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Mehrotra S.,Command Hospital Central Command
Indian Journal of Plastic Surgery | Year: 2010

Background: The tenuous blood supply of traditional flaps for wound cover combined with collateral damage by sacrifice of functional muscle, truncal vessels, or nerves has been the bane of reconstructive procedures. The concept of perforator plus flaps employs dual vascular supply to flaps. By safeguarding perforators along with supply from its base, robust flaps can be raised in diverse situations. This is achieved while limiting collateral damage and preserving nerves, vessels, and functioning muscle with better function and aesthesis. Materials and Methods: The perforator plus concept was applied in seven different clinical situations. Functional muscle and fasciocutaneous flaps were employed in five and adipofascial flaps in two cases, primarily involving lower extremity defects and back. Adipofascial perforator plus flaps were employed to provide cover for tibial fracture in one patients and chronic venous ulcer in another. Results: All flaps survived without any loss and provided long-term stable cover, both over soft tissue and bone. Functional preservation was achieved in all cases where muscle flaps were employed with no clinical evidence of loss of power. There was no sensory loss or significant oedema in or distal to the flap in both cases where neurovascular continuity was preserved during flap elevation. Fracture union and consolidation were satisfactory. One patient had minimal graft loss over fascia which required application of stored grafts with subsequent take. No patient required re-operation. Conclusions: Perforator plus concept is holistic and applicable to most flap types in varied situations. It permits the exercise of many locoregional flap options while limiting collateral functional damage. Aesthetic considerations are also addressed while raising adipofascial flaps because of no appreciable donor defects. With quick operating times and low failure risk, these flaps can be a better substitute to traditional flaps and at times even free tissue transfers. Source


Dhillan R.,Army Hospital R and R | Sen D.,Command Hospital Central Command
Medical Journal Armed Forces India | Year: 2015

Penile fractures are an uncommon surgical emergency. They result from trauma to the erect penis leading to rupture of the tunica albuginea of the penile corpora. Prompt diagnosis and early surgical repair are essential to ensure a successful outcome.1 We report a case of a young male with penile fracture who presented late to the hospital. Urgent imaging and emergency surgery were undertaken. He was found to have two separate fractures of the tunica which were repaired successfully without any complications. © 2012, Armed Forces Medical Services (AFMS). All rights reserved. Source


Bisht Y.S.,Base Hospital | Bhasin R.,Base Hospital | Manoj S.,Command Hospital Central Command | Sunita B.S.,Command Hospital Central Command | Singhal E.,Base Hospital
Medical Journal Armed Forces India | Year: 2015

Becker’s nevus (BN) was first described by Becker in 1949.1 BN typically presents as hyperpigmented patch with irregular borders that gradually enlarges for few years and then remains stable. Hypertrichosis within lesion is common but not universal. Happle in 1997, described Becker’s nevus syndrome (BNS) or hairy epidermal nevus syndrome, where BN was associated with multiple cutaneous and musculoskeletal abnormalities, mostly ipsilateral.2. © 2013, Armed Forces Medical Services (AFMS). All rights reserved. Source


Sen D.,Command Hospital Central Command | Sandhu A.S.,Command Hospital Central Command
Indian Journal of Urology | Year: 2014

Hepatic portal venous gas (HPVG) is an uncommon radiological sign and often portends significant underlying abdominal disease. A number of conditions may produce this sign and identifying the underlying etiology is essential for management. The advent of ultrasonography-color Doppler imaging and computerized tomography has led to more frequent recognition of this condition. This article describes the very rare association of HPVG in a patient with emphysematous pyelonephritis. Source


Mutreja D.,AIR INDIA | Nangia R.,Command Hospital Central Command | Mishra P.,Command Hospital Central Command
Indian Journal of Pathology and Microbiology | Year: 2010

We report the postmortem findings in a 28-year-old immunocompetent male patient, a rare case of tuberculous liver abscesses with concomitant pericardial abscess in the absence of pleuropulmonary or splenic involvement, who continued to be a diagnostic dilemma. This case report illustrates the difficulty in reaching the correct diagnosis in case of hepatic masses, which are most often confused with carcinoma of the liver, primary or metastatic and, hence, have been aptly referred to as pseudotumoral hepatic tuberculosis in the past. Source

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