elite sou-2018-3 - thrissur plastic surgery

1Sushrutha Institute of Plastic Reconstructive & Aesthetic Surgerywww.thrissurplasticsurgery.com

2 Sushrutha Institute of Plastic Reconstructive & Aesthetic Surgerywww.thrissurplasticsurgery.com

Sushrutha (6th Century BC) is considered as the father of Plastic Surgery


Koorkkenchery, Thrissur, Kerala, India Ph: 0487-2436118, 2436100, 2445850E-mail: [email protected] Website: www.thrissurplasticsurgery.com


Sushrutha Institute of Plastic Reconstructive and AestheticSurgery (SIPRAS), conceptualised as a dedicated team ofsurgeons catering to the whole spectrum of emergency andelective services under the purview of ‘Plastic Surgery, is a partof the Elite Mission Hospital, Thrissur, Kerala, which is an NABHand ISO 9001 accredited institution.

Initially formed by a team of three plastic surgeons on the 1st ofOctober 2007, over the last ten years, SIPRAS has grown to ateam of six specialist plastic surgeons and has a teachingprogramme catering to 5 trainees in plastic surgery under theDiplomate of National Board. Working as team, we make surethat the combined efforts of the trained minds go into thetreatment of each patient and the expertise of all in the team isused to the optimum in an efficient and happy environment.

Doing justice to our motto of being a comprehensive centre forplastic surgery, we handle cases of reconstruction for trauma,onco reconstruction, hand surgery, peripheral nerve andbrachial plexus , vascular surgery and the whole spectrum ofaesthetic plastic surgery as well.

Dedicated to providing excellent care and state of the arttreatment options to patients and clients, we strive to be acentre of excellence in plastic and cosmetic surgery services inour state and region.

About us


Design: Smritidesign.com Printing : Anaswara.in


Messages 06

Our Mission 08

Team Sushrutha 09

Our Work 10

1. Hand Surgery 10

2. Reconstructive microsurgery 14

3. Brachial plexus surgery 20

4. Peripheral nerve surgery 22

5. Aesthetic surgery 24

6. Congenital anomalies 32

7. Chronic wounds 36

8. Benign & Malignant Tumors 40

9. Lower Limb 42

10. Head and Neck 44

Residents & Staff 48

Annual CMEs 50

Supporting departments in our hospital 57

Patients’ Stories 58

Innovations 60

Consultants’ Profile 61

Publications 72

Visiting Trainees 76

Visiting Surgeons and Comments 78

Statistics-Master Chart 80



I am very happy to note that Sushrutha Institute is bringing out a magazine duringthe decennial year to highlight the activities of the department for the last ten years.Elite Mission Hospital has been in the forefront of Health Care activities since its inceptionin 1979. Started with minimal facilities, it has grown up steadily and reached the presentstage. Today Elite Mission is a 350 bedded Multi-Super Speciality Hospital with ISO9001 and NABH accreditation.Sushrutha Institute started in the year 2007 became very popular with in a short spanof time. Now this department is functioning most successfully with Six Plastic Surgeons,DNB Post Graduate Doctors and Paramedical staff working as a team producing excellentresults. During the 10th anniversary this Institute has started a new clinic – SushruthaHair Care Clinic which provides all modalities of treatment for hair loss including HairTransplantation.I am confident that with sincerity, dedication and hard work of the team, SushruthaInstitute will be able to climb the ladder further heights.My Heartiest Greetings and Best Wishes to the Sushrutha Team in all future endeavours.

Message

Dr. K. K. MohandasMedical Superintendent & Managing Partner



It gives me immense pleasure that the Sushrutha institute of plasticreconstructive and aesthetic surgery is bringing out a magazine assouvenir on its tenth anniversary.Elite mission hospital has, from its inception, been a forerunner in qualitypatient care in this state. Its commitment to quality care has beenacknowledged by the ISO and NABH accreditations.The Sushrutha institute, established in 2007, has been a very active playerin patient care in our hospital over the last ten years. Its commitment toteam work and academic excellence has brought a good reputation amongboth the public and medical fraternity. Over the years it has grown tobecome a centre of excellence in major reconstructive work such asbrachial plexus surgeries in India. I am happy to note the huge volume ofpatients that it has catered to, over the years, in both emergency andelective setting and the large number of happy and satisfied patients.Elite Mission Hospital has a six year post graduate training programme inPlastic surgery under the aegis of National Board of Exams. I am glad tonote that medical students all over India consider this institution amongtheir first preference for DNB ( Diplomate of National Board) post graduatetrainingI wish the institute all success in future endeavours and hope this activityreport will bring it more recognition and respect.

Dr. K. C. PrakasanManaging Partner

Message



To expand ourselves as a centre of excellencein the practice of all sub-specialities under

Plastic surgery, to maintain a scientific andresearch oriented environment, impart

knowledge and to translate all our efforts tostate of the art care for our patients.

By providing the best possibleservice and the most appropri-ate treatment at an affordablecost.

By ensuring that the staff at thecentre are trained to take careof the kind of patients it catersto.By making rehabilitationtherapy an essential factor ofcare to aid a speedy and nearperfect recovery.

By ensuring timely feedback tothe referring doctors withphotographic records andmaintaining cooperation toaid best possible follow upcare for the patients at theirconvenience.

We strive to fulfil our aims

Our Mission

By being associated with an in-stitution like the elite missionhospital, we are able to sharethe resources to ensure com-prehensive care and avail theexpertise of even other superspecialist doctors therebymaking the whole process tocomplete convenient and af-fordable to the patient

By undertaking post graduatetraining for plastic surgeryresidents under the diplomateof national board, we ensurethat the knowledge is sharedand new surgeons trained inthe best way.

By maintaining a well-kept li-brary, having subscription toalmost all leading journals inthe field and having Wi-Fi ac-

cess to the e-journals, we en-sure that we are updated onthe latest trends and translatethat to real time patient careBy conducting annual aca-demic conferences where re-nowned national and interna-tional faculty share theirknowledge and experienceson selected topics each year.This programme is open to allthe medical fraternity free ofcost and has always been wel-comed wholeheartedly byboth the seniors and juniors inthe field of surgery,·

Artist’s depiction of sushrutha’s very fine surgeries of pre christian era



Team Sushrutha

Dr. Aniljith. V.G Dr. Anto FrancisDr. Shaji Mathew Dr. Pradeep Kumar Dr. Jyoshid R Balan Dr.Raj Gopal



Hands play a pivotal role in the functioning of an individual. Hands allow us toperform our daily activities, help us to communicate and even form bonds with otherindividuals. Hands don’t just make us functional; they help to make us human.

Afflictions of the hands are particularly distressing. They make the individualdependent upon others for his daily activities. Acute injuries frequently affect the youngerworking population, more commonly of the lower socioeconomic status. This frequentlyrobs them and often their families of their means of livelihood. Non traumatic afflictionsof the hands involve the aged more frequently. Although less common than the traumaticinjuries to the hand, they can be very debilitating. The individual becomes a dependentfor even the basic needs and frequently goes into a gloomy cycle of depression andworthlessness, which transforms him from a productive member of the society to adependent one.

We, at SIPRAS, have a team of surgeons with a keen interest in the field of handsurgery. One of the most commonly seen patients,in our emergency department, is onewith an injured hand. Injuries ranging from fingertip injuries caused by entrapment indoor to major industrial injuries are managed at our institute. Automobile accidents andassociated injuries form major part of our hand injury cases.

We offer utmost care in management of patients with hand injuries. Appropriatetreatment ranging from wound repair, to grafts and flaps are routinely performed at ourinstitute. We are one of the few centres in India performing transfer of digits from thefoot to restore the form and function of the fingers. Difficult and complex reconstructionsare a welcome challenges for our team of reconstructive hand surgeons.

Diseases affecting the hands is also managed at our institute. Afflictions like carpaltunnel syndrome, Dupuytren’s contracture, post burn deformities and nerve palsies aremanaged using the standard and latest techniques. Our team of hand surgeons alongwith the therapists ensure that the treatment is continued till the function of the handis restored and the patient is rehabilitated.

We also provide treatment for congenital diseases of the hands, like syndactyly,polydactyly and radial club hand. The art of creating the thumb for a child who does nothave one requires skill, diligence and experience.



Pre Operative Toe Harvesting

Donor SiteHarvested Toe

Amputated Part Immediate Post Operative

Late Post Operative

Pre Operative

Post Operative

Pre Operative

Late Post Operative

Pre Operative Immediate Post Operative Late Post Operative

Toe transfer for thumb creation

Replant thumb

Replant little finger



HAND SURGERY 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017

Major Hand Reconstruction 2 2 3 3 3 3 3 4 5 4 3

Blast Injuries 18 24 29 28 30 32 28 18 20 15 12

Finger Injuries 530 540 560 621 715 728 756 781 812 852

Suturing 280 258 312 328 325 336 331 342 356 383 436

Nail bed repair 97 120 157 160 163 182 206 212 202 226 220

Nail bed graft 3 2 8 6 9 6 8 10 8 8 6

FTSG 12 15 21 24 23 28 24 26 24 23 24

SSG 140 177 184 169 172 183 191 188 202 212 192

Terminalisation 150 172 190 163 180 162 178 182 163 195 155

Ray amputation 15 8 15 16 14 16 12 12 11 16 8

Tumor excision 1 3 12 11 13 12 9 11 12 18 16

I&D 12 15 17 21 16 18 19 21 18 28 23

JESS Fixation 8 10 13 12 14 16 18 16 14 14 12

Hematoma Evacuation 4 2 3 4 3 4 4 6 5 6 4

Surgery on Extensor Tendons 72 86 112 120 125 136 122 139 163 220 169

Surgery on Flexor Tendons 58 72 84 91 102 95 87 84 72 86 63

Compressive Neuropathies 36 42 49 51 54 48 62 74 68 82 54

Tumors 8 12 10 11 15 18 16 20 18 16 15

Infections 12 10 13 15 16 18 14 13 15 18 14

Local Flaps 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017

V-Y Flaps 18 23 32 29 36 38 42 54 49 52 41

Cross Finger Flaps 19 26 31 34 35 30 38 42 34 36 30

Chest Flap 1 1 0 1 0 0 1 2 1 0 0

FDMA 1 1 1 2 2 1 2 6 8 9 6

RDMA 1 2 2 1 5 6 6 7 8 6 5

Groin flap 16 21 27 31 36 32 37 36 42 39 28

Lateral arm flap 1 2 1 1 3 4 5 6 8 7 5

Free flaps 4 6 4 3 3 5 4 3 4 6 5

Statistics



Pre Operative Defect and Flap Marking Immediate Post Operative Late Post Operative

Pre Operative Pre Operative Post Operative Post Operative

Pre Operative Post Operative Post Operative

Pre Operative Flap Before DivisionGroin Flap Marking Late Post Operative

Pre Operative Flap Elevation Post Operative

RDMA flap for finger

Radial club hand

Pollicisation - Index finger for thumb

Hand reconstruction- Groin flap

Finger dorsal defect- Hatchet flap



Reconstructive microsurgery is the application of micro-vascular and micro-neuraltechniques for the ultimate reconstruction of a variety of defects. These techniques utilize fineinstruments, microsutures, and operating microscope.

In plastic surgery, microsurgery is applied to surgery of the hand, replantation, and tomove of tissue from one area to another, re-establishing its blood supply and possibly nervesupply (this application is called free tissue transfer). Micro-vascular reconstruction has evolvedover the past decade to be the standard of care for many difficult reconstructive problems.

We at SIPRAS have dedicated team of trained expert micro-surgeons and equipment forthe best possible outcomes in microsurgery.

We routinely perform microsurgeries like

Replantations and revascularisations: Reattaching amputated and devascularised fingers ,toes or limbs. Our specialist plastic surgeons are available round the clock and with theoperating rooms exclusively dedicated to micro-vascular surgeries, we are able to avoid anydelay in surgeries and thereby optimising the chances of salvage of the amputated parts.

Micro-neural surgeries: In Brachial Plexus Injuries and peripheral nerve injuries, both inthe emergency and elective set up which involve repair of traumatised and transected nervesas well as the transfer of appropriate nerves to aid speedy and best possible functional recovery.

Micro-vascular free tissue transfer: Covering open fractures of bones and critical raw areaswith skin and soft tissues using free flaps of various kinds and from various donor sites. Ourmicrosurgeons are experts in handling and operating blood vessels as small as less than 0.8mmin diameter and those classified under super micro-vascular surgery. The latest state of the artmicroscopes, using the international standard Carl Zeiss optics, available at our centre helpsus attain the best possible results in such cases. We also routinely do micro-vascular surgeriesfor reconstruction of defects like congenital facial anomalies, toe transfers and free functioningmuscle transfers for a functional limb and for facial reanimation.



