krittika Aggarwal - Academia.edu (original) (raw)

Papers by krittika Aggarwal

Türk plastik cerrahi dergisi, 2022

Introduction: Windblown hand or congenital ulnar drift of hand is a rare deformity which affects ... more Introduction: Windblown hand or congenital ulnar drift of hand is a rare deformity which affects all the digits including the thumb and can lead to functional impairment. Associated syndromes affecting the head, face, and feet should be ruled out. Windblown hand has three main features: (1) Contracture of the fingers with flexion deformity, (2) adduction contracture of the thumb causing narrowing of the first webspace, and (3) ulnar deviation of the fingers at the metacarpophalangeal joint. Early treatment is effective. Methods: We performed surgical correction in three cases of bilateral windblown hands. The extensor digitorum tendons were repositioned over the metacarpophalangeal heads by longitudinal plication of radial sagittal bands. In one case, skin contracture release for the first webspace was also done. Splinting with radial deviation and extension at metacarpophalangeal joint was done for 3 weeks. The average follow-up time was 6 months. Results: No skin necrosis or infection was seen in postoperative period. The patient satisfaction ranged from very good to excellent. For all the patients, first, the nondominant hand was operated, then all opted for surgical correction of the opposite hand as well. Conclusions: Windblown hand can lead to functional impairment and needs early correction. Parents and patients should be counseled about the chances of recurrence and incomplete correction. However, surgical treatment and subsequent physiotherapy can improve the functional range and aesthetics of the hand.

Indian Journal of Plastic Surgery, Dec 1, 2022

Archives of Plastic Surgery, Mar 1, 2023

Anz Journal of Surgery, Sep 1, 2015

Indian Journal of Plastic Surgery

Background Reconstruction of thumb tip, while providing a durable and sensate flap, is a challeng... more Background Reconstruction of thumb tip, while providing a durable and sensate flap, is a challenging task. It is important as thumb accounts for 50% of hand functions. Options for coverage are: healing by secondary intention, local/regional flaps, microsurgical toe wraparound flap, etc. First dorsal metacarpal artery (FDMA) flap is one regional flap that has been used for thumb cover, usually for defects till interphalangeal joint or just distal to it. We present our case series for FDMA flap and its variations for thumb reconstruction. We also report reverse FDMA flap cover for reconstruction of defects over distal phalanx of thumb. Methods The procedure was performed in patients with partial loss of thumb soft tissue in 16 patients presenting during 2017 to 2020. The FDMA flap was performed according to the standard technique. In case after “planning in reverse,” it was seen that the reach of FDMA flap was insufficient, reverse FDMA flap was done. Physiotherapy for index finger an...

Indian Journal of Plastic Surgery

Introduction Hand helps us perform our work and express ourselves. Cleft hand is an aesthetic def... more Introduction Hand helps us perform our work and express ourselves. Cleft hand is an aesthetic deformity rather than functional. We document our experience in five such cases from the ages of 3 to 5 years who underwent reconstruction under general anesthesia. Materials and Methods Three patients underwent Snow–Littler procedure, one underwent osteotomy for angled metacarpal and transverse metacarpal ligament reconstruction, and one underwent removal of transverse bone and transverse metacarpal ligament reconstruction. Splintage was done for 6 to 8 weeks and physiotherapy started. Function was assessed at 6 months. Results The operating time ranged from 2 to 3 hours. No major postoperative complications were noted. The parents' satisfaction was excellent at 6 months. None of the patients needed revision surgery for recurrence or first web space widening. Conclusion Cleft hand needs to be analyzed for the adequacy of first web space. The reconstruction is aimed at functional first ...

