PMC4878242_01
Soft tissue injury to limb with ischemia
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D1
She presented to us with a devascularised hand [Figure 1].
Reverse vein graft for vascularity and flap cover to soft tissue defect
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D2
She was taken up for an emergency flow through flap which was hooked to the ulnar vessels and the hand was salvaged [Figures 2-4].
Simultaneous coverage and restoration of vascularity of limb by flow through flap
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D3
She was taken up for an emergency flow through flap which was hooked to the ulnar vessels and the hand was salvaged [Figures 2-4].
Ischemic hand with soft tissue loss
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F1
She was taken up for an emergency flow through flap which was hooked to the ulnar vessels and the hand was salvaged [Figures 2-4].
PMC4878242_02
Harvesting of flow through anterolateral thigh flap
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F2
Emergency below knee amputation of the left lower limb and debridement of right lower limb with fracture fixation by external fixator was done at the primary care centre [Figure 5].
Harvested flow through flap
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F3
Adequate debridement and flow through ALT flap [Figures 6 and 7] was done to the posterior tibial vessels to salvage the limb and provide soft tissue cover [Figure 8].
Salvaged limb
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F4
Adequate debridement and flow through ALT flap [Figures 6 and 7] was done to the posterior tibial vessels to salvage the limb and provide soft tissue cover [Figure 8].
Soft tissue defect of leg with ischemia of foot
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F5
Adequate debridement and flow through ALT flap [Figures 6 and 7] was done to the posterior tibial vessels to salvage the limb and provide soft tissue cover [Figure 8].
PMC4878242_03
Harvested flow through flap
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F6
A 13-year-old boy presented to us 5 h after a railway accident with an amputation at left forearm level and left lower limb vascular injury [Figures 9 and 10].
Flap cutaneous side
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F7
A 13-year-old boy presented to us 5 h after a railway accident with an amputation at left forearm level and left lower limb vascular injury [Figures 9 and 10].
Salvaged foot and coverage of leg
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F8
The patient started developing necrosis of forearm skin and gradual ischaemia of replanted hand [Figure 11].
Amputation at distal forearm
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F9
On debridement, it was found that the radial vessels were thrombosed for 10 cm segment and hence a flow through ALT flap was harvested and anastomosed with radial vessels [Figure 12].
Proximal stump
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F10
The post-operation recovery was uneventful [Figures 13 and 14].
Necrosis of forearm skin and ischemic hand
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F11
The post-operation recovery was uneventful [Figures 13 and 14].
PMC4878242_04
Harvested flow through flap
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F12
A 35-year-old patient presented 14 h after a crush injury to the distal right forearm with doubtful vascularity of hand [Figure 15].