ALT ( Anterolateral Thigh) Flap For Forearm & Hand Dorsal Defect

Pre Operative Flap Elevation Post Operative

Pre Operative Post Operative

Pre Operative Flap Post Operative

Pre Operative Flap Marking Flap Elevation Post Operative

ALT For Leg & Foot

Medial plantar artery flap

MSAP ( Medial Sural Artery Perforator) flap for leg defect



Micro surgical Free Flaps 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017

Upper Limbs andLower LimbsToe Pulp 0 0 0 0 0 0 1 1 2 1 1T-DAP 0 0 0 0 0 1 2 1 2 2 1

Gracilis Flap 9 12 15 18 21 19 20 23 21 20 10

Latissimus dorsi Flap 8 9 18 21 24 27 23 27 31 28 19

Anterolateral Thigh Flap 12 22 38 36 30 28 26 23 22 16 8

Free Fibula flap 2 3 2 4 4 6 5 4 4 3 2

Toe transfer 1 2 3 2 0 1 0 1 1 1 0

Parascapular Flap 5 8 6 7 8 5 6 3 2 2 1

Rectus abdominis 1 0 1 0 1 1 2 1 1 0 0

Vastus Lateralis Free Flap 8 6 9 8 9 12 11 12 15 13 8

MSAP Flap 1 2 4

Medial plantar artery flap 1

Statistics

Sushrutha Samhitha is a collection of medical teachings of the Indian saints handed down over the generations



Omentum flap cover for scalp avulsion injury

Pre Operative Omental Flap Immediate Post Operative

Post Operative Post Operative

Amputated PartStump Immediate Post Operative

Late Post Operative Late Post Operative Late Post Operative

Pre Operative

Replant hand at the wrist level

Replantation Upper limb

Post Operative17Sushrutha Institute of Plastic Reconstructive & Aesthetic Surgery

www.thrissurplasticsurgery.com


Three finger crush - Revascularisation

Pre Operative Volar Pre Operative Dorsum Immediate Post Operative

Late Post-Operative Dorsum Late Post Operative Late Post Operative Writing

Bilateral Thumb replantation

Pre Operative Left Pre Operative Right Amputated Parts

Late Post Operative Replant Late Post Operative



Free Toe pulp flap for ring fingertip defect

Pre Operative

Post Operative

Intra Operative

Toe pulp for Thumb defect

Defect Pre Operative Flap Marked Post Operative

Partial Toe transfer for thumb defect

Pre Operative Donor Site Post Operative



Brachial plexus comprises of the network of nerves that supply the upper limb arising from spinal cord.Pathologies of brachial plexus mostly occur due to injuries during child birth or in adults following road trafficaccidents. They also occur due to tumours involving the nerve sheaths, compression neuropathies like thoracicoutlet syndrome. In our institute all the above mentioned pathologies needing surgical treatment are treated byadvanced microsurgical techniques by a team of experts. Our centre is one of the few centres in the country offeringthese surgeries.

Obstetric brachial plexus palsy

Patients present to us either immediately or following initial evaluation elsewhere. All these babies’ mothersare instructed about physiotherapy for initial 3 months for which we give separate pamphlets. Then they are reviewedfor spontaneous recovery at appropriate age, when not present, are taken up for the appropriate surgery. In ourinstitute we do both nerve transfers and nerve grafting, by individualizing the treatment required for a particularpatient. Following the surgery patients are kept under proper follow up and further treatments like muscle release,Botox injections are also being done as and when deemed appropriate. Muscle transfers and free functioning muscletransfers are also being done as per the childs functional requirements. Having done more than two hundred casesof obstetric brachial palsy, our centre is one of the very few high volume centres not only in Kerala but also acrossthe country giving a comprehensive care for such unfortunate children.

Adult brachial plexus palsy

Most of adult brachial plexus palsies that present to us are following trauma. Their clinical presentations andtime at presentation varies across a wide spectrum of immediate partial plexus injuries to delayed pan plexusinjuries. After evaluating the patient with MRI and electro-diagnostic studies as appropriate, treatment plan isindividualized. Nerve transfers, nerve grafting, opposite C7 transfers, muscle transfers all are being done here.Having operated on more than 200 cases of adult brachial plexus injuries, we are again one of the very few centrespractising even the latest innovation in opposite C7 transfer, the Wang procedure with better predictable andsatisfactory results to the patient. All the patients are kept on proper long term follow up with physiotherapy andfurther treatment as and when required.

BRACHIAL PLEXUS SURGERY2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017

Obstetric Brachial Plexus PalsyMuscle Transfer /Nerve 8 10 14 15 14 16 16 17 16 16 18 Transfer/Botox

Adult Brachial Plexus InjuryMuscle Transfer/ 8 12 10 12 14 12 13 14 15 15 16Nerve Transfer

Tumor/Sarcoma 0 0 0 1 0 0 0 1 1 1 1



Obstetric Brachial plexus Sugery

Pre op- Not able to lift the right arm Post Operative

Pre op- Not able to lift the upper limb Post Operative




Adult Brachial plexus Sugery



Peripheral nerve disorders that need surgical treatment encompass acute nerveinjuries, entrapment neuropathies and nerve tumours. Treatments also varyaccording to a particular patient’s requirement and the underlying basic pathology.They are decompression procedures as in carpal tunnel syndrome, primary nerverepairs as in traumatic nerve transections, nerve grafting and nerve transfers asrequired in delayed presentation after a nerve injury and resection and grafting asin nerve sheath tumours or neuromas.

Our institute has been carrying out the whole spectrum of peripheral nervesurgeries since 2007. Procedures are performed here by experts with a well-trainedteam and advanced equipment. Facilities for initial investigations like nerveconduction studies, electromyograms are also available at the hospital make it easierand convenient for the patient , to get a comprehensive care in such cases.

These surgeries are followed by physiotherapy as per need, by the well-readand trained team of physiotherapists available at the hospital.

PERIPHERAL NERVE SURGERY2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017

Digital Nerve 78 120 126 129 132 158 172 183 197 225 212

Medial Nerve 33 46 55 59 62 69 76 92 86 98 72

Ulnar Nerve 34 35 56 61 72 88 84 79 73 82 68

Radial Nerve 25 24 36 37 38 36 42 52 59 62 53

Nerve Grafts 24 23 33 37 36 48 38 45 52 71 42

Nerve Transfers 6 12 18 21 20 22 26 28 32 36 28

Neurolysis 2 5 8 10 14 15 12 16 18 19 16



Nerve transfer for finger function

Pre Operative Intra Op

Late Post Operative Late Post Operative

Ulnar nerve decompression at elbow and Guyon's canal

Pre op Intra op Intra Op

Secured with fascial slingNerve transposedNerve dissected

Ulnar nerve transposition



Cosmetic plastic surgery includes surgical and nonsurgical procedures thatenhance and reshape the body to improve appearance and confidence of theindividual.

Our experienced team of aesthetic surgeons at SIPRAS specialize in.Rhinoplasty

Aesthetic correction of nose for congenital defects, post traumatic deformitiesand plain cosmetic correction for the more concerned clientele is done at ourinstitute with good results and a satisfied patient population to vouch for it.

Surgery for the ageing faceTo reverse the changes of ageing that appear on the face, neck and eyelids

with a long lasting result, face lifts, neck lifts and blepharoplasties are done herewith optimal results and satisfied patients.

Facial aesthetic surgeriesRemodelling of the facial skeleton in congenital and posttraumatic

deformities, like mandibular and maxillary ostotomies are done in our department.Liposuction

Liposuction is a minimally invasive procedure to get rid of the excess fatdeposits under the skin that make you look fat especially in localised areas likethe abdomen, male chest , arms, buttocks, thighs and under the chin.

Fat graftStructural fat grafting using patients own fat harvested by minimally invasive

techniques and transferred using modified Coleman’s technique has given goodresults in patients with cosmetic soft tissue deficiencies, either congenital oracquired. It is also used for cosmetic augmentation of breasts and buttocks. Nanofat grafting improves the skin quality by rejuvenation and improves scar quality.

Abdominoplasty/Tummy tuckFor clients who have a problem with excess skin and fat in the abdomen,

especially middle aged and elderly ladies postpartum, abdominoplasty is thesurgery of choice.

It is also done in conjunction with umbilical and incisional hernia correctionwherein the excess skin and fat are excised leaving an inconspicuous scar and arejuvenated and repositioned aesthetically placed umbilicus with a reinforced andstrengthened abdominal wall musculature.



Abdominoplasty



Pre Operative Implant Post Operative


Facial Contouring- Fat graft

Breast Augmentation

Breast reduction



Depiction of surgical procedures for the war wounded from the ancient Greek civilization

Hair restorationHair loss management and hair restoration therapies

are multi modal, including a spectrum of medicalmanagement with drugs and scalp applications, injectiontherapies, LASERs and hair transplantation, surgeries. Atour centre we focus on the comprehensive managementof hair loss and hair restoration using all the modalities inoptimal combination. Having expertise in both the strip(FUT) and FUE techniques of hair transplantation we caterto the needs of clients for baldness, scar alopecia,moustache and eye brow reconstruction with state of theart facilities and at affordable costs.

Breast surgeriesOur centre caters to the cosmetic needs of the fairer

gender in breasts by providing surgeries for breastreshaping in sagging breasts by mastopexies, cosmeticreduction of large breasts and augmentation of breasts asper patient’s desire using both implants and patients ownfat as grafts. Many of these surgeries are life changing in

empowering the clients with a boost in their self-confidenceand body image as well as functional such as in cases ofmacromastia.

Male breasts we help the adolescents and the image conscious male

population with difficulties due to their enlarged breasts(gynaecomastia) with minimally invasive techniques ofliposuction and transnipple excision of breast fibrous tissueoffering them a very negligible post-operative recoverytime compared to conventional surgeries.

Genital rejuvenation surgeriesFor female post-partum vaginal laxity and for aesthetic

improvement of the intimate female anatomy, vulvo-vaginal rejuvenation surgeries are being done in ourdepartment.

Tattoo and scar removal surgeriesUsing the fine techniques of cosmetic surgery we

reshape and revise ugly scars and undesired tattoos leavingvery negligible and aesthetically placed scars.



Gynaecomastia


Hair transplant


Hemifacial microsomia - bone grafting


Lip Reduction




COSMETIC /AESTHETIC SURGERY2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017

Gynaecomastia 18 26 35 36 38 40 38 42 44 48 36

Abdominoplasty/ 11 15 24 23 23 22 25 24 27 31 28Hernia repair

Body Countouring 3 10 12 10 9 10 12 11 10 9 7

Liposuction 3 5 8 12 - 16 18 16 20 26 18(Flanks, Thigh, arm, chin)

Reduction Mammoplasty 1 4 5 4 5 4 4 5 6 8 4

Breast Augmentation 1 2 2 3 2 2 3 4 3 3 3

Rhinoplasty 15 12 16 15 18 16 15 13 14 12 6

Secondary Rhinoplasty 11 12 14 16 12 10 10 9 11 10 5

Tip Plasty 8 6 8 7 6 7 8 8 7 6 5

Genioplasty 1 1 2 1 1 1 1 1 2 2 1

Hair Transplant 2 3 8 11 10 14 16 18 15 16 12

Otoplasty 1 0 1 2 2 3 2 2 3 2 1

Fat Injection 16 19 25 26 23 25 26 28 30 36 38

Laser 72 70 75 80 82 75 79 81 83 76 73

Microdermabrasion 123 125 120 129 132 148 152 165 174 182 128

Chemical Peeling 30 35 32 36 38 42 56 67 80 75 54

Photo Rejuvenation 57 53 45 54 63 59 67 74 79 82 63



Lip Reduction


Masseteric hypertrophy


Orthognathic Surgery

Pre Operative Lateral

Post Operative LateralPost Operative Front

Pre Operative Front



Otoplasty


Post Bariatric Surgery

Pre Operative Post Operative Post Operative

Rhinoplasty


Rhinoplasty





Abdominoplasty

Testicular implant

Pre Operative Post OperativeImplant

Vascular malformation lip




Surgeries are undertaken by experts in our department to tackle various congenitalanomalies like

Cleft lip and palate

We help the children with this common and devastating congenital anomalies withtimely appropriate surgeries and rehabilitation protocols. All the complex surgeriesthat are needed for the comprehensive care of cleft of the lip and palate are donefree of cost for the deserving patients as part of our charity.