Turkish Journal of Plastic Surgery

Introduction: Windblown hand or congenital ulnar drift of hand is a rare deformity which affects ... more Introduction: Windblown hand or congenital ulnar drift of hand is a rare deformity which affects all the digits including the thumb and can lead to functional impairment. Associated syndromes affecting the head, face, and feet should be ruled out. Windblown hand has three main features: (1) Contracture of the fingers with flexion deformity, (2) adduction contracture of the thumb causing narrowing of the first webspace, and (3) ulnar deviation of the fingers at the metacarpophalangeal joint. Early treatment is effective. Methods: We performed surgical correction in three cases of bilateral windblown hands. The extensor digitorum tendons were repositioned over the metacarpophalangeal heads by longitudinal plication of radial sagittal bands. In one case, skin contracture release for the first webspace was also done. Splinting with radial deviation and extension at metacarpophalangeal joint was done for 3 weeks. The average follow-up time was 6 months. Results: No skin necrosis or infection was seen in postoperative period. The patient satisfaction ranged from very good to excellent. For all the patients, first, the nondominant hand was operated, then all opted for surgical correction of the opposite hand as well. Conclusions: Windblown hand can lead to functional impairment and needs early correction. Parents and patients should be counseled about the chances of recurrence and incomplete correction. However, surgical treatment and subsequent physiotherapy can improve the functional range and aesthetics of the hand.

ANZ Journal of Surgery, 2015

Archives of Plastic Surgery

Background Human bite wounds in emergency department need evaluation in regard of reconstruction.... more Background Human bite wounds in emergency department need evaluation in regard of reconstruction. These are due to occlusive bite injuries over face. Most commonly, human bites over face involve ear and nose, and may lead to avulsion injury. Defects over nose can be reconstructed immediately after debridement or delayed till the wound heals and scar becomes supple. Thorough wash and lavage with broad- spectrum antibiotic cover has utmost importance in preventing cartilage infection. Methods We report 20 cases of human bite injuries over nose who presented to us in emergency department between 2018 and 2020. At the time of presentation the wound was assessed for closure. If not possible, patient was planned for delayed reconstruction after 3 months. In case delayed reconstruction was planned, the skin and nasal mucosa were approximated at first presentation. The patients underwent paramedian forehead flap after recreation of defect with conchal cartilage graft. Second stage of flap d...

Journal of Cleft Lip Palate and Craniofacial Anomalies

A 29-year-old gentleman presented to surgery emergency with severe upper abdominal pain and vomit... more A 29-year-old gentleman presented to surgery emergency with severe upper abdominal pain and vomiting. He reported to had been hit in his abdomen by a ball during a cricket match. Computerized tomogram of the abdomen revealed hematoma within the gallbladder lumen, laceration of segment six of liver, and hemoperitoneum. The patient did not agree for laparotomy advised to him, and so, managed conservatively. The patient reported back to us with high grade fever, jaundice, and painful abdominal distension after seven days of discharge from the hospital. His abdominal examination showed features of generalized peritonitis. Surgical abdominal exploration revealed a single perforation in the fundus of gallbladder with frozen calot’striangle. Subtotal cholecystectomy was done. Histopathology of excised gallbladder revealed xanthogranulomatous inflammation. The present case report highlights that early exploration and cholecystectomy should be considered in patients with gallbladder injury t...

Turkish Journal of Plastic Surgery, 2021

Introduction: Nose is the most noticeable feature in the facial profile. Any deformity of nose ca... more Introduction: Nose is the most noticeable feature in the facial profile. Any deformity of nose causes social embarrassment and ridicule. Isolated nasal alar hypoplasia/cleft or traumatic loss is a rare anomaly which requires reconstruction. Congenital deficiency of soft triangle of nose and part of ala is not paid attention to in early childhood. Hence, most of these individuals present in late childhood, adolescence or adulthood. We report ten such cases and their reconstruction using two stage ipsilateral interpolated nasolabial flap. Material and Methods: Demographic data including age, sex, associated co-morbidities, previous surgeries or history of trauma were documented. Patients were in age group of 10-25 years. The mean size of defect was 1.5 X 1.6 cm. Inferiorly based skin flap raised from ala was turned down and used as inner lining. Conchal cartilage graft was placed for support in the first stage itself. Nasolabial flap was raised by subcutaneous dissection and insetting...

Introduction: Burn injuries constitute a major part of traumatic injuries and most commonly are a... more Introduction: Burn injuries constitute a major part of traumatic injuries and most commonly are accidental. They have devastating mental and functional sequelae apart from increased chances of mortality. Knowledge about the prognosis of various burn injuries and the risk factors leading to complications helps treat them. This study was undertaken to document the epidemiological data of burn patients admitted in Pt BD Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India, from January 2019 to December 2019. Materials and Methods: Demographic details including age, sex, cause and nature of injury, associated comorbidities, depth and percentage of body area involved, involvement of the face and suspected inhalation injury, survival, period of survival, and mortality rate were recorded. For the pediatric population, weight for age was taken as an indicator for nutrition. Patients who left against medical advice were excluded from the study. P < 0.05 was considere...

