – Thrissur 2008

• Basic hand course – Thrissur 2008

• INDOCLEFT con 2009 – 8th annual conference of Indian Society of Cleft Lip, Palate and Craniofacial Anomalies, 12th February 2009- Pondichery

• 15th KPSA instructional course – Aesthetic surgery – Trivandrum, 22nd August 2009

• Annual CME Association of surgeons of India, Thrissur, 12th & 13th September 2009

• Haircon 2009 – 1st annual conference of association of hair restroration sur-geons – India – Ahmedabad, 18th – 20th December 2009

• 2nd Annual conference SIPRAS – “NERVECON 2009” – Thrissur 2009

Dr. Shaji Mathew

M.S. (Gen. Surgery) M.Ch (Plastic surgery)

Activity Report 2007-’10 Activity Report 2007-’1038 39

Page 22: Sushrutha Institute of Plastic Reconstructive & Aesthetic ...thrissurplasticsurgery.com/pdf/Annual-report1.pdf · Sushrutha Institute of Plastic Reconstructive & Aesthetic Surgery

• 18th KPSA instructional course & 3rd annual conference SIPRAS “ Head & neck reconstruction” – Thrissur 2010

• ISAPS ( Indian Association of Aesthetic Plastic Surgery)- symposium – Port Blair, 2nd April 2010

• “AESURG” 2010 – Annual meeting of Indian association of Aesthetic Plastic Surgeons – Port Blair, Andamans – 2nd & 3rd April 2010

• INDOCLEFTCON 2011- Annual conference of cleft lip, palate and craniofacial surgery, Chennai, February 2011

• TANPAPS – Annual conference of Tamilnadu Association Of Plastic Surgeons, Kodaikanal, February 2011

• APSICON 2011 – Annual conference of Association of Plastic Surgeons of India – Goa 2011

• Amrita Tutorials in Plastic & Reconstructive Surgery – Kochi, March 11th – 13th 2011

Lectures delivered (from September 2009):• Invited lecture- “Aesthetic Plastic Surgery ” -IMA Thrissur 2009

• “Deep Vein Thrombosis”- Elite mission hospital, Thrissur 2010

• “Vascular Malformation in the extremities” – KPSA Conference 2010 Trivan-drum

Attended conferences (from September 2009):• 2nd annual conference SIPRAS – “Nerve con 2009” – Thrissur

• KPSACon 2010 – Trivandrum

• 10th Biennial Conference of Indian Society for Reconstructive Microsurgery Hyderabad 2010

• 18th KPSA instructional course & 3rd annual conference SIPRAS “ Head & neck reconstruction” – Thrissur 2010

• APSICON – 2010 - Goa

• TANPAPS – Kodaikanal 2011

• 4th Biennial meeting of brachial plexus surgery group of India, Bangalore 2011

Article Published:• “Perforator propeller flaps for sacral and ischial soft tissue reconstruction” -

Indian Journal of Plastic Surgery 2010 Jul–Dec; 43(2): 151–157.

Journal Reviewer: • University of Mauritius Research Journal, Mauritius 2011

Dr. K. M. Pradeoth

M.S. (Gen. Surgery) M.Ch (Plastic surgery)

Dr. Ravindra Bhat

Inauguration of the CME by Dr. K.C. Prakasan, Managing Partner

Dr. Mukund Thatte

Dr. Ashok Koul

Dr. Vijay Joseph

Dr. Sudhir Warrier

Dr. E. Mohandas

Faculty:

1st Annual Conference

Activity Report 2007-’10 Activity Report 2007-’1040 41

Page 23: Sushrutha Institute of Plastic Reconstructive & Aesthetic ...thrissurplasticsurgery.com/pdf/Annual-report1.pdf · Sushrutha Institute of Plastic Reconstructive & Aesthetic Surgery

Gurupooja - Paying tribute to teachers

Inauguration of the annual function Dr. K. K. Mohandas

Medical superintendent & Managing partner

Chief guest Dr. V. Chandramohan

Vice Chancellor, Kannur University

Dr. Sridhar

Dr. Mukund Thatte

Dr. P.S. Bhandari

Dr. Krishnakumar

Dr. Gautam Biswas

Dr. Jayakumar

Faculty:

Inauguration of the CME by Dr. K.C. Prakasan, Managing Partner

Prof. Dr. G. Balakrishnan 2nd Annual Conference

Activity Report 2007-’10 Activity Report 2007-’1042 43

Page 24: Sushrutha Institute of Plastic Reconstructive & Aesthetic ...thrissurplasticsurgery.com/pdf/Annual-report1.pdf · Sushrutha Institute of Plastic Reconstructive & Aesthetic Surgery

Dr. Subramania Iyer Dr. Binu Thomas Dr. Anil Bhatia

Dr. Ashok Koul

Entertainment ProgrammeChief Guest. Dr. V. K. Baby, District collector, Thrissur

Inauguration - Dr. K. K. Mohandas Medical superintendent & Managing partner

Guest lecture Prof.G. Lakshmipathi

Dr. Sreekumar Pillai

Dr. Krishna kumar

Dr. K. Pradeep Kumar

Dr. Shivram Bharadwaj

Dr. Samir Kumta

Dr. Devendra Kumar Gupta

Faculty:

Inauguration of the CME by Dr. K.C. Prakasan, Managing Partner

3rd Annual Conference

Activity Report 2007-’10 Activity Report 2007-’1044 45

Page 25: Sushrutha Institute of Plastic Reconstructive & Aesthetic ...thrissurplasticsurgery.com/pdf/Annual-report1.pdf · Sushrutha Institute of Plastic Reconstructive & Aesthetic Surgery

Entertainment ProgrammeGuest lecture - Mr. Nagesh prabhu, Chairman Aushadhi

Inauguration - Dr. K. K. Mohandas Medical superintendent & Managing partner

Chief guest, Prof. Saramma Varghese

Dr. Usha Kim Dr. Antony Arvind

Dr. Prabha Yadhav

Dr. Jayakumar

Dr. Subramania Iyer

Visitors

“I am highly impressed by the Microvascular and Microneural work.

Keep it up”

Dr. P. S. Bhandari

“I enjoyed visiting the Elite Mission Hos-pital and impressed by your

excellent work here”

Dr. Shyh Joh Shieh

High quality & excellent team effort. Let the “Sushrutha Institute”

rises to still higher levels!!”

Dr. Lekshmi. M Asst. Prof. of Plastic Surgery

Medical college, Kottayam

Activity Report 2007-’10 Activity Report 2007-’1046 47

Page 26: Sushrutha Institute of Plastic Reconstructive & Aesthetic ...thrissurplasticsurgery.com/pdf/Annual-report1.pdf · Sushrutha Institute of Plastic Reconstructive & Aesthetic Surgery

Activity Report 2007-’10 49

PatientsFeedback

Page 27: Sushrutha Institute of Plastic Reconstructive & Aesthetic ...thrissurplasticsurgery.com/pdf/Annual-report1.pdf · Sushrutha Institute of Plastic Reconstructive & Aesthetic Surgery

Activity Report 2007-’1050

Des

igne

d &

Prin

ted

by, A

cces

s -

0487

232

1923