Other facial anomalies

Surgeries for deforming facial anomalies like Hemifacial Microsomia, Treacher Collinssyndrome and Pierre Robin Sequence are done at our centre with utmost care andusing the best possible options like free tissue transfer even including vascularisedbone transfer if needed

Congenital limb anomalies

We routinely deal with congenital limb anomalies like polydactyly, syndactyly, radialclub hand, CTEV, other finger anomalies like campto and clinodactyly. With thesupport of our able team of physiotherapists, we give comprehensive surgical andconservative management for these afflictions.

CONGENITAL DEFORMITY CORRECTION2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017

Cleft Lip 8 14 21 19 18 15 10 12 7 8 5Cleft Palate 10 12 26 23 28 23 18 10 8 5 3Radial Club Hand 2 2 2 3 2 3 2 3 2 2 1Pollicisation 2 2 3 2 2 3 2 2 2 2 0Trigger thumb 8 10 12 10 12 9 13 8 10 12 9Macrodactyly 1 1 2 3 2 3 2 4 3 5 3Syndactyly 3 4 9 14 12 15 19 16 15 18 8Constriction ring syndrome 2 2 3 3 4 3 5 4 6 5 3Thumb Duplication 1 0 1 0 0 1 1 0 0 0 0Cleft Hand 1 0 0 1 2 2 1 3 2 1 1Polydactyly 2 4 3 3 3 4 3 5 3 4 2Hypospadias 1 2 5 6 5 4 3 3 4 5 3Cleft lip secondary



Cleft lip

Cleft lip

Cleft lip




Congenital thumb duplication




The growth of plastic surgery, as with all other surgical sciences,was associated with major battles and wars along the history of mankind



Vascular Malformation - Sclerosant Injection Treatment

Post TreatmentPre Treatment

Hemifacial microsomia


Hypospadias

Syndactyly fingers

Pre Operative Post Operative MicturitionPost Operative




We have a large patient population of chronic wounds like

Diabetic foot

We aim at the salvage of maximum possible limbs by timely intervention and bestpossible conservative therapies. With the support of our physician and diabetologistcolleagues, we are able to give the optimum care for such patients with diabetic wounds.The use of technologies like the negative pressure wound therapy, the limb salvagerate has increased drastically and the duration of hospital stays and thereby theeconomic and social setbacks have been considerably reduced. We use the aid of trainedexpert prosthetists to provide custom made footwear and prosthesis appropriate forthe patients.

Pressure sores

Another chronic wound of concern to a large population of patients is the pressuresore. Mostly seen in chronically bed ridden patients, they rob the patients of theirfinancial resources as well as quality of life. We At our centre provide excellent care forpressure sores by skilfully combining conservative wound care methods and surgicaltechniques using a wide array of flaps, chosen as appropriate for the individual patient.



Negative Pressure Wound Therapy

Bedsore - Superior Gluteal Artery Perforator Flap


PBC Neck - Release and Parascapular Flap Cover

Before Application After Application

After Skin Grafting




Miscellaneous2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017

Diabetic Foot 739 1200 1553 1612 1659 1850 1789 1880 1896 2112 1982Debridement 221 412 467 512 612 801 725 912 859 954 632VAC 3 4 4 5 8 12 26 32 28 38 34Terminalisation/Disarticulation 36 55 59 62 72 79 63 68 73 82 64SSG 16 19 21 26 36 34 29 32 36 42 28

Pressure Sore 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017Sacral 38 54 62 59 54 61 48 38 40 36 22Trochantric 12 13 14 19 21 18 16 17 16 18 13Ischial 18 28 38 29 32 36 34 41 36 31 28Heel 9 12 18 21 19 12 14 16 14 15 12

Burns 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017Debridement 53 60 82 86 88 76 86 71 65 32 21Contracture Release 9 15 19 28 30 22 28 32 18 16 12Tangential excision 5 6 8 10 12 9 11 14 16 14 12Skin Grafting 18 26 38 32 36 42 39 45 38 33 28Local flap 15 23 32 33 36 42 51 56 48 41 36

Free flaps 1 2 4 4 5 4 6 5 6 5 2

Statistics

Arabs were pioneers of plastic surgery practice



Post burn Contracture

Pre Operative

Post Operative

Post Operative Post Operative

Post Operative

Pre Operative

Post Burns Contracture Neck- Release + ALT Flap Cover

Pre Operative Pre Operative



We deal with a lot of patients of skin and oral malignancies where aplastic surgeon has an undeniable role in proper surgical planning andreconstruction of the post ablation tissue defect. In combination withoncologists as need may be, we excise and reconstruct head and neckand skin defect using an array of techniques ranging from geometricallyplanned primary closures to complex reconstruction with vascularisedfree bone and soft tissue transfer. These help the patients to have a diseasefree survival with a good quality of life with aesthetic reconstruction ofdefects that could otherwise be grotesque.



BCC face - Mustarde's Cheek Rotation Flap

Pre Operative After Excision Immediate Post Operative Late Post Operative

Carcinoma lip - Estlander flap

Pre Operative Post OperativeFlap Marking Flap Inset

Carcinoma tounge - Radial artery Forearm flap

Pre Operative Post OperativeFlap Marked Immediate Post Operative

Ear reconstruction Post tumor excision

Pre Operative Post OperativeMarking



Lower limb trauma is one of the common challenges we face at SIPRAS. One of the mostcommon causes of lower extremity injuries is road traffic accidents. Injuries to the lower extremitymay involve the muscles, blood vessels, nerves and bone. Challenges faced in handling lower limbinjuries include managing the extent of injuries, the loss of blood which can be often life threatening,risk of reperfusion injury and its sequelae as well as injury to other organ systems like centralnervous system, chest and abdomen. A patient presenting in such a setting requires prompt andproper care as any delay can worsen the outcome significantly. Senior faculty in all departmentsare available at all times to manage such injuries. We have anaesthesiologists, neuro-surgeons,maxillofacial surgeons, orthopaedicians and general surgeons available round the clock to providetheir expert assistance along with us in managing these patients.

The treatment of a patient begins the moment he enters the hospital and finishes only oncehe is rehabilitated as a productive member of the society. These patients usually have a protractedcourse of therapy and we are with them all the way. We have expertise in micro-vascular as well asmicro neural procedures which help to restore the normal function of the extremity. Refinementsin free flap procedures have improved outcomes both in terms of function as well as aesthesis. Wealso have an active department of physiotherapy which helps to rehabilitate the patient once hiswounds have healed.

LOWER LIMB TRAUMA2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017

Lower limb inuries 222 280 352 435 612 714 841 852 841 789 547Major degloving inuries 98 112 116 124 142 138 141 153 144 162 132Split Skin Graft /FullThickness Skin Graft 92 125 142 186 215 199 228 216 238 252 284Ilizarov Fixation 8 9 12 15 14 16 12 10 8 7 6External Fixator 16 18 26 34 38 42 52 46 51 42 26LRS 8 12 14 18 26 32 37 36 33 29 24Free flaps 42 58 89 93 94 96 92 93 97 80 86

Toe Revascularisation




Foot bilateral crush

Late Post OperativeInitial appearenceAfter debridement

Foot reconstruction- Latissimus dorsi flap

Pre Operative Pre Operative Late Post Operative Late Post Operative

Lymphadema


TDAP ( Thoraco Dorsal Artery Perforator ) flap for foot dorsal defect

Pre Operative Flap Marking Flap Elevation Post Operative



HEAD & NECK 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017Suturing 148 182 228 248 239 248 257 265 332 368 288SSG 3 5 12 14 16 12 18 20 22 18 16Local Flaps 7 8 11 16 18 20 24 19 26 22 20Free Flaps 6 10 11 14 19 16 18 16 8 6 2Naevus excision 8 12 18 24 29 26 32 38 32 40 36Tracheostomy 17 20 24 26 22 18 12 10 8 6 4Parotidectomy 13 12 14 16 15 13 16 14 13 14 10Facial nerve surgery 3 2 4 7 6 8 8 7 6 8 6Dermoid cyst 6 8 12 10 8 12 14 12 13 12 10Vascular malformations 3 7 14 12 10 14 12 16 12 13 14Ear lobe repair 28 36 42 38 46 52 48 42 38 35 32Ear piercing 32 41 39 46 56 60 58 49 48 42 44Biopsy 22 38 30 42 40 35 42 48 38 36 31Tongue tie release 2 2 4 9 8 6 7 8 6 8 6Sebaceous cyst excision 8 6 6 12 14 12 15 12 14 12 10Lipoma excision 4 6 8 11 10 8 12 10 15 14 10

Facial Surgery 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017Nasal & Zygomatic boneelevation 22 29 27 26 31 32 28 18 22 19 12Orthognathic Surgery 1 2 1 2 2 2 3 2 4 3 3Major head & Neckreconstruction 24 23 23 24 25 26 24 20 15 13 10

Head and neck reconstruction is an integral part of Plastic Surgery. We at Sushrutha perform various procedurespertaining to head and neck reconstruction.

Malignancy of the head and neck region is one of the major killers in our population. We provide services for thesurgical management of such tumors. In tandem with the oncological team, we perform resection, lymph node dissectionsand reconstruction of the resulting defect. We have multiple tools in our armamentarium, ranging from local flaps to freeflaps.

Swellings arising from the Salivary glands (Pleiomorphic adenomas, etc) are managed with excellent results. It involvesdelicate dissection, preserving the facial nerve, which makes us the ideal surgeons to perform these sort of procedures.

Reconstruction of the burnt face and neck is also a burden borne by the Plastic Surgeon. We at Sushruthaperformrelease and reconstructions using grafts or flaps, as required. This results in both cosmetic and functional relief for thepatient.

Traumatic injuries to the head and neck regions are frequent, especially in high velocity trauma. We provide round theclock facilities for management of such injuries. We at Sushrutha have excellent support from other specialities likeneurosurgery, orthopaedics, anaesthesia and critical care. This allows us the take care of the patient in a comprehensiveand holistic manner.



Ear lobe reconstruction


Ear reconstruction

Pre Operative Intra Op Post Operative

Facial reanimation


Facial trauma reconstruction


Intra Operative Planning Gracilis Flap Harvested Flap Inset



Mandible Reconstruction- Free Fibula Flap

Pre op- Carcinoma alveolus free fubula osteocutaneous flap Post Surgery

Nose - Bilobed flap

Post Operative Marking Flap Transfer Immediate Post Operative Late Post Operative

Nose - Forehead flap

Pre Operative Forehead Flap Late Post Operative

Rhinophyma




Total Conservative Parotidectomy

Scalp reconstruction - Rotation flap

Pre Operative Intra Operative Facial Nerve Dissection

Excised Parotid Gland Post Operative

Pre Operative Pre Operative Marking Immediate Post Operative Late Post Operative Late Post Operative

Total Conservative Parotidectomy

Pre op Pre op Facial nerve dissected Excised gland



At SIPRAS we have a national board accredited six year post graduatetraining programme. Our students get exposure to almost all types ofcases that come under the purview of Plastic surgery. We have a well-structured training programme where students attend case planningand presentation sessions and theory discussions every week. All theconsultants take part in every academic session so that the studentsget the benefit of the experience and knowledge of the whole team.They also get mock exams and case presentations to prepare them forthe very demanding board exams.The training programme started in the year 2011 and with an intake ofone student per year we have five students undergoing training with usnow. Our first trainee has cleared his final exam in December 2016 inhis first attempt and has made us all proud.

DNB Training

Dr. Anitha M, Dr. Harsha Vardhan, Dr. Ram Prabhu M, Dr. Subramanya B.R., Dr. Nanthini Dhevi



Our hospital management has been gracious to have provided us with anexclusive dedicated team of staff- both clinical and administrative, rightfrom the inception of our department. The nursing staff, having beenattached to the same unit for long, having been trained in assisting plasticsurgery procedures and patient care specific to the speciality, and havebeen the pillars of support in enabling comprehensive patient care. Thededicated administrative office staff take care of the public relations andhelps in patient conveniences as arranging appointments, ensuring properfollow up, coordinating social welfare and insurance services and recordmaintenance. They also are our main support in arranging and conductingvarious academic and public interaction events, maintaining follow up andcommunication with referring centres and physicians. As conceptualisedat the inception, the incorporation of exclusive support staff in the patternof SIPRAS has helped us a long way in travelling this distance withsatisfaction of providing optimal care and encourage us to look forward tostepping up our quality of work notch by notch at par with the expectedexcellent standards.

Staff



In connect with our concept of imparting knowledge and sharingexperiences to our medical fraternity, we have been conductingannual Continuing Medical education programmes. Each year, wehave dedicated the focus of the programme on a specific aspectof plastic surgery practice and have tried to make the programmesworth the participants’ time. Renowned international and Indianfaculty have been invited for each event and were rich academictreats.We have conducted ten Academic events so far and all theregistrations to the event and hospitality was on the house andall those events so far have been appreciated and have gone wellamong the members of the fraternity.