Indian Journal of Plastic Surgery : Official Publication of the Association of Plastic Surgeons of India, 2021

Introduction Reconstruction forms the primary tenet in plastic surgery. Venous flaps are a known... more Introduction Reconstruction forms the primary tenet in plastic surgery. Venous flaps are a known option but the survival is limited. Arterialization of venous flap can enhance its survival. While various techniques of arterialization of venous flaps are described, there are very few studies comparing them. Material and methods The current study was conducted among 34 rats weighing 160 to 200 grams. The rats were divided into four groups. Group I—islanded epigastric flap was raised with superficial caudal epigastric vessels as pedicle. Group II—arterialized flow through venous flap was raised with superficial caudal epigastric vein (SCEV) as afferent and lateral thoracic vein as drainage vein. Side-to-side anastomosis was done between femoral artery and vein, lateral to the origin of superficial caudal epigastric artery. Group III—after raising the flap, as in group II, femoral vein was ligated proximal to superficial caudal epigastric vessels. Group IV—an arterialized flow through...

Indian Journal of Plastic Surgery

Indian Journal of Plastic Surgery

The Malaysian journal of medical sciences : MJMS, 2016

Castleman disease (CD) is a rare lymphoproliferative disorder of unknown aetiology. It manifests ... more Castleman disease (CD) is a rare lymphoproliferative disorder of unknown aetiology. It manifests in two distinct clinical presentations: unicentric and multicentric. Unicentric CD is rare and may present as an isolated neck mass. A 22-year-old man presented with a 6-month history of right neck swelling that occupied the posterior triangle of the right neck region. After surgical exploration, a solitary, well defined, and hyper vascular mass was excise. A histopathological examination confirmed the lesion as CD, hyaline-vascular variant. CD of the neck is a diagnosis that is usually not taken into consideration while evaluating neck masses due to its rarity and unassuming presentation. It should be keep in the differential diagnosis of neck masses as the clinical and radiological features evade a firm diagnosis. The treatment of unicentric CD is complete surgical excision, which cures the patient.

Türk plastik cerrahi dergisi, 2022

Introduction: Windblown hand or congenital ulnar drift of hand is a rare deformity which affects ... more Introduction: Windblown hand or congenital ulnar drift of hand is a rare deformity which affects all the digits including the thumb and can lead to functional impairment. Associated syndromes affecting the head, face, and feet should be ruled out. Windblown hand has three main features: (1) Contracture of the fingers with flexion deformity, (2) adduction contracture of the thumb causing narrowing of the first webspace, and (3) ulnar deviation of the fingers at the metacarpophalangeal joint. Early treatment is effective. Methods: We performed surgical correction in three cases of bilateral windblown hands. The extensor digitorum tendons were repositioned over the metacarpophalangeal heads by longitudinal plication of radial sagittal bands. In one case, skin contracture release for the first webspace was also done. Splinting with radial deviation and extension at metacarpophalangeal joint was done for 3 weeks. The average follow-up time was 6 months. Results: No skin necrosis or infection was seen in postoperative period. The patient satisfaction ranged from very good to excellent. For all the patients, first, the nondominant hand was operated, then all opted for surgical correction of the opposite hand as well. Conclusions: Windblown hand can lead to functional impairment and needs early correction. Parents and patients should be counseled about the chances of recurrence and incomplete correction. However, surgical treatment and subsequent physiotherapy can improve the functional range and aesthetics of the hand.

Indian Journal of Plastic Surgery, Dec 1, 2022

Archives of Plastic Surgery, Mar 1, 2023

Anz Journal of Surgery, Sep 1, 2015

Indian Journal of Plastic Surgery

Background Reconstruction of thumb tip, while providing a durable and sensate flap, is a challeng... more Background Reconstruction of thumb tip, while providing a durable and sensate flap, is a challenging task. It is important as thumb accounts for 50% of hand functions. Options for coverage are: healing by secondary intention, local/regional flaps, microsurgical toe wraparound flap, etc. First dorsal metacarpal artery (FDMA) flap is one regional flap that has been used for thumb cover, usually for defects till interphalangeal joint or just distal to it. We present our case series for FDMA flap and its variations for thumb reconstruction. We also report reverse FDMA flap cover for reconstruction of defects over distal phalanx of thumb. Methods The procedure was performed in patients with partial loss of thumb soft tissue in 16 patients presenting during 2017 to 2020. The FDMA flap was performed according to the standard technique. In case after “planning in reverse,” it was seen that the reach of FDMA flap was insufficient, reverse FDMA flap was done. Physiotherapy for index finger an...

