Plastic surgery Digital flexor tendon repair

Digital Flexor Tendon Repair

Objective

In case of tear of flexon tendons:

•   Repair of severed ends of a tendon caused by injury.

Position

Supine hand on hand rest.

Anesthesia

General.

Procedure

   1.  Esmarch bandage.

   2.  Midlateral digital incisions are often employed.

   3.  Care is taken to avoid injury to the neurovascular bundle.

   4.  Pulleys are preserved when possible.

   5.  The proximal tendon end is retrieved.

   6.  If length is not sufficient a graft (e.g. from the palmaris longus tendon) is prepared.

   7.  The tendon ends are approximated.

   8.  If the tendon insertion is involved, suture to the bone may be facilitated using fine drill holes.

   9.  The suture fixing the tendon graft to the insertion is tied over a button on the dorsum of the distal phalanx to prevent soft tissue necrosis.

10.  The wound is closed.

11.  A splint is applied.

Instruments

•   Limited plastic procedure set 

•   Power drill and fine drill points 

•   Microinstrumentation (Neddle holder, scissors, forceps) 

•   Basin set 

•   Sheet wadding 

•   Esmarch bandage 

•   Tube (or impervious) stockinette 

•   Blades (2) No. 15 

•   Bulb syringe 

•   Marking pen 

•   Straight Keith needle and button 

•   Magnification

Any questions be sent to drmmkapur@gmail.com

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Plastic surgery Syndactltaly repair

•   

Repair of Syndactylism

Objective

In cases of congenital fused fingers:

•   Separation of webbed fused digits.

Position

Supine.

Anesthesia

General.

Procedure

1.  Zig-zag or Z-plasty incisions are made in the interdigital space(s).

2.  The neurovascular bundles are protected.

3.  Bony and ligamentous defects if present are corrected.

4.  The incisions are closed.

5.  Full thickness grafts (e.g. skin from the abdomen or the medial aspect of the arm or the thigh) may be required to close defects.

6.  Stents are sutured over the grafts.

7.  A bulky dressing and splint are applied.

Instruments

•   Minor orthopedic procedure set 

•   Basin set 

•   Sheet wadding 

•   Esmarch bandage 

•   Blades (2) No. 15 

•   Bulb syringe 

•   Marking pen 

•   Stents.

Any questions be sent to drmmkapur@gmail.com

All older posts are stored in archive for accessand reiew
Thosewho follow may post contributions to the site,please writo tp address above.

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Plastic Surgery Dermoabrasion

Dermabrasion

Ovjective

In cases of minor scars of face:

•   Abrasion of the skin to smooth scars and surface irregularities.

Position

Supine.

Anesthesia

Local.

Procedure

1.  Skin is stretched by hand.

2.  The epidermis is abraded by means of a motor-driven sanding cylinder and/or a wire brush.

3.  The area is irrigated copiously with saline during (and following) the procedure.

4.  The wound may be dressed with nonadherent gauze (e.g. Owens gauze).

5.  Compression bandage may be applied.

Instruments

•   Adson forceps 

•   Straight Mayo scissors 

•   Dermabrader (with wire brush and sanding cylinder) and cord, for example, Stryker 

•   Basin set 

•   Marking pen or methylene blue 

•   Syringes (2) Luer-Lok control, and needles (2) 25 or 27 gauge

•   Local anesthetic with epinephrine

Any questions be sent to drmmkapur@gmail.com

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Repair 

Plstic Surgery mentoplasty

Mentoplasty Augmentation

Objective

In cases of micrognathia (small chin):

•   Correction of cosmetic defect with the insertion of a chin prosthesis.

Position

Supine.

Anesthesia

Local.

Procedure

1.  A short transverse incision in the submental region or in the labial sulcus.

2.  A supraperiosteal pocket is created just large enough to accommodate the prosthesis.

3.  Implant may be fixed with a deep mattress suture.

4.  Wound is closed.

5.  A bulky pressure dressing is applied.

Instruments

•   Limited plastic procedure set 

•   Basin set 

•   Bipolar electrocoagulating forceps 

•   Blades (2) No. 15 

•   Marking pen or methylene blue 

•   Syringes (2) Luer-Lok control, and needles (2) 25 or 27 gauge 

•   Local anesthetic with epinephrine implant (e.g. silicone).

Any questions be sent to drmmkapur@gmail.com

All older posts are stored in archive for accessand reiew
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Plastic surgery Otoplasty

Otoplasty

Objective

Correction of bat ears.

Position

Supine.

Anesthesia

General.

Procedure

1.  Mark incisions.

2.  Incise and raise flaps.

3.  Reshape the cartilage.

4.  Closure.

Instruments

Limited plastic procedure set.

Suture

•   6‘0’ Prolene on curved cutting needle 

•   5‘0’ Vicryl on curved cutting needle 

•   Crepe bandage 4" 2 rolls.

Any questions be sent to drmmkapur@gmail.com

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Plastic surgery Abdominoplasty

Abdominoplasty

Objective

Excision of excessive fatty tissue over the lower abdomen.

Position

Supine with pillow under the knees.

Anesthesia

General.

Procedure

1.  Mark incisions.

2.  Excise excess skin and fat.

3.  Plicate abdominal muscles.

4.  Closure in layers over suction drains.

Instruments

•   Limited plastic procedure set 

•   General surgery set.

Sutures

•   2‘0’ Prolene on curved round body needle 

•   1‘0’ Catgut/Vicryl on curved cutting needle 

•   5‘0’ Prolene on curved cutting needle.

Any questions be sent to drmmkapur@gmail.com

All older posts are stored in archive for accessand reiew
Thosewho follow may post contributions to the site,please writo tp address above.

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Blepheroplasty

Blepharoplasty

Objective

Correct of Baggy eyelids.

Position

Supine. 

Anesthesia

Local.

Procedure

1.  Mark incisions.

2.  Infiltrate local anesthesia.

3.  Incise.

4.  Remove excess fat.

5.  Trim excess skin.

6.  Hemostasis.

Instruments

•   Limited plastic procedure set 

•   Sutures 

     6‘0’ Prolene on curved cutting needle.

Any questions be sent to drmmkapur@gmail.com

All older posts are stored in archive for accessand reiew
Thosewho follow may post contributions to the site,please writo tp address above.

To create consumer/provider enagement visit www.surginstruatlas.blogspot.co

www.drmmkapur.blogspot.com                 www.surgseminar.blogspot.com
Also available now on android & smartphones same internet address