Nervecon

Dr. Mukund Thatte Dr. Raveendra Bhat Dr. Vijay Joseph Dr. Ashok Raj Koul Dr. Sudheer Warrier

Dr. Sridhar Dr. Mukund Thatte Dr. Krishna Kumar Dr. Gautam Biswas Dr. Jayakumar



Head & NeckReconstruction Dr. Sreekumar Pillai Dr. Sameer Kumta

Dr. Shivram Bharadhwaj Dr. Antony Aravind Dr. Prabha Yadhav Dr. Subramania Iyer

Dr. Nandakumar U. Dr. Bijoy Methil

Dr. Giovanni Botti Dr. S. Raja Sabapathy Dr. C. Thomas Dr. Ramachandran



Dr. Vidyasagaran Dr. Jerry Paul

Dr. J. Mohan Dr. Athul Kumar Shah Dr. A.K. Singh

Dr. Jayakrishnan Dr. Murugesan

Dr. Roy Kanjoor Dr. Ramachandran Dr. Sundeep Vijayaraghavan Dr. Jayakumar



Dr. P.V. Narayanan Dr. H.S. Adenwala

Dr. Ramesh Sharma Dr. Roshni Gopinath Dr. Jiten Kulkarny

Dr. P.J. Jacob Dr. Ani Raj R.

Dr. Ashok Raj Koul Dr. Bhaskara Dr. Adhish Basu


Dr. Jerry R. John


BurnsDr. Sunil M Keswani Dr. A.K. Choudhary

Dr. Karoon Agrawal Dr. Chandini Periera Dr. Ani Raj R. Dr. Roshni Gopinath

Dr. Lakshmi M. Dr. Jimmy Mathew

Dr. Krishnakumar Dr. Siby Punnoose Dr. Sridhar Dr. Manoharan


56 Sushrutha Institute of Plastic Reconstructive & Aesthetic Surgerywww.thrissurplasticsurgery.com56 Sushrutha Institute of Plastic Reconstructive & Aesthetic Surgerywww.thrissurplasticsurgery.com


1. Anaesthesiology2. Audiology3. Cardiology4. Dental Surgery5. Dermatology6. Diabetology7. Emergency Medicine8. E.N.T.9. Gastroenterology10.General Medicine11.General Surgery12.Gynaecology and

Obstetrics13.Microbiology14.Neonatology

15.Nephrology16.Neurology17.Neurosurgery18.Obesity clinic19.Ophthalmology20.Orthopaedics21.Pathology22.Paediatrics23.Physiotherapy24.Psychiatry25.Psychology26.Pulmonology27.Radiology28.Rheumatology29.Urology


59Sushrutha Institute of Plastic Reconstructive & Aesthetic Surgerywww.thrissurplasticsurgery.com 59Sushrutha Institute of Plastic Reconstructive & Aesthetic Surgerywww.thrissurplasticsurgery.com


State of the art most modern innovations in thefield of plastic surgery are available at our centre

which help us give the best possible resultsin the cases we undertake,

be it reconstructive or aesthetic.The various new generation machines and

equipment available at our institute include

1. Micro aire power assistedliposuction

2. Negative pressure woundtherapy- VAC

3. Fibrin glue for nervecoaptation

4. Coleman technique fat transferfor structural fat grafting

5. LASER for pre and post-operativetherapy like in epilation



Dr. ANILJITH. V.GMS (General Surgery) MCh (Plastic Surgery)

Lectures delivered (From Oct -2007)Invited lecture “ bed sore and its management” – Orthoclub,Thrissur 2009Invited lecture “Cosmetic Surgery” – IMA , Thrissur,2010

Attended Conferences (From Oct -2007)1st Annualconferences SIPRAS –”Trauma care” – Thrissur 2008.Basic hand course – October 2008 Thrissur15th KPSA instruc tional course – Aesthetic surger y-Trivandrum,22nd August 2009.2nd annual conference SIPRAS – “Nerve Con 2009”- Thrissur2009.Haircon 2009 – 1st annual conference of association of hairrestoration surgeons – 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 ofAesthetic Plastic Surgeons – Port Blair ,Andamans -2nd and3rd April 2010.18th KPSA instructional course and 3rd annual conferenceSIPRAS “ Head and neck reconstruction “-Thrissur 2010.

24th KPSA conference, 19thKPSA Instructional course and 4th

Annual conference SIPRAS – April 29th,30th and 1st May 2011.5th Annual conference of Indian Society of Facial plastic andreconstructive surgery – Kumarakom 2011.Indian Society of Facial Plastic and Reconstructive Surgery,February 2011 – Kottayam.Workshop in Ear reconstruction “ Sreeramachandra MedicalCollege , Chennai”- January 29th&30th 2012AESURG 2012 – March 2012, Kodaikanal5th Annual conference SIPRAS “Plastic Surgery and TraumaCurrent Trends” – 6th OCT 2012, Thrissur.6th Annual conference SIPRAS “ Aesthetic Plastic Surgery”- 26th

Oct 2013, Thrissur.7th Annual conference SIPRAS “Pediatric Plastic Surgery” – 8th

Nov 2014, Thrissur.8th Annual conference SIPRAS “ Lower Limb Trauma” – 3rd Oct2015, ThrissurAPSICON 2015 – December 2015, Mumbai.NABICON 2016 - Orrissa9th Annual conference SIPRAS “ Burns” – 23rd Oct 2016, Thrissur30th KPSA conference 2017 and 10th Annual conference SIPRAS- April 7th ,8th&9th 2017.SAMHITA APSICON 2017, 15th -19th Nov, Kochi



Lectures delivered (From Oct -2007)“Diabetic foot” – Thrissur 2007“External fixators” – Kannur 2008“Hand Infections” – ( Basic Hand Course) Kannur 2008“Pulp space infection , Flexor tendon sheath infection , Skingraft”- Kannur 2009“Pediatric hand injuries and Splinting “– Kannur 2009.“Dupuytren’s contracture” – Trivandraum 2010.Various hand surgical Procedures – Kottayam 2013Heel pad Avulsion injuries – Thrissur 2013Scaphoid Fracture – Palakkad 2014

Attended Conferences (From Oct -2007)Basic hand course- Kannur 20081st Annualconferences SIPRAS –”Trauma care” – Thrissur 2008.Basic hand course- Thrissur 2008Basic hand course- Banglore 20092nd annual conference SIPRAS – “Nerve Con 2009”- Thrissur2009.8th Asian Pacific Federation of Societies of Surgery of Hand –Taiwan 200918th KPSA Instructional Course and 3rd Annual ConferenceSIPRAS “ Head and neck reconstruction “-Thrissur 2010.Ganga International Wrist course 2011.24th KPSA conference, 19thKPSA Instructional course and 4th

Annual conference SIPRAS – April 29th,30th and 1st May 2011.

AESURG 2012 – March 2012, KodaikanalISSHCON 2012 – 8th& 9th Sept, 2012, Amritsar.5th Annual conference SIPRAS “Plastic Surgery and TraumaCurrent Trends” – 6th OCT 2012, Thrissur.International Hand Conference - 4th& 5th March , 2013, DelhiKPSA conference – 26th ,27th and 28th April 2013, Kottayam.6th Annual conference SIPRAS “ Aesthetic Plastic Surgery”- 26th

Oct 2013, Thrissur.OASIS conference - 16th August 2014, Palakkad7th Annual conference SIPRAS “Pediatric Plastic Surgery” – 8th

Nov 2014, Thrissur.Foot and ankle symposium – May 9th ,10th and 11th ,EKM8th Annual conference SIPRAS “ Lower Limb Trauma” – 3rd Oct2015, ThrissurKOA conference 2016 – ThrissurOperative Hand Course – July 8th -10th 2016, Coimbathore9th Annual conference SIPRAS “ Burns” – 23rd Oct 2016, Thrissur61st IOACON 2016- December 2016.30th KPSA conference 2017 and 10th Annual conference SIPRAS- April 7th ,8th&9th 2017.Brachial con 2017 – 9th Biennial National Conference of BrachialPlexus Surgery Group of India – 28- 30th July 2017, Mangalore.ISSHCON 2017 – 41st Annual conference of Indian society forsurgery of the hand – 21st -23rd Sept 2017, Mumbai.SAMHITA APSICON 2017, 15th -19th Nov, Cochi

Dr. Anto FrancisMS (Orthopeadics) MCh (Plastic Surgery)



Dr. Shaji MathewMS (General Surgery) MCh (Plastic Surgery)

Lectures delivered (From Nov -2008)Oman experience in Plastic Surgery – Elite Mission Hospital monthlymeeting – Nov 2008“Pressure sore management “ Elite Mission Hospital meet 2009.“Lymphoedema management” IMA , Thrissur2009“Embryology of hand and classification of congenital anomalies ofhand” – Instructional course – Thiruvananthapuram – April 23rd

2010.Local & regional flaps in hand &Gynecomastia - Annual conference ofassociation of Plastic Surgeons of Oman -2013Tissue expansion – principles & application – Face 2013- 13/12/13Gynecomastia – 6th annual conference of SIPRAS, 26-10-13

Attended Conferences (From Nov-2008)1st Annualconferences SIPRAS –”Trauma care” – Thrissur 2008.Basic hand course – Thrissur 2008INDOCLEFT con 2009 – 8th annual conference of Indian Society of CleftLip, Palate and Craniofacial Anomalies , 12th Feb 2009, Pondichery15th KPSA instructional course – Aesthetic surgery- Trivandraum , 22nd

August 2009Annual CME Association of surgeons of India , Thrissur , 12th and 13th

Sept 2009Haircon 2009 – 1st annual conference of association of hair restorationsurgeons – India – Ahamedabad , 18th -20th December 20092nd annual conference SIPRAS – “Nerve Con 2009”- Thrissur 2009.18th KPSA Instructional Course and 3rd Annual Conference SIPRAS “Head and 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 AestheticPlastic Surgeons – Port Blair ,Andamans -2nd and 3rd April 2010.INDOCLEFT con 2011 – Annual conference of Cleft Lip, Palate andCraniofacial Surgery, Chennai, February 2011.

TANPAPS- Annual conference of Tamilnadu Association of PlasticSurgeons of India – Goa 2011.Amrita Tutorials in Plastic & Reconstructive Surgery – Kochi, March11th -13th 2011.24th KPSA conference, 19thKPSA Instructional course and 4th Annualconference SIPRAS – April 29th,30th and 1st May 2011.Workshop in Ear reconstruction “ Sreeramachandra Medical College ,Chennai”- January 29th&30th 201225th annual conference of KPSA, Kochi – 4th ,5th&6th of May 2012.21st KPSA instructional course , Kochi – 8th& 9th Sept 2012.5th Annual conference SIPRAS “Plastic Surgery and Trauma CurrentTrends” – 6th OCT 2012, Thrissur.APSICON 2012 – Annual conference of association of Plastic Surgeonsof India – St George Medical University ,Lucknow- 4th -8th Nov 2012.6th Annual conference SIPRAS “ Aesthetic Plastic Surgery”- 26th Oct2013, Thrissur.Work shop on hair transplant surgery , Amritha Institute of MedicalScience , Kochi – 31stJan,1st& 2nd Feb 2014Annual conference of association of hair restoration surgeons ofIndia, Goa – 19th ,20th and 21st Sept 2014.7th Annual conference SIPRAS “Pediatric Plastic Surgery” – 8th Nov2014, Thrissur.8th Annual conference SIPRAS “ Lower Limb Trauma” – 3rd Oct 2015,Thrissur9th Annual conference SIPRAS “ Burns” – 23rd Oct 2016, ThrissurAmritha Hospital, Kochi- 18th&19th Nov 2016.Diabetic Conference , Aurangabad30th KPSA conference 2017 and 10th Annual conference SIPRAS -April 7th ,8th&9th 2017.SAMHITA APSICON 2017, 15th -19th Nov, kochi



Presentations1. Routine topic presentations during post graduation and super

specialization.2. Faculty lecture ‘Locally advanced breast cancer – an overview’,

Annual conference, Association of surgeons of India. June 1999.3. ‘Laprostomy in diffuse intra-abdominal sepsis’, Peripheral

conference, Association of surgeons of India. October 1998.4. ‘Primary psoas abscess’, Annual conference, Association of

surgeons of India. February 1998.5. ‘Post operative complications’, Amala cancer hospital. March 2002.6. ‘Free flaps in Head & Neck reconstruction’, Peripheral meet,

Association of surgeons of India. February 2001.7. ‘Lower limb – vascular injuries’, Annual conference, Association

of plastic surgeons of India. Kochi.8. ‘Management of huge ventral hernia’, Annual conference,

Association of plastic surgeons of India. Calicut. April 2005.9. ‘Experiences of a beginner in plastic surgery’, 5th south zone Ass of

plastic surgeons of India conference, thrissur, may 200610. Invited lecture – ‘possibilities in plastic surgery’ IMA Thrissur ,

200711. Invited lecture – ‘possibilities in plastic surgery’ IMA

Wadakkanchery , 200712. Invited lecture – ‘possibilities in plastic surgery’ IMA Irinjalakuda

, 200713. Invited lecture – ‘possibilities in plastic surgery’ IMA Palakkad ,

200714. Invited lecture – ‘possibilities in plastic surgery’ IMA

Kunnamkulam , 2007

15. Invited lecture – ‘possibilities in plastic surgery’ IMA Thrissursurgical club , 2007

16. Invited lecture – ‘possibilities in plastic surgery’ IMA West fortclinical meeting , 2007

17. Invited lecture – ‘reconstructive microsurgery’ IMA Thrissur , 200718. Invited lecture – ‘reconstructive microsurgery’ Thrissur surgical

club, Thrissur , 200719. Invited lecture VIDEO PRESENTATION – free radial artery forearm

flap, KPSA instructional course, Trivandrum, 2007.20. Invited lecture – ‘reconstructive microsurgery’ Thrissur ortho club,

Thrissur , 200821. Invited lecture – ‘possibilities in resection & reconstruction of oral

cavity and head and neck cancers’ Indian Dental Association,Thrissur , 2007

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

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

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

25. ‘’Experience with T-DAP’’ flaps’- Indian society of reconstructivemicrosurgery – biennial meeting Delhi, –feb 2008.