Indian Journal of Plastic Surgery

Introduction Hand helps us perform our work and express ourselves. Cleft hand is an aesthetic def... more Introduction Hand helps us perform our work and express ourselves. Cleft hand is an aesthetic deformity rather than functional. We document our experience in five such cases from the ages of 3 to 5 years who underwent reconstruction under general anesthesia. Materials and Methods Three patients underwent Snow–Littler procedure, one underwent osteotomy for angled metacarpal and transverse metacarpal ligament reconstruction, and one underwent removal of transverse bone and transverse metacarpal ligament reconstruction. Splintage was done for 6 to 8 weeks and physiotherapy started. Function was assessed at 6 months. Results The operating time ranged from 2 to 3 hours. No major postoperative complications were noted. The parents' satisfaction was excellent at 6 months. None of the patients needed revision surgery for recurrence or first web space widening. Conclusion Cleft hand needs to be analyzed for the adequacy of first web space. The reconstruction is aimed at functional first ...

Turkish Journal of Plastic Surgery

Introduction: Windblown hand or congenital ulnar drift of hand is a rare deformity which affects ... more Introduction: Windblown hand or congenital ulnar drift of hand is a rare deformity which affects all the digits including the thumb and can lead to functional impairment. Associated syndromes affecting the head, face, and feet should be ruled out. Windblown hand has three main features: (1) Contracture of the fingers with flexion deformity, (2) adduction contracture of the thumb causing narrowing of the first webspace, and (3) ulnar deviation of the fingers at the metacarpophalangeal joint. Early treatment is effective. Methods: We performed surgical correction in three cases of bilateral windblown hands. The extensor digitorum tendons were repositioned over the metacarpophalangeal heads by longitudinal plication of radial sagittal bands. In one case, skin contracture release for the first webspace was also done. Splinting with radial deviation and extension at metacarpophalangeal joint was done for 3 weeks. The average follow-up time was 6 months. Results: No skin necrosis or infection was seen in postoperative period. The patient satisfaction ranged from very good to excellent. For all the patients, first, the nondominant hand was operated, then all opted for surgical correction of the opposite hand as well. Conclusions: Windblown hand can lead to functional impairment and needs early correction. Parents and patients should be counseled about the chances of recurrence and incomplete correction. However, surgical treatment and subsequent physiotherapy can improve the functional range and aesthetics of the hand.

ANZ Journal of Surgery, 2015

Archives of Plastic Surgery

Background Human bite wounds in emergency department need evaluation in regard of reconstruction.... more Background Human bite wounds in emergency department need evaluation in regard of reconstruction. These are due to occlusive bite injuries over face. Most commonly, human bites over face involve ear and nose, and may lead to avulsion injury. Defects over nose can be reconstructed immediately after debridement or delayed till the wound heals and scar becomes supple. Thorough wash and lavage with broad- spectrum antibiotic cover has utmost importance in preventing cartilage infection. Methods We report 20 cases of human bite injuries over nose who presented to us in emergency department between 2018 and 2020. At the time of presentation the wound was assessed for closure. If not possible, patient was planned for delayed reconstruction after 3 months. In case delayed reconstruction was planned, the skin and nasal mucosa were approximated at first presentation. The patients underwent paramedian forehead flap after recreation of defect with conchal cartilage graft. Second stage of flap d...

Journal of Cleft Lip Palate and Craniofacial Anomalies

A 29-year-old gentleman presented to surgery emergency with severe upper abdominal pain and vomit... more A 29-year-old gentleman presented to surgery emergency with severe upper abdominal pain and vomiting. He reported to had been hit in his abdomen by a ball during a cricket match. Computerized tomogram of the abdomen revealed hematoma within the gallbladder lumen, laceration of segment six of liver, and hemoperitoneum. The patient did not agree for laparotomy advised to him, and so, managed conservatively. The patient reported back to us with high grade fever, jaundice, and painful abdominal distension after seven days of discharge from the hospital. His abdominal examination showed features of generalized peritonitis. Surgical abdominal exploration revealed a single perforation in the fundus of gallbladder with frozen calot’striangle. Subtotal cholecystectomy was done. Histopathology of excised gallbladder revealed xanthogranulomatous inflammation. The present case report highlights that early exploration and cholecystectomy should be considered in patients with gallbladder injury t...

