No abstract

Abdominal aps have been a workhorse aps for complex upper extremity defects since last 5 decades. Since the evolution of microsurgery, free aps have revolutionised the upper extremity defect reconstruction and have invariably replaced abdominal aps as the primary option for reconstruction. Abdominal aps due to their reliablity still continue to be the lifeboat and primary surgical option in centres where microsurgery is not possible and in events of failure of free aps. It is documented in the literature that long term outcomes of successful pedicled aps are equal or even better than free aps. With their lesser learning curve, requiring lesser resources and very reliable outcomes abdominal aps will stay as a primary option for reconstruction in some centres and as a life boat for free ap failure in some

Background: The goal of lower extremity reconstruction in cases of skin loss is the coverage of defects and open wounds of the leg, so that they resume their life and prevent the deformity or amputation. Skin loss is either managed by dressings or surgically providing skin cover in the form of skin graft or flap.Methods: This was a prospective, observational hospital based study which involved 100 patients who were admitted in the ward with a diagnosis of skin loss in lower limb in Department of General Surgery and Department of Plastic surgery, Gandhi medical college and associated Hamidia Hospital, Bhopal, Madhya Pradesh from October 2017 to July 2019. Based upon history, clinical and local examination of the wound, necessary investigations, the plan of management, reconstructive procedure was done. The results were compared after one follow up.Results: The patients suffering were commonly males between 18-29 years and mostly due to trauma. Initial management of wounds with skin loss in lower limb was debridement and dressings. Commonly involved anatomical area was below knee area upto both malleoli. Reconstructive measures were commonly undertaken between 3-7 days. The commonest reconstructive option was split skin grafting. Commonly flap used was perforator based flap and local transposition flap.Conclusions: It can be concluded that the most common etiology responsible for the loss of skin in lower limb is trauma and the most used reconstructive measure in skin loss of lower limb is split skin grafting. Flap coverage acts as the best modality of reconstruction.

BACKGROUND: Post burn upper limb contractures is still a common complication, in spite of better treatment available (Debridement, skin substitute and early skin grafting) and early initiation of physiotherapy procedures. In view of broad range of surgical procedures performed at our centre Gandhi Medical College, Plastic Surgery Department Bhopal, we considered it worthwhile to review post-burn contractures of the upper limb, which are amongst the most frequent sequelae we treat. This has been an object of observation also in the past, and we will demonstrate that there has been a consistent increasing trend in the number of patients presenting such burns sequelae, a finding that has a sound explanation.