26. Invited lecture , VIDEO PRESENTATION, ‘PMMC FLAP’’, 31st annualconference of ASI, Thrissur, 2008

27. Invited lecture, aesthetic free tissue transfers in lower leg andfoot defects, KPSA, Kottayam, 2008

28. ‘’Experience with T-DAP’’ flaps’ , , KPSA, Kottayam, 200829. ‘’Reconstruction of abdominal & perineal defects with pedicled

Dr. Pradeep KumarMS (General Surgery) MCh (Plastic Surgery)



flaps’, KPSA, Kottayam, 200830. . Faculty, free fibula harvest, cadaver flap dissection workshop,

Organised by AIMS, Kochi, 200831. Invited lecture – ‘Adult brachial plexus injury’ Neuroyaan, state

NSI conference, Thrissur , 200932. Case presentation “Penis replant” “DIEP flap” “Toe transfer” –

Clinical Meeting, EliteMissionHospital, Thrissur – 19th March 2009.33. Invited lecture – “Reperfusion injury” Critical care society, Thrissur,

27th March 2009.34.Clinical case presentation – Surgical club, Thrissur on 22/04/2009.35. Faculty, cadaver flap dissection workshop, Organised by AIMS,

Kochi, 2008 & Anatomy, ThrissurMedicalCollege – June 13th& 14th

2009.36. Invited faculty – “Moderator on ALT & pedicles major flaps”- Head

& Neck Oncology Conference- 2009, Amritha Institute Of MedicalSciences, Kochi.

37. Invited lecture – “Onco Plastic Breast surgery “, Onco club Kozhikode38. Clinical case presentation – Doctors club, EliteMissionHospital39 . Faculty , Live workshop on Oncoplastic Breast conservation– BCSCON- 2010 –Department Of SurgeryCalicutMedicalCollege On

February 28th

2010 40 Invited lecture- Spinal Accessory Nerve Injury- KPSACon-TVM. on

April 2010.41. Free Paper - Composite Chimeric Tissue Transfer- KPSACon-TVM.

on April 2010.42. Chair free paper Session - Brachial Plexus Injury- KPSACon,-Tvm.

On April 2010.43. Clinical case presentation on ‘Penetrating neck injuries’, Surgical

club, Thrissur, 19th Aug 2010.44. Clinical case presentation – Doctors club, Thrissur, 31st Aug 2010.45. Faculty, cadaver flap dissection workshop, Organised by AIMS,

Kochi, 4th July, 201046. Faculty - lecture “Reconstruction of tongue & floor of mouth

defects” -18th KPSA in instructional course & 3rd annual conferenceof Sushrutha Institute of Plastic, Reconstructive & AestheticSurgery, Sept. 11th & 12th 2010.

47.Case presentation – “Disputed neurogenic thoracic outletsyndrome, Surgical club, Thrissur, 01st December 2010.

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

49. Faculty, panel discussion on nerve injuries, tendon injury andreplant, APLAST( plastic surgery tutorial), AIMS, Kochi, March 11th– 13th, 2011

50. Invited lecture – “ Brachial Plexopathy”. What a surgeon looks forin electro-diagnostics and what can be achieved” – thrissurneurological society. March 2011.

51. Invited lecture – “ Peripheral nerve transfers”, 24th annual stateconference – KPSA, 19th KPSA instructional course & 4th annualconference of Sushrutha Institute of Plastic, Reconstructive &Aesthetic Surgery, April 29, 30 &May 1st 2011

52. Invited lecture – “ Double crush syndrome – Does it excist ?” –Free paper session 24th annual state conference – KPSA, 19th KPSAinstructional course & 4th annual conference of Sushrutha Instituteof Plastic, Reconstructive & Aesthetic Surgery,

April 30th 201153. Invited lecture – “Obstetric brachial plexus palsy” – Association of

paediatrics of India – Kerala chapter, 7th June – 201154.Case presentation – “Peripheral nerve injuries”, Surgical club,

Thrissur, 26th October 201155. Invited lecture – “Nerve injuries of lower limb” – 20th KPSA

Instructional course, Calicut, 04th December 201156. Invited lecture – “ Peripheral nerve surgeries”, - Annual Conference

of the Association of Surgeons Of India – Kerala chapter, 4th, 5th&6th May 2012, Kottayam

57. Invited lecture – “ Obstetric brachial plexus palsy” – Trichurobstetric & gynecology society, 09th June 2012

58. Invited Lecture – “ Liposuction-Abdominoplasty” – Gynecologyclub, Thrissur, 18th October 2012

59. Invited Lecture - “ Obstetric brachial plexus palsy” – Kannur , 09th

February 201360. Invited Lecture –” Triple nerve transfer in BPI” – Video session.

26th KPSA CON 2013 Kottayam, 26th, 27th& 28th April 201361. Invited Lecture – “Secondary deformity correction in OBPI” 26th

KPSA CON 2013 Kottayam, 26th, 27th& 28th April 201362. Invited Lecture – “ Facial nerve injury following parotidectomy”,

Annual state conference of ASI – Kerala Chapter, 3rd May 2013.63. Invited Lecture – “ Liposuction”, Surgical club, Palakkad, 29th June

201364. Invited Lecture –”Peripheral nerve surgeries”, Surgical club,

Palakkad, 27th July 201365. Invited Lecture – “Vascularised ulnar nerve graft in brachial plexus

injuries” - 27th KPSA CON - 2014, Calicut, April – 25th, 26th& 27th

66. Invite Lecture – “BRACHION” – Live surgery workshop & CME,Govt.MedicalCollege, Calicut, 10th May 2014

67. Invited Lecture – National conference of Indian Society ofPeripheral Nerve Surgery – “NERVECON” – 2014 – November7,8,9– SGPGI, Lucknow – “Approach to patient with BPBP – When tooperate ? , Where to ?.

68. . Invited Lecture – National conference of Indian Society ofPeripheral Nerve Surgery – “NERVECON” – 2014 – November7,8,9– SGPGI, Lucknow – “ Approach to patient with BPBP shouldersequalae – muscle transfer”



69. Invited Lecture – National conference of Indian Society ofPeripheral Nerve Surgery – “NERVECON” – 2014 – November7,8,9– SGPGI, Lucknow – “Nerve transfer in forearm & hand”

70. Invited Lecture – National conference of Indian Society ofPeripheral Nerve Surgery – “NERVECON” – 2014 – November7,8,9– SGPGI, Lucknow – Video presentation – “Single stage facialreconstruction with gracilis FFMT with masseteric nerve”

71. . Invited Lecture – National conference of Indian Society ofPeripheral Nerve Surgery – “NERVECON” – 2014 – November7,8,9– SGPGI, Lucknow – Video presentation –

“ Vascularised ulnar nerve graft “72. Invited lecture , VIDEO PRESENTATION, “Single staged free

functioning muscle transfer for facial nerve palsy” – SAMHITA2015, 28th KPSA Conference – 2015 April 16th – 19th , Munnar.

73. Invited lecture – OBPP – When to operate? – SAMHITA 2015, 28th

KPSA Conference – 2015 April 16th – 19th , Munnar.74. Invited lecture – PLEXUS DEFINED- First International Hands – on

Cadaveric Brachial Plexus Dissection Course. Dept. Of Orthopaedics,M.S. Ramaiah Medical College & Hospital, Bangalore – 28th, 29th&30th August 2015

75. Invited lecture , VIDEO PRESENTATION – FFMT for facial palsy. Channal session – Adult brachial plexus injury. World congress of Neurosurgery 4th –7th Feb 201676. Invited lecture – The Erb’s shoulder – A Gordian Knot, KPSA con

2017, Thrissur77. Moderator – Symposium : Surgical strategies for pan adult brachial

plexus palsy, SAMHITA APSICON 2017, 15th -19th Nov, Kochi78. Invited lecture – Lead lecture - Primary repair of obstetric brachial

plexus palsy. SAMHITA APSICON 2017, 15th -19th Nov, Kochi

Courses / Conferences / Workshops1. Annual conference, Association of surgeons of India. June 1999.2. Peripheral conference, Association of surgeons of India. October

1998.3. Annual conference, Association of surgeons of India. February

1998.4. Annual conference, Association of surgeons of India. June 1998.5. Live surgical workshop on ‘Mandible reconstruction’. Amala CME

centre, January 1999.6. ‘Current trends in breast cancer’, Dept of Radiotherapy, Kottayam,

March 1999.7. National conference & workshop, surgical gastroenterology,

Madurai. September 1997.8. National trauma symposium, Kovai medical centre & hospital,

Coimbatore. September 1996.

9. Workshop on therapeutic endoscopy, Madurai. September 1997.10. South zone annual urology conference, Urological society of India.

October 1998.11. Continuing medical education programme, Madurai. 3 consecutive

years 1997,1998,1999.12. Indian society of gastroenterology, Kolenchery. September 1997.13. Association of surgeons of India, south zone, KG hospital,

Coimbatore CME and live workshop. June 1997.14. Programme on ‘Research methodology’, Kottayam. March 1999.15. ‘Neurolinguistic Programming’, Kottayam. December 1999.16. CME on anorectal diseases, Thrissur. March 1998.17. Annual conference, Association of surgeons of India. May 1997.18. Midterm conference, Association of surgeons of India. October

1997.19. Annual conference, Association of surgeons of India. February.

1997.20. CME ‘decade of the brain’, Neurosurgery. Kottayam. August 1998.

21.‘Update on breast diseases’, Association of surgeons ofIndia,Kottayam. April 1997.

22. ‘Development anamolies in children’, Paediatric surgery, Kottayam.January 1998.

23. CME – pancreas. Kottayam. January 1999.24. Peripheral conference, Association of surgeons of India. Kannur.

February 2001.25. ‘Update on thyroid surgery’, Kottayam. July 200226. ‘Infection control and hospital waste management’, 10th june 2003,

Medical college, Kottayam.27.‘National workshop on rapid free flap harvest’, 14th june 2003, NIMS,

Hyderabad.28.‘Microsurgery workshop’, 15th july 2003, Medical college, Kottayam.29. ‘Review course in hand surgery’, 2nd to 4th jan 2004, Ganga hospital,

Coimbatore.30. ‘Facial, plastic and reconstructive surgery’, 24th to 26th jan 2004,

Amritha institute, Kochi.31. ‘Burns’, 28th march 2004, Medical college, Thiruvananthapuram.32. ‘Operative workshop in paediatric urology’, 1st august 2004, St

John’s medical college,Bangalore.33. ‘Workshop on craniofacial surgery’, 6th to 8th august 2004, AJ

Institute of dental sciences, Mangalore.34. ‘Lower limb reconstruction’, Instructional course, 11th& 12th

December 2004, Medical college, Kottayam.35. ‘Reconstructive options in oncology’, 23rd jan 2005, RCC,

Thiruvananthapuram.