Turkish Journal of Plastic Surgery, 2021

Introduction: Nose is the most noticeable feature in the facial profile. Any deformity of nose ca... more Introduction: Nose is the most noticeable feature in the facial profile. Any deformity of nose causes social embarrassment and ridicule. Isolated nasal alar hypoplasia/cleft or traumatic loss is a rare anomaly which requires reconstruction. Congenital deficiency of soft triangle of nose and part of ala is not paid attention to in early childhood. Hence, most of these individuals present in late childhood, adolescence or adulthood. We report ten such cases and their reconstruction using two stage ipsilateral interpolated nasolabial flap. Material and Methods: Demographic data including age, sex, associated co-morbidities, previous surgeries or history of trauma were documented. Patients were in age group of 10-25 years. The mean size of defect was 1.5 X 1.6 cm. Inferiorly based skin flap raised from ala was turned down and used as inner lining. Conchal cartilage graft was placed for support in the first stage itself. Nasolabial flap was raised by subcutaneous dissection and insetting...

Introduction: Burn injuries constitute a major part of traumatic injuries and most commonly are a... more Introduction: Burn injuries constitute a major part of traumatic injuries and most commonly are accidental. They have devastating mental and functional sequelae apart from increased chances of mortality. Knowledge about the prognosis of various burn injuries and the risk factors leading to complications helps treat them. This study was undertaken to document the epidemiological data of burn patients admitted in Pt BD Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India, from January 2019 to December 2019. Materials and Methods: Demographic details including age, sex, cause and nature of injury, associated comorbidities, depth and percentage of body area involved, involvement of the face and suspected inhalation injury, survival, period of survival, and mortality rate were recorded. For the pediatric population, weight for age was taken as an indicator for nutrition. Patients who left against medical advice were excluded from the study. P < 0.05 was considere...

Indian Journal of Plastic Surgery : Official Publication of the Association of Plastic Surgeons of India, 2021

Introduction Reconstruction forms the primary tenet in plastic surgery. Venous flaps are a known... more Introduction Reconstruction forms the primary tenet in plastic surgery. Venous flaps are a known option but the survival is limited. Arterialization of venous flap can enhance its survival. While various techniques of arterialization of venous flaps are described, there are very few studies comparing them. Material and methods The current study was conducted among 34 rats weighing 160 to 200 grams. The rats were divided into four groups. Group I—islanded epigastric flap was raised with superficial caudal epigastric vessels as pedicle. Group II—arterialized flow through venous flap was raised with superficial caudal epigastric vein (SCEV) as afferent and lateral thoracic vein as drainage vein. Side-to-side anastomosis was done between femoral artery and vein, lateral to the origin of superficial caudal epigastric artery. Group III—after raising the flap, as in group II, femoral vein was ligated proximal to superficial caudal epigastric vessels. Group IV—an arterialized flow through...

Indian Journal of Plastic Surgery

Indian Journal of Plastic Surgery

The Malaysian journal of medical sciences : MJMS, 2016

Castleman disease (CD) is a rare lymphoproliferative disorder of unknown aetiology. It manifests ... more Castleman disease (CD) is a rare lymphoproliferative disorder of unknown aetiology. It manifests in two distinct clinical presentations: unicentric and multicentric. Unicentric CD is rare and may present as an isolated neck mass. A 22-year-old man presented with a 6-month history of right neck swelling that occupied the posterior triangle of the right neck region. After surgical exploration, a solitary, well defined, and hyper vascular mass was excise. A histopathological examination confirmed the lesion as CD, hyaline-vascular variant. CD of the neck is a diagnosis that is usually not taken into consideration while evaluating neck masses due to its rarity and unassuming presentation. It should be keep in the differential diagnosis of neck masses as the clinical and radiological features evade a firm diagnosis. The treatment of unicentric CD is complete surgical excision, which cures the patient.