The Dept of Plastic,Burns & Reconstructive Surgery,STNM Hospital,Gangtok

31/08/2024

31/08/2024

We successfully performed Sikkim's first-ever single-stage basilic vein transposition arteriovenous fistula (AVF) surgery for dialysis access. This challenging procedure was undertaken on a patient with limited vein options and multiple previous AVF failures.

Traditionally, basilic vein transposition requires two stages: initial AVF creation, followed by vein transposition six weeks later, and an additional two-three weeks for healing. This single-stage approach combined both steps, eliminating the need for two surgeries and accelerating access creation. This advancement directly impacts overall survival rates

This was possible by the joint collaboration of Plastic Surgery and Nephrology Department, of STNM hospital along with the technical expertise of Anaesthesia dept and the OT technicians. The continuous and unswerving support from the OT staffs, the Paraclinincal dept like Biochem, micro , pathology for the quick blood reports, all of which made this surgery possible. The fistula is fully functional.The patient is recovering well and is ready for discharge today.

06/08/2024

Last week we operated on a case of advanced Left Breast Carcinoma .The cancer was staged as T4c N2 M0.

Dr. Karma and her Surgery team from the Department of Surgery did a Modified Radical Mastectomy. Following proper clearance, the Plastic Surgery Team was tasked with closing the significant surgical defect.

We opted for a Latissimus Dorsi myocutaneous flap to address the need for both muscle and skin in the reconstruction. Skin grafting was done on the donor area on the back, and the breast defect was closed using the LD flap.

This marks the first instance of Breast reconstruction using an LD flap in our hospital, although we regularly perform reconstructions for Head & Neck oncology cases. Attached are some pictures captured during the surgery.

06/08/2024

Last week we operated on a case of advanced Left Breast Carcinoma .The cancer was staged as T4c N2 M0.

Dr. Karma and her surgical team from the Department of Surgery did a Modified Radical Mastectomy. Following proper clearance, the Plastic Surgery Team was tasked with closing the significant surgical defect.

We opted for a Latissimus Dorsi myocutaneous flap to address the need for both muscle and skin in the reconstruction. Skin grafting was done on the donor area on the back, and the breast defect was closed using the LD flap.

This marks the first instance of Breast reconstruction using an LD flap in our hospital, although we regularly perform reconstructions for Head & Neck oncology cases. Attached are some pictures captured during the surgery.

11/07/2024

Plastic Surgery Week
Day-3-Trauma Surgery .

Another tendon injury case required meticulous wound suturing to ensure that the tattoo of his significant other remained intact.

11/07/2024

Plastic Surgery Week
Day 3-Trauma Surgery

Plastic Surgeons play a vital role in trauma care, performing a variety of surgeries to address traumatic injuries such as managing machine cut injuries, sickle injuries, glass cut injuries, and soft tissue injuries resulting from road traffic accidents, which may involve significant soft tissue loss, tendon injuries, vascular injuries, or nerve injuries. Each injury is treated based on its unique presentation.

Hand injuries involving severed muscles, tendons, blood vessels, and nerves are frequent at our hospital, with 4-5 cases seen weekly in the emergency department. We have successfully treated and managed these cases .Highlighting a few of them here .

10/07/2024

Plastic Surgery Week:
Day 2 – Surgical Intervention for Bed Sore/Pressure Ulcers

The surgical treatment of Bed Sores /Pressure ulcers ) also falls under the domain of Plastic Surgery). Patients with severe pressure ulcers (Grade 3-4) that do not respond to standard dressings and require surgical intervention are referred to us from various departments.

In addition to the physical discomfort and pain experienced by these patients, pressure ulcers are commonly observed in the very elderly population, individuals with neurological conditions, and those who have had prolonged hospital stays due to their accompanying chronic illness -factors that can make them emotionally vulnerable.

Therefore, apart from providing surgical solutions to address their pressure ulcers, we also collaborate with the Psychiatry Department to offer counselling . We strive to create a warm and supportive environment during their time with us, aiming to uplift their mental well-being in any way possible.

Sharing one of the many case of Bed sore that we have treated in the last five years .The Dept of Plastic,Burns & Reconstructive Surgery,STNM Hospital,Gangtok

09/07/2024

Plastic Surgery Week
Day 1 -Reconstructive Surgery.

A significant aspect of our work here in STNM Hospital ,Gangtok ,involves reconstructive surgeries, where we collaborate closely with Oncosurgeons. Initially, the Oncosurgeons, who specialize in cancer operations, remove the affected areas of organs with cancer. Once the cancerous tissues have all been removed, this often leaves behind a significant defect that needs to be covered. (To give an example -think of it like repairing a torn piece of fabric by sewing on a patch).Subsequently, plastic surgeons step in to address these resulting defects by utilizing tissues from adjacent areas to achieve aesthetic restoration.

Here is one case we had operated on a cancer patient who needed reconstruction following removal of the diseased part .A small note has been added to each picture for ease of understanding.

08/07/2024

World Plastic Surgery Week (July 8-July 15 ,2024)

Plastic surgery is more than skin deep. Contrary to common perception,cosmetic procedures represent just a small fraction of what we are trained to do . Moreover, Cosmetic surgery is a luxury surgery and we personally do not get the time attend to these patients in a Government Hospital as we prioritize the needs of the more critical patients . Our primary focus remains on Reconstructive Surgeries ,Burns Surgery, and Trauma surgery .

As we celebrate the World Plastic Surgery Week ,we aim to showcase the broad spectrum of surgeries undertaken by plastic surgeons. Each day throughout the week, we will share insights into various surgeries conducted at our Department. By the end of the week ,culminating on World Plastic Surgery Day(15th July ), our goal is to dispel prevalent myths surrounding this specialized field and create awareness of this often misunderstood branch of surgery.

Wishing all my fellow Plastic Surgeons a Happy World Plastic Surgery Week !

01/07/2024

Healing hands, Caring hearts!
Doctors day 2024,
Truly touched by the love shown by our dear sisters and other staffs. They try know how to make you feel special.
Would like to thank each and everyone more making this day so special.

10/05/2024

We begin with a presentation delivered at the All India Conference of the Association of Plastic & Reconstructive Surgeons at Indore in December 2023. The presentation briefly summarizes the accomplishments of the department since its establishment in 2019, marking its inaugural presence in our state of Sikkim.

P.S.Our apologies -due to the time constraint of 10 minutes,we had to rush through the slides towards the end .