36. ‘Annual conference TNPAPS’, 27th to 30th jan 2005, Chennai.37. ‘Aesthetic plastic surgery’, Instructional course, 22nd to 24th april

2005, Medical college, Calicut.38. ‘Back to basics’, Instructional course, 30th&31st july 2005, Medical

college, Thiruvananthapuram.39. ‘Training in microsurgery’, conducted by the Indian Society for

Reconstructive Microsurgery, at Ethicon institute, Chennai. August 16-20,2005.40. Indian society for surgery of hand, workshop and conference, Kochi.

26-28 august 2005.41. Indian society of reconstructive microsurgery – biennial meeting

coimbatore –feb 2006.42. 5th south zone Ass of plastic surgeons of India conference, Thrissur,

may 200643. Annual conference of KPSA , Kochi, 200744. 1ST Instructional course in plastic surgery,TNPAPS ‘lower limb

reconstruction’ Coimbatore, 2007.45. KPSA Instructional course in plastic surgery, head and neck

reconstruction, Trivandrum, 200746. Annual conference of APSI, Pune 200747. Advanced head and neck cancers –symposium, Amritha institute,

Kochi, 200848. Indian society of reconstructive microsurgery – biennial meeting

Delhi, –feb 2008.49. 2nd national workshop on Propellar flaps, Chennai, 2008.50. 31st annual conference of ASI, Thrissur, 200851. 21st annual conference KPSA, Kottayam, 200852. 12th international perforator flap course, Coimbatore 2008.53. 21st annual conference of ISSH & 2ND combined BSSH meet,

Bangalore, 2008.54. 3rd biennial meeting , brachial plexus surgery group of India,

Coimbatore,200955. APSICON 2009, Mahabalipuram, Chennai.56. 2nd annual conference, “nervecon 2009” -Peripheral nerve / Brachial

plexus Repair & Reconstruction , Sushrutha Institute Of Plastic,Reconstructive & Aesthetic Surgery,EliteMissionHospital, Thrissur

57. C.M.E on Head & Neck surgery, I. M.A, Ernakulam58. Workshop Brachial plexus surgery, Chang Gung Memorial Hospital,

Taiwan ,2009.59. 8th Asian Pacific Federation of Societies for Surgery of Hand,

Kaohsiung, Taiwan.November 13 – 15, 2009.60. “KPSACon” - Tvm. April 2010.61. cadaver flap dissection workshop, Organised by AIMS, Kochi, 4th

July, 201062. ,18th KPSA in instructional course & 3rd annual conference of

Sushrutha Institute of Plastic, Reconstructive & Aesthetic Surgery,Sept. 11th & 12th 2010.

63. 4th Biennial meeting of brachial plexus surgery group of India,February 16th,17th& 18th 2011, Bangalore

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

65. “Neuro Update” state meet of - Kerala Neurological Society, 20th

March 201166. 24th annual state conference – KPSA, 19th KPSA instructional course

& 4th annual conference of Sushrutha Institute of Plastic,Reconstructive & Aesthetic Surgery, April 29, 30 & May 1st 2011

67. Workshop on congenital hand differences – Chennai, 18th and 19th

June 201168. 5th Annual conference Sushrutha Institute of Plastic, Reconstructive

& Aesthetic Surgery “Plastic Surgery and Trauma Current Trends”– 6th OCT 2012, Thrissur.

69. Biennial brachial plexus meet - Hyderabad, August – 22,23 &24th 2013.

70. 6th Annual conference Sushrutha Institute of Plastic, Reconstructive& Aesthetic Surgery “ Aesthetic Plastic Surgery”- 26th Oct 2013,Thrissur.

71. IMCAS India 2013, November 16th& 17th – Goa72. ISAPS 2014, January 16 – 19 – Jaipur73. 27th KPSA CON - 2014, Calicut, April – 25th, 26th& 27th

74. “BRACHION” – Live surgery workshop & CME, Govt.MedicalCollege,Calicut, 10th May 201475. . National conference of Indian Society of Peripheral Nerve Surgery

– “NERVECON” – 2014 – November7,8,9 – SGPGI, Lucknow76. SAMHITA 2015, 28th KPSA Conference – April 16th – 19th , Munnar.77. PLEXUS DEFINED- First International Hands – on Cadaveric Brachial

Plexus Dissection Course. Dept. Of Orthopaedics, M.S. RamaiahMedical College & Hospital, Bangalore – 28th, 29th& 30th August2015

78. 8th Annual conference Sushrutha Institute of Plastic, Reconstructive& Aesthetic Surgery “ Lower Limb Trauma” – 3rd Oct 2015, Thrissur

79. World Congress of Neurosurgery 4th –7th Feb 2016.80. KPSA Con 2016, Trivandrum81. 9th Annual conference Sushrutha Institute of Plastic, Reconstructive

& Aesthetic Surgery “ Burns” – 23rd Oct 2016, Thrissur82. KPSA con 2017, Thrissur83. 30th KPSA conference 2017 and 10th Annual conference Sushrutha

Institute of Plastic, Reconstructive & Aesthetic Surgery - April 7th

,8th&9th 2017.84. SAMHITA APSICON 2017, 15th -19th Nov, Kochi.



Dr. Jyoshid R BalanMS (General Surgery JIPMER)MCh (Plastic Surgery PGI Chandigarh), DNB

CERTIFICATES & COURSES:AS FACULTY1. 3rd Annual Live surgery workshop & CME on Brachial Plexus

Injuries, BRACHICON 2014, Govt Medical College Calicut2. Talk on Role of microsurgery in Burns, 9th Annual conference of

Sushruta Institute of Plastic aesthete And Reconstructive Surgery,Elite Mission Hospital, Burns 2016

3. Talk on Super microsurgery, Trichur Orthopaedic Society, India4. Talk on Mandibular reconstruction, Midterm conference and PG

convention of Oral and Maxillofacial Surgery, MAXFED 2015,Kothamangalam, India

5. Chaired session, CME on recent advances in surgery, AmalaInstitute of Medical Science, Thrissur, India

6. Chaired session, ISRM (Indian Society of ReconstructiveMicrosurgery) 2014, Kolkata, India

7. Guest National Faculty for CTRF Plastic Surgery’Flap dissectioncourse’, may2017 , All India Institute of MedicalScience, AIIMS,New Delhi, India

8. Faculty panelist - Nerve transfer in adult brachial plexus injury,APSICON, November 2017 Kochi

AS DELEGATE1)International college of surgeons Indian chapter- 2005, Workshop

and CPSE on Portal hypertension held at Government Generalhospital Pondicherry.

2. International college of surgeons Indian chapter-2006, Surgualupdate and work shop on dysphagia and cancer stomach. held atGovernment General hospital Pondicherry.

3. 5th annual conference of Tamil nadu and Pondicherry Chapter ofIndian association of paediatric surgeons 2006, JIPMER& IGGH&PGIPondicherry.

4.RNTCP conference 2007, PIMS, Puducherry5. Cleft Course 2012, Held at KGs Medical University, Lucknow6.ISRM (Indian Society of Reconstructive Microsurgery) 2014, Kolkata,

India7.ISRM (Indian Society of Reconstructive Microsurgery)

2016,Kochi,Kerala, India8.APSICON 2005 APSI-ETHICON Accredited Course in Plastic Surgery

on Hand and Extremity surgery 2016, Ganga Hospital Coimbatore,India

9. 47th Annual conference of Association of Plastic Surgeons of India,APSICON 2012, Lucknow, India.

10. 49th Annual conference of Association of Plastic Surgeons of India,APSICON 2014, PGIMER, Chandigarh, India

11.51sh Annual conference of Association of Plastic Surgeons of India,APSICON 2016, Delhi, India

12. 28th Annual conference of Kairali Plastic surgeons Association,2015, Samhita 2015Cochin, India

13. 29th Annual conference of Kairali Plastic surgeons Association,KPSACON 2016, Trivandrum , India

14.30th Annual conference of Kairali Plastic surgeons Association,KPSACON 2017, Thrissur, India

15. Indian Society for Surgery of the Hand, ISSHCON-2012, Amritsar,India

16.8th Congress of World Society for ReconstructiveMicrosurgery,WSRM 2015, Mumbai, India



17.8th Annual conference os Indian Society of Cleft lip palate andCraniofacial anomalies, Indocleftcon 2009, JIPMER, Pondicherry,India.

18.12th Triennial congress of the IFSSH& 9th Triennial congress of theIFSHT,2013, Noida,New Delhi, India

19. Amrita Tutorial in Plastic and reconstructive surgery , APLAST 2011,AIMS, Kochi, India

20. Golden Jubilee CME, 2012, PGIMER Chandigarh, Advances in Plasticsurgery

PRESENTED PAPERS1. Free toe Pulp Flap for finger reconstruction, ISRM (Indian Society

of Reconstructive Microsurgery) 2016,Kochi,Kerala, India2. Free medial sural artery perforator flap foot and ankle

reconstruction, ISRM (Indian Society of ReconstructiveMicrosurgery) 2016,Kochi,Kerala, India

3. free Medial plantar artery perforator flap for great one pulpreconstruction, ISRM (Indian Society of ReconstructiveMicrosurgery) 2016,Kochi,Kerala, India

4. Free toe Pulp Flap for finger reconstruction, 29th Annualconference of Kairali Plastic surgeons Association, KPSACON 2016,Trivandrum , India

5. Free medial sural artery perforator flap foot and anklereconstruction, 29th Annual conference of Kairali Plastic surgeonsAssociation, KPSACON 2016, Trivandrum , India

6. free Medial plantar artery perforator flap for great one pulpreconstruction, 29th Annual conference of Kairali Plastic surgeonsAssociation, KPSACON 2016, Trivandrum , India

7. Poster Presentation- The triangular lip repair scar and role of topicalretinoids, 47th Annual conference of Association of PlasticSurgeons of India, APSICON 2012, Lucknow, India.

8. Reverse dorsal Metacarpal artery flap in finger reconstruction: Areliable choice,30th Annual conference of Kairali Plastic surgeonsAssociation, KPSACON 2017, Thrissur, India

8. Symbosium: Adult pan brachial plexus injuryTalk on nurve transfer in adult brachial plexus injury 52nd annualconference of Association of Plastic Surgeons of India, APSICON2017, Kochi, Kerala

BEST PAPER AWARDReverse dorsal Metacarpal artery flap in finger reconstruction: Areliable choice, 30th Annual conference of Kairali Plastic SurgeonsAssociation, KPSACON 2017, Thrissur, India

EDITORIAL BOARD MEMBERIP Journal of Cosmetic, Reconstructive and Aesthetic Surgery

REVIEWERJournal of hand surgery and plastic SurgeryJournal of Xiangya Medicine

Chapters in BooksText book of plastic reconstructive and aesthetic surgery- Handand upper extremity (Thieme publishers)Peripheral nerve injuries and nerve transfers in the upper limb.Text book of plastic reconstructive and aesthetic surgery- Headand neck (Thieme publishers)Lip and cheek reconstruction (Yet to be published)

Published Research Papers:Journal of Plastic Reconstructive And Aesthetic Surgery,2014 Free medial plantar artery flap for the reconstruction of greattoe pulp.J Plast Reconstr Aesthet Surg. 2014 Jun;67(6):863-5. doi: 10.1016/j.bjps.2013.12.038. Epub 2013 Dec 31.Jyoshid RB1, Vardhan H2, Anto F2.Journal of Craniofacial Surgery 2014Lid cranioplasty: an elegant method of calvarial reconstruction.Balan JR, Tripathy S. J Craniofac Surg. 2014 Nov;25(6):2172-3.Australia and New Zealand (ANZ) Journal of Surgery 2014Peroneal artery perforator-based flaps for reconstruction of middleand lower third post-traumatic defects of the leg. John JR, TripathyS, Sharma RK, Balan JR, Jadhav C, Bhattacharya S. ANZ J Surg. 2015Nov;85(11):869-72.Plastic and aesthetic research, 2014The keystone-design perforator-based flap for leg defects: asynthesis of philosophies. Jerry R John, Jyoshid R Balan,SatyaswarupTripathy, Ramesh Kumar Sharma, ChandanJadhav.Plastic and Aesthetic Research. 2014;1(2):70-72 DOI 10.4103/2347-9264.139704Reconstructive surgery and anaplastology, 2014Balan JR, John JR, Sharma RK (2014) An Uncommon Presentationof Camel Bite Injury to the Head with Frontal Calvarial Bone Loss.Anaplastology 3:137. doi: 10.4172/2161-1173.1000137Indian Journal Of Plastic Surgery, 2016Free toe pulp flap for finger pulp and volar defect reconstruction.Balan JR. Indian J Plast Surg. 2016 May-Aug;49(2):178-184.Indian Journal of Plastic Surgery, 2016Hatchet flap and rotation flap for distal dorsal finger defectreconstruction. Balan JR. Indian J Plast Surg. 2016 May-Aug;49(2):283-284. No abstract available. 1PMID: 27833299Indian Journal of Burns, 2016Electrical injury of external genitalia and reconstruction withgracilis muscle flap. Jyoshid R Balan, Indian journal of Burns 201624(1): 78-80Australia and New Zealand (ANZ) Journal of Surgery 2017Medial sural artery perforator free flap for the reconstruction ofleg, foot and ankle defect: an excellent option. Balan JR. ANZ JSurg. 2017 May 16. doi: 10.1111/ans.14050. [Epub ahead of print]



