PMC4073453_01
Front profile preoperatively
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F1
Pradesh with history of trauma due to road traffic accident with motor bike, which resulted in total avulsion of his mandible [Figures 1 and 2], with the avulsed bone wrapped in a piece of wet cloth for almost 2 h [Figures 3-5].
Lateral profile preoperatively
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F2
Pradesh with history of trauma due to road traffic accident with motor bike, which resulted in total avulsion of his mandible [Figures 1 and 2], with the avulsed bone wrapped in a piece of wet cloth for almost 2 h [Figures 3-5].
Avulsed mandible along with attached skin in front view
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F3
Pradesh with history of trauma due to road traffic accident with motor bike, which resulted in total avulsion of his mandible [Figures 1 and 2], with the avulsed bone wrapped in a piece of wet cloth for almost 2 h [Figures 3-5].
Avulsed mandible along with attached skin from superior view
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F4
Pradesh with history of trauma due to road traffic accident with motor bike, which resulted in total avulsion of his mandible [Figures 1 and 2], with the avulsed bone wrapped in a piece of wet cloth for almost 2 h [Figures 3-5].
Avulsed mandible along with attached skin from inferior view
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F5
Pradesh with history of trauma due to road traffic accident with motor bike, which resulted in total avulsion of his mandible [Figures 1 and 2], with the avulsed bone wrapped in a piece of wet cloth for almost 2 h [Figures 3-5].
Patient tracheostomized and intubated
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F6
Patient was immediately examined for airway and hemostasis. Patient was shifted to operation theater and tracheostomy was done to secure the airway [Figure 6].
Intraoperative view of microvascular anastomosis
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F7
Under continuous irrigation with heparinized lactated Ringer's solution, end to end anastomosis was done with fine, non-absorbable sutures 9-0 nylon using firstly three oriental suture and then remaining equal numbers of suture [Figure 7].
Immediate postoperative after closure of skin
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F8
After microvascular anastomosis, vascular clamps were removed and closure was done in layers with 4-0 vicryl and finally skin was sutured with nylon [Figure 8].