TFL flap for facial reconstruction

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Xeroderma pigmentosum and its treatment

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These horrifying pictures are of facial tumors suffered by patients of Xeroderma pigmentosum.This is a genetic condition in which body ability to repair genetic damage is greatly impaired. As a result theses children are greatly susceptible to damaging effects of UV rays. They develop facial skin tumors  or in other exposed part of body. This patient had these skin tumors which were excised and skin grafted. Bilateral neck dissection was done as it showed enlarged lymph nodes. Patient tolerated surgery as were happy to get rid of horrendous deformity it was causing. All margins were negative and nodes were negative. Dr Adhishwar  Sharma MBB,BS MS Gen Surgery PGIMER Chd Mch Plastic Surgery brahmanandclinic.com 8860650846, adhishwar7@gmail.com
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Marjolins ulcer leg post burn

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Marjolins ulcer is a variant of skin cancer , it is a ulcerating squamous  cell carcinoma . Described by Jean Nicolas Marjolin in 1828. Which develops in scars it can be burn scar ,osteomyelitis ,venous ulcers, post radiotherapy , pressure sores  or post traumatic scars. Unstable wound which are prone to breakdown are frequent site of this cancer . It can be very aggressive tumour  . Initial lymphatic spread is slow because of scarring ,but once barrier is breached spread can be aggressive .  Any wound which is not healing for 3 months should be biopsied .  original ulcer 30 year old male history of burns sustained burns 20 years ago which was treated conservatively with right get skin grafted . Patient developed ulceration over medial aspect of ankle which refused to heal . Patient was subjected to biopsy which came out to be squamous cell carcinoma . Surgical Oncology advice was taken and patient was taken for surgery. Lymph node dissection of g...
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Head and neck carcinosarcoma and Reconstruction

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preop preop frontal view post op one year Resected specimen inside Resected specimen outside  post op photo April 2017 A 48 year old man who developed swelling in face for past six months. Swelling was in lower face and very massive, Biopsy come as carcinosarcoma. imaging studies CT scan was ordered which revealed true extent of tumor. He was planned for resection and neck dissection.  Reconstruction was done with a ALT free flap. Flap vessel were connected to facial artery and EJV. Post op was uneventful . He was offered radiotherapy which he refused . He went back home and after one year send his photograph, he was doing well . All photo with a consent. Dr Adhishwar Sharma MB,BS , MS General Surgery PGIMER  Chd Mch Plastic Surgery brahmanandclinic.com 8860650846 adhishwar7@gmail.com
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