Dr.Raj GopalMS (General Surgery JIPMER), DNBMCh, DNB (Plastic Surgery)

COURSES AND CONFERENCES

1. 52nd annual conference of the Association of Plasticsurgeons of India, APSICON2017, Cochin, Kerala; 15-19th

November, 20172. Comprehensive Master class on hair transplantation,

APSICON 2017, Cochin, Kerala; 17-19th November 20173. Training in Hair loss Treatment and Hair Trnasplant-

Dr.Rajesh Rajput hair Restore, Mumbai, India; 17-22 July, 20174. Instructional course on Hair Restoration- Vasa Hair Academy,

Ahmedabad , India; 3-7 July, 20175. 30th Annual Conference of the Association of Plastic

Surgeons of Kerala, 7-9 April, 2017, Thrissur, Kerala6. Annual conference of the Association of Plastic Surgeons

of India, APSICON 2016, Delhi7. 29th Annual Conference of the Association of Plastic

Surgeons of Kerala, 2016, Thiruvananthapuram8. 9th Annual conference of Sushrutha Institute of Plastic,

Reconstructive and Aesthetic Surgery, Thrissur, Kerala, onBurns; 2016

9. Hands on training course on hair transplant, APSICON 201510. Ethicon accredited course on Breast, APSICON 201511. Annual conference of the Association of Plastic Surgeons

of India, APSICON 2015, Mumbai12. Tendon Transfers in nerve palsies- Hands-on cadaveric

workshop, MS Ramaiah Advanced Learning Centre, Bangalore,Oct31st, Nov1st,2015

13. 8th Annual Conference of Sushrutha Institute of Plastic,

Reconstructive and Aesthetic Surgery, Thrissur, Kerala, onLower Limb Trauma; 3rd October, 2015

14. 28th Annual Conference of the Association of PlasticSurgeons of Kerala; 17th-19th April, 2015 at Munnar, Kerala

15. 27th Annual Conference of the Association of PlasticSurgeons of Kerala; 25th-27th April, 2014 at Kozhikode

16. Specialists’ 13thRhinoplasty Course, 2014 conducted by theSpecialists’ hospital, Cochin, Kerala; 7th to 9th March,2014

17. 6th Annual Conference of Sushrutha Institute of Plastic,Reconstructive and Aesthetic Surgery, Thrissur, Kerala onAesthetic Plastic surgery; 26th October, 2013.

18. APLAST 2013- Amrita Tutorials in Plastic Surgery- conducted bythe Department of plastic and Reconstructive Surgery, AmritaInstitute of Medical Sciences; 29th - 31st March, 2013

19. Basic Cadaveric Flap Dissection Course and Workshopconducted by the departments of Plastic Surgery and Anatomy,JIPMER, Pondicherry; 19th January, 2103

PUBLICATIONSGopal R, Elamurugan TP, Kate V, Jagdish S, Basu D. Standard tripleversus levofloxacin based regimen for eradication of Helicobacterpylori. World J GastrointestPhar-macolTher 2013; 4(2): 23-27.Gopal R, Elamurugan TP, Hage S, Muthukumarassamy R, Kate V.Retrograde jejunogastric intussusception following Braun’sjejunojejunostomy. World J Clin Cases 2014; 2(1): 24-26.



PRESENTATIONSOral presentationsHuman tissue Allotransplantation-29th KPSACON,2016ThiruvananthapuramPaediatric free flaps- our experience- 29th KPSACON,2016ThiruvananthapuramArt- facial contouring, Medium- Fat graft- 30th KPSACON,2017, Thrissur.Comparison of the efficacy of Standard triple versus levofloxacinbased regimen for eradication of Helicobacter pylori and ulcerrecurrence in patients with perforated duodenal ulcer – 21st

IASG conferencePioneers in Plastic Surgery- T.P.Kilner- Trivandrum plasticSurgery ClubALT flap anatomy and variations- Trivandrum plastic SurgeryClubReverse Sural Artery Flap-Trivandrum plastic Surgery ClubTrans-nipple Excision of breast tissue in gynaecomastia-Trivandrum plastic Surgery ClubArt of fat grafting- Thrissur Plastic Surgery clubThe art of Liposculpuring– IMA GuruvayoorRadio talk show – Doctoroduchodikkam- All India Radio- oncosmetic surgeries.Poster presentation- Retrograde jejunogastricintussusception following Braun’s jejunojejunostomy; a casereport – 21st IASG conference

AwardsGold Medal - MS General Surgery JIPMER 2009Gold Medal - Best Outgoing Student JIPMER 2009Gold Medal - RN Sinha Essay Competition KPSA 2013Gold Medal - RN Sinha Essay Competition KPSA 2014



Chapter : Cheek & Lip Reconstruction ( Under Review)

Chapters in Books



VISITINGVISITINGVISITINGVISITINGVISITINGTRAINEESTRAINEESTRAINEESTRAINEESTRAINEES

COMMENTSCOMMENTSCOMMENTSCOMMENTSCOMMENTS

Dr.Arun V, Oral and Maxillofacial Surgeon,Ottapalam

Happy to hear that Sushrutha institute is celebrating its10th anniversary. I had the fortune to be in the department

as an observer for 2 weeks. it really was an amazingexperience to see the way the doctors and support staff,

who considers stitching the vessels and nerves as a passionlight up the hopes of patients who come in a devastated

condition. Elite hospital has become the pioneer in Plasticand Reconstructive Surgery in central Kerala. I wish the

entire department best wishes for all future endeavours.

Dr Ravi RajanAreekkal, BDS , MDSConsultant Oral and Maxillofacial surgeon and ImplantologistBeing with the faculty members and my dear elder brothersand sisters of the department of plastic surgery , elitehospital was an amazing experience...Even though it was of a limited time period it was a greatexperience being a part of their team for enormous casebeing done in the institution.Best wishes to the team of Sushrutha institute of plasticreconstructive and aesthetic surgery for their futureachievements and for the souvneir for the 10th anniversary!!!

Dr.AshinoIt was a privilege to be an

observer in elite mission underplastic surgery. They have the

best team of doctors, whoregardless of what fraternity

you are, give youoppurtunity to learn.

Dr Meenu AntonyI had a great learning experience

during my training days atSushruta institute of plastic

surgery. Thankyou.



VISITING TRAINEES1 Dr. Sarfras Raseel .T

II nd year MDSDept Of OMFSKMCTDentalCollegeMukkam, Calicut15/02/15 – 28/02/15

2 Dr. Dheeraj Eldho PauloseIInd Year MDSDept of OMFSMar Baselios dental collegeKothamangalam16/02/15-17/03/15

3 Dr. Abu VargheseIInd Year MDSDept of OMFSMar Baselios dental collegeKothamangalam16/02/15 – 17/03/15

4 Dr. Anooj.P.DIInd Year MDSDept of OMFSKannurDentalCollegeKannur01/04/15-15/04/15

5 Dr. Ashind JohnIIIrd year MDS StudentPushpagiriCollege of DentalSciences, Thiruvalla01/07/15-15/07/15

6 Dr. Tripti NairIIIrd year MDSPushpagiriCollege of DentalSciences, Thiruvalla01/07/15-15/07/15

7 Dr. Arun.VII year MDSDept of OMFSKannurDentalCollegeKannur11/11/15 – 25/11/15

8 Dr. Archana ShenoyII year MDSDept of OMFSKannurDentalCollegeKannur05/12/15-20/12/15

9 Dr. Jasmine John KII nd year MDSDept Of OMFSKMCTDentalCollegeMukkam, Calicut01/01/16-15/01/16

10. Dr. Jasly.KII nd year MDSDept Of OMFSKMCTDentalCollegeMukkam, Calicut16/01/16-30/01/16

11.Dr.T.Alarvi ShiyasII nd year MDSDept Of OMFSKMCTDentalCollegeMukkam, Calicut01/02/16-15/02/16

12. Dr. Paul SteaphenIII rd year MDSDept Of OMFSMar Baselios dental collegeKothamangalam

13. Dr. Kiran K SChithira, Sasthan RoadAyukulam,Chempazhanthy P O15/06/15-30/06/15

14. Dr. Nipun MohanKuyilamparambil HouseP O kighakkummuriPeringottukara, Thrissur05/10/15-20/10/15

15. Dr. Ravi Rajan AreekkalIIIrd year PG studentPushpagiriDentalCollegePerumthuruthy, Thiruvalla05/10/16-20/10/16

16. Dr. Jaseem MuhammedIInd year PGKMCTDentalCollegeMukkam, Calicut01/02/17-14/02/17

17. Dr. SameenaShamsudheenIInd year PG (OMFS)KannurDentalCollegeKannur16/02/17-02/03/17

18. Dr. Ananth C ChaamaChaama HouseThingode P O ,Navodaya,KakkanadErnakulam02/03/17 -16/03/17

19. Dr. Mohammed JamsherIInd year PGKannurDentalCollegeKannur20/03/17-03/04/17

20.Dr. Aswathi VinodIInd Year PGKMCT dental collegeCalicut01/04/17-15/04/17

21.Dr. Meenu AntonyIInd year PGPushpagiriDentalCollegeThiruvalla02/05/17-16/05/17


Sushrutha performing his famed cheek flap rhinoplasty

1 27/11/10Shyh –Jou Shieh, MD,PhD138,Sheng-Li Road, Tainan,TaiwanNational Cheng Kung UniversityHospitalI enjoyed visiting the Elite MissionHospital and impressed by yourexcellent work here.

2 19/03/12Alex Muset LaraThank you all for your greathospitality and congratulationsfor you, surgery team. See you soon.

3 30/07/11Dr. Mukund RThatteBombay Hospital , MumbaiWhat a pleasure to participate in anexcellent work shop.Thank you for inviting me.

4 Col (Dr) P S BhandariDept. of Plastic SurgeryAFMC& command Hospital, PuneVisited the department as an inspectorfor DNB accreditation. Good amount ofwork being done in trauma cares.I am highly impressed withmicrovascular and microneutral work.Keep it up.



5 18/09/13Dr. Rajeev AhujaVery strong team of plastic surgeryand great work. Keep it up.

6 7/04/12Dr. Arun Kumar SinghPresident –APSIProf & Head PG Dept.Of Plastic surgeryCSM MedicalUniversity (Upgraded KG’s MedicalCollege)LucknowVisited the SIPRAS and enjoyed mystay. Good work and comprehensivePlastic Surgery work being done in aco-ordinated way. Keep it up and allthe good wishes for the future.

7 Dr. Lakshmi.MAsst. Prof. of Plastic SurgeryMedicalcollege , Kottayam 9446065454“High quality work and excellent teameffort. Let the Sushrutha Institute riseto still higher levels”

8 05/01/13Dr. Sheeja RajanAsst. Prof., Plastic SurgeryDept.Calicut Medical CollegeCongratulation for the excellentsurgery and teamwork. Wishing youthe very best in all you futureendeavors. Thank you so much.

9 29/07/11Dr. Vinoth KumarVijaya Health Center, ChennaiExcellent team work.Impressed withmicrosurgical work anddedicated work.

10 02/07/11Dr. T.M. Meera SahibTutor in Plastic Surgery TuticorinMedical college, TuticorinExcellent, dedicated team work.

11 02/07/11Dr. N.M.SemalesanCentury Hospital, PathanamthittaWonderful pan plastic surgery . Workof excellent standard. Best wishes.

12 30/07/11Dr. Kumaran, TirupurGood Work

13 30/07/11Dr. G.I. Nambi Const.Plastic Surgeon Kovai Medical CenterHospital, Avinash Road,Coimbatore -641014Congratulations and thanks forinvolving me here this time. It uses agood learning experience. Theprevious occasions ie the KPSAconference and annual on brachialplexus workshop were also excellent.Happy to participate again in future.

14 18/01/12Dr. Shenith Koshy (Post Graduate)Karanacheril House, Podiyadi P O,ThiruvallaMar Baselios Dental College,KothamanglamWe are thankful for a wonderfultraining in plastic surgery.

15 18/01/12Dr. Sivaprasad.K.K (Post GraduateStudent) Shivshylam, PO ChottanikaraMar Baselios Dental College,KothamanglamWe are thankful for a wonderfultraining in plastic surgery.

16 19/03/12Anil BhatiaPuneCongratulations on your excellentunit.

17 01/11/12Dr. Pravin MathewKozhikodeThank you to everyone; our onemonth posting was very useful.

18 25/08/16Dr. Rajshree JayarajanExtremely good work going in theDept. very friendly and helpfulenvironment and staff.



STATISTICSMASTERCHART

HAND SURGERY 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017Major Hand Reconstruction 2 2 3 3 3 3 3 4 5 4 3Blast Injuries 18 24 29 28 30 32 28 18 20 15 12

Finger Injuries 530 540 560 621 715 728 756 781 812 852Suturing 280 258 312 328 325 336 331 342 356 383 436Nail bed repair 97 120 157 160 163 182 206 212 202 226 220Nail bed graft 3 2 8 6 9 6 8 10 8 8 6FTSG 12 15 21 24 23 28 24 26 24 23 24SSG 140 177 184 169 172 183 191 188 202 212 192Terminalisation 150 172 190 163 180 162 178 182 163 195 155Ray amputation 15 8 15 16 14 16 12 12 11 16 8Tumor excision 1 3 12 11 13 12 9 11 12 18 16I&D 12 15 17 21 16 18 19 21 18 28 23JESS Fixation 8 10 13 12 14 16 18 16 14 14 12Hematoma Evacuation 4 2 3 4 3 4 4 6 5 6 4Surgery on Extensor Tendons 72 86 112 120 125 136 122 139 163 220 169Surgery on Flexor Tendons 58 72 84 91 102 95 87 84 72 86 63Compressive Neuropathies 36 42 49 51 54 48 62 74 68 82 54Tumors 8 12 10 11 15 18 16 20 18 16 15Infections 12 10 13 15 16 18 14 13 15 18 14

Local Flaps 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017V-Y Flaps 18 23 32 29 36 38 42 54 49 52 41Cross Finger Flaps 19 26 31 34 35 30 38 42 34 36 30Chest Flap 1 1 0 1 0 0 1 2 1 0 0FDMA 1 1 1 2 2 1 2 6 8 9 6RDMA 1 2 2 1 5 6 6 7 8 6 5Groin flap 16 21 27 31 36 32 37 36 42 39 28Lateral arm flap 1 2 1 1 3 4 5 6 8 7 5



SOFT TISSUE COVER 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017Upper LimbPedicle LD Flap 2 2 2 3 2 3 2 3 2 3 2Propeller Flap 2 1 3 2 3 4 3 5 3 4 2 Radial Artery Flap 1 2 2 2 3 4 4 3 6 7 4Split Skin Graft /Full ThicknessSkin Graft 75 83 92 110 125 138 141 138 126 132 112

Lower Limb 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017Fasciocutaneous flap 38 52 66 59 62 58 60 65 62 60 48Gastrocnemius Flap 5 12 14 15 16 19 17 16 15 14 12Sural Artery Flap 10 14 24 21 23 24 27 22 26 24 18Soleus Flap 2 5 6 5 5 6 7 8 7 8 5Abductor Hallucis Flap 3 2 2 3 3 2 4 5 3 5 2Adipo Fascial flap 2 7 12 13 14 15 16 15 18 22 15Peroneus Brevis Muscle Flap 8 11 9 10 12 14 14 16 12 17 12Perforator Based Flap 6 8 9 12 15 17 18 20 28 26 19Propeller Flap 8 10 11 10 12 14 17 19 18 16 13

LOWER LIMB TRAUMA Lower limbinuries 222 280 352 435 612 714 841 852 841 789 547Major degloving inuries 98 112 116 124 142 138 141 153 144 162 132Split Skin Graft /FullThickness Skin Graft 92 125 142 186 215 199 228 216 238 252 284Ilizarov Fixation 8 9 12 15 14 16 12 10 8 7 6External Fixator 16 18 26 34 38 42 52 46 51 42 26LRS 8 12 14 18 26 32 37 36 33 29 24

CONGENITAL DEFORMITY 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 CORRECTIONCleft Lip 8 14 21 19 18 15 10 12 7 8 5Cleft Palate 10 12 26 23 28 23 18 10 8 5 3Radial Club Hand 2 2 2 3 2 3 2 3 2 2 1Pollicisation 2 2 3 2 2 3 2 2 2 2 0Trigger thumb 8 10 12 10 12 9 13 8 10 12 9Macrodactyly 1 1 2 3 2 3 2 4 3 5 3Syndactyly 3 4 9 14 12 15 19 16 15 18 8Constriction ring syndrome 2 2 3 3 4 3 5 4 6 5 3Thumb Duplication 1 0 1 0 0 1 1 0 0 0 0Cleft Hand 1 0 0 1 2 2 1 3 2 1 1Polydactyly 2 4 3 3 3 4 3 5 3 4 2Hypospadias 1 2 5 6 5 4 3 3 4 5 3Cleft lip secondary correction 2 4 12 8 6 10 9 8 5 6 5

COSMETIC /AESTHETIC 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 SURGERYGynaecomastia 18 26 35 36 38 40 38 42 44 48 36Abdominoplasty/Herniarepair 11 15 24 23 23 22 25 24 27 31 28



Body Countouring 3 10 12 10 9 10 12 11 10 9 7Liposuction (Flanks, Thigh,arm, chin) 3 5 8 12 11 16 18 16 20 26 18Reduction Mammoplasty 1 4 5 4 5 4 4 5 6 8 4Breast Augmentation 1 2 2 3 2 2 3 4 3 3 3Rhinoplasty 15 12 16 15 18 16 15 13 14 12 6Secondary Rhinoplasty 11 12 14 16 12 10 10 9 11 10 5Tip Plasty 8 6 8 7 6 7 8 8 7 6 5Genioplasty 1 1 2 1 1 1 1 1 2 2 1Hair Transplant 2 3 8 11 10 14 16 18 15 16 12Otoplasty 1 0 1 2 2 3 2 2 3 2 1Fat Injection 16 19 25 26 23 25 26 28 30 36 38Laser 72 70 75 80 82 75 79 81 83 76 73Microdermabrasion 123 125 120 129 132 148 152 165 174 182 128Chemical Peeling 30 35 32 36 38 42 56 67 80 75 54Photo Rejuvenation 57 53 45 54 63 59 67 74 79 82 63

REPLANTATION 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017Arm 1 2 3 2 2 2 3 2 3 2 2Forearm 3 2 4 3 6 4 5 4 4 3 2Hand/Wrist 3 4 8 6 9 8 8 10 9 8 6Thumb 2 6 15 16 18 22 27 24 28 26 19Fingers 9 12 20 29 32 38 42 49 52 61 42Ring Avulsion 2 3 12 19 18 20 26 22 25 23 19

REVASCULARISATION 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017Digital Artery 18 26 54 60 62 66 68 72 76 85 62Ulnar Artery 14 14 27 32 39 31 38 32 35 37 25Radial artery 18 24 28 30 32 35 44 30 46 47 26Brachial artery 3 4 8 7 8 7 9 8 6 7 5Axillary Artery 1 4 6 7 8 10 9 7 10 9 8Femoral Artery 4 4 8 12 16 18 20 18 22 18 16Popliteal Artery 3 4 9 10 13 16 15 18 14 16 12Posterior Tibial artery 3 5 8 11 12 14 16 17 18 17 15Anterior Tibial Artery 4 3 8 14 16 14 17 14 16 18 12Vein Graft 24 26 28 31 32 36 34 38 36 34 32

PERIPHERAL NERVE 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 SURGERYDigital Nerve 78 120 126 129 132 158 172 183 197 225 212Medial Nerve 33 46 55 59 62 69 76 92 86 98 72Ulnar Nerve 34 35 56 61 72 88 84 79 73 82 68Radial Nerve 25 24 36 37 38 36 42 52 59 62 53Nerve Grafts 24 23 33 37 36 48 38 45 52 71 42Nerve Transfers 6 12 18 21 20 22 26 28 32 36 28Neurolysis 2 5 8 10 14 15 12 16 18 19 16



Micro surgical Free 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 Flaps Upper Limbs and Lower LimbsToe Pulp 0 0 0 0 0 0 1 1 2 1 1T-DAP 0 0 0 0 0 1 2 1 2 2 1Gracilis Flap 9 12 15 18 21 19 20 23 21 20 10Latissimus dorsi Flap 8 9 18 21 24 27 23 27 31 28 19Anterolateral Thigh Flap 12 22 38 36 30 28 26 23 22 16 8Free Fibula flap 2 3 2 4 4 6 5 4 4 3 2Toe transfer 1 2 3 2 0 1 0 1 1 1 0Parascapular Flap 5 8 6 7 8 5 6 3 2 2 1Rectus abdominis 1 0 1 0 1 1 2 1 1 0 0Vastus Lateralis Free Flap 8 6 9 8 9 12 11 12 15 13 8Gastrocnemius Flap 8 11 13 12 14 16 15 14 16 18 16

Brachial plexus surgery 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017OBSTETRIC BRACHIAL PLEXUS PALSYMuscle Transfer /Nerve Transfer/Botox 8 10 14 15 14 16 16 17 16 16 18

ADULT BRACHIAL PLEXUS INJURYMuscle Transfer/ Nerve Transfer 8 12 10 12 14 12 13 14 15 15 16Tumor/Sarcoma 0 0 0 1 0 0 0 1 1 1 1Primary Repair 4 3 4 2 5 4 4 3 3 2 3

HEAD & NECK 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017Suturing 148 182 228 248 239 248 257 265 332 368 288SSG 3 5 12 14 16 12 18 20 22 18 16Local Flaps 7 8 11 16 18 20 24 19 26 22 20Free Flaps 6 10 11 14 19 16 18 16 8 6 2Naevus excision 8 12 18 24 29 26 32 38 32 40 36Tracheostomy 17 20 24 26 22 18 12 10 8 6 4Parotidectomy 13 12 14 16 15 13 16 14 13 14 10Facial nerve surgery 3 2 4 7 6 8 8 7 6 8 6Dermoid cyst 6 8 12 10 8 12 14 12 13 12 10Vascular malformations 3 7 14 12 10 14 12 16 12 13 14Ear lobe repair 28 36 42 38 46 52 48 42 38 35 32Ear piercing 32 41 39 46 56 60 58 49 48 42 44Biopsy 22 38 30 42 40 35 42 48 38 36 31Tongue tie release 2 2 4 9 8 6 7 8 6 8 6Sebaceous cyst excision 8 6 6 12 14 12 15 12 14 12 10Lipoma excision 4 6 8 11 10 8 12 10 15 14 10

Maxillo-Facial Surgery 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017Nasal & Zygomatic bone elevation 22 29 27 26 31 32 28 18 22 19 12Orthognathic Surgery 1 2 1 2 2 2 3 2 4 3 3



Major head & Neckreconstruction 4 3 3 4 5 6 4 5 3 3 0Miscellaneous 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017Diabetic Foot 739 1200 1553 1612 1659 1850 1789 1880 1896 2112 1982Debridement 221 412 467 512 612 801 725 912 859 954 632VAC 3 4 4 5 8 12 26 32 28 38 34Terminalisation/Disarticulation 36 55 59 62 72 79 63 68 73 82 64SSG 16 19 21 26 36 34 29 32 36 42 28

Pressure Sore 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017Sacral 38 54 62 59 54 61 48 38 40 36 22Trochantric 12 13 14 19 21 18 16 17 16 18 13Ischial 18 28 38 29 32 36 34 41 36 31 28Heel 9 12 18 21 19 12 14 16 14 15 12

Burns 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017Debridement 53 60 82 86 88 76 86 71 65 32 21Contracture Release 9 15 19 28 30 22 28 32 18 16 12Tangential excision 5 6 8 10 12 9 11 14 16 14 12Skin Grafting 18 26 38 32 36 42 39 45 38 33 28Local flap 15 23 32 33 36 42 51 56 48 41 36Free flaps 1 2 4 4 5 4 6 5 6 5 2

Others 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017Penile replant 1 0 1 0 0 1 1 1 1 0 0Varicose Veins 18 12 22 26 23 28 32 37 42 39 32Embolectomy 4 3 8 7 9 8 10 9 8 9 5Aneurysm 18 38 23 27 26 28 26 24 23 25 21Implant removal 382 415 463 436 425 582 589 612 689 755 668AV Fistula 360 420 469 512 582 651 686 692 780 914 1026Ingrowing toe nail 3 9 14 17 18 21 19 21 18 20 14Chest tube drainage 8 12 16 14 13 14 12 9 8 10 6


elite sou-2018-3 - thrissur plastic surgery

Documents