Audit Report

Dear sir /Madam,

                May this new year be a step forward, in leading you to new adventures, new roads to explore and new success to reach: Warm wishes for a bright and a prosperous new year. Another reason for writing this letter is to present my last 16 months surgical audit and to share my experience at Nagpur city.

                I have operated many types of patients at various hospitals at Nagpur, alone and in association with senior plastic surgeons of Nagpur.  Microvascular and Hand surgery is my special area of interest, I have  done tendon transfer in different types of nerve injuries. I always try to reinforce the plastic surgery services available at our city by continues patient care, refinement in surgical procedures, case discussions and presentation at various forums and with seniors and colleagues.  Plastic surgery is also known as, a problem solving specialty so fortunately we have opportunity to have association with all the known specialties and super specialties available at present in medical science.

                In future,  the scope of plastic surgery and medical sciences will become more demanding because of patient awareness and social media. Therefore it becomes necessary for us to know about available services and doctors at our place to guide our patients to solve his /her problem. This surgical audit is a way to inform you about my surgical capabilities and the options, I am providing to my patients at Nagpur.

Cases operated from 01-08-2012 to 01-12-13

		Vascular Surgery
No.	Diagnosis	Procedure	Cases	Remarks
1	CRF/ Other kidney diseases	A-V Fistula	58	1 pt developed Brachial A. Aneurysm
2	Radial / Ulnar Artery Injury	Primary repair	13
3	Radial / Ulnar Artery Injury	Thromboembolectomy  and Vein graft	5
4	Brachial Artery Injury	Primary repair	2
5	Brachial Artery Injury	Thromboembolectomy and Vein graft	3
6	Popliteal  Artery Injury	Primary repair/ Thromboembolectomy and Vein graft	1	Operated at Getwell Hospital with Dr Y. Deshmukh
7	Post Traumatic amputation	Replantation  Fore arm	2	1Pt went in to septicemia so replanted arm was amputated
		Replantation Thumb	1	Thumb survived
8	Flexor tendon and Vascular injury	Revascularisation Wrist	8
9	Various Defects	Microvascular free Flap	28	All of them With Dr S. Nisal and At Sparsh Clinics, Care Hospital & Others Flap Necrosis - 2 Pt
10	Bleeding	Artery Ligation	2
11	Radial Artery / Brachial Artery Aneurysm	Post Infectious	2
12	Lower limb Varicosity	Varicose Vein Surgery	2
13	Ext. Iliac Artery Injury	Vein Graft	1
		Reconstructive Surgery
No	Procedure	Diagnosis	Cases	Remarks
1	SSG	Raw Area	86
2	VAC Therapy	Infected Wound	22	Followed by SSG or Flap
3	fasciocuteneous flap	Ant Tibial / fore arm defect	18
4	Muscle Flap/ Musculocutaneous Flaps	Ant Tibial / Fore arm/Bed sore	9
5	Free Flap(Free Fibula, RAFF, ALT & LD)	Lower limb / Upper limb / Oral Malignancy	31	All of them With Dr S. Nisal and At Sparsh Clinics, Care Hospital & Others Flap Necrosis - 2 Pt
6	Flap for head neck Region (pedicle)	Trauma/Malignancy	11
7	Abductor Digiti Minimi Flap	Sole defect	2
8	Tendo Achilles Repair	Repair with Modified Technique & Plantaris Tendon Graft	1
		Cosmetic Surgery
No	Procedure	Diagnosis	Cases	Remarks
1	Rhinoplasty	Nose deformity	17
2	Lip repair	Cleft lip/ trauma	8
3	Face lift	Ageing	-
4	Breast Augmentation	Small Breast deformity	5	At Sparsh Clinics
5	Breast Reduction	Big Breast	1
6	Scar revision	Scar Face	14
7	Tattoo removal		3
8	Liposuction		4	At Sparsh Clinics
9	Breast reconstruction	-	-
10	Temporalis / Masseter Muscle  Transfer	Facial Palsy	2	At Sparsh clinics and at Pioneer Nursing  Home
11	Fibroadenoma Breast Excision by NAC incision	Fibroadenoma Breast	3	Cosmetic Breast Surgery with minimal scaring over breast
12	Gynecomastia	Excision / Liposuction	3
		Oro Maxillofacial Surgery
No	Procedure	Diagnosis	Cases	Remarks
1	# Nasal bone Reduction	Trauma	9	Closed reduction
2	# Mandible Fixation	Trauma	29	ORIF Plating
3	# Maxilla Fixation	Trauma	13	ORIF Plating
4	# Condyle Reduction	Trauma	7	1 pt treated by ORIF Plating
5	Gap Arthroplasty And Interposition of temporal fascia	TM Joint Ankylosis	-	-
6	# Frontal Bone Fixation	Trauma	5	2 cases with neuro Surgeon

		Hand Surgery
S No	Diagnosis	Procedure	Cases	Remarks
1	Finger Tip Defect / Soft tissue Defect	V-Y Advancement Flap/ Cross finger flap	7
2	# Phalanx / Metacarpal	K wire / Closed reduction	5
3	Large Hand defect	Free ALT/ SSG / Post interosseous flap	8
4	Contracture	Release and SSG	9
5	Flexor Tendon injury	FPL/ FDP/ FDS repair	13
6	Extensor tendon injury	EIP/ EDC/ EPL repair	9
7	Wrist drop	Tendon Transfer (Pronator teres/PL/FCU)	1
8	PIN injury with EPL, EDC Muscle tear	PIN and Muscle repair with Tendon Transfer (PL to EPL and BR to EDC)	1
9	Finger drop	Tendon Transfer (Pronetor teres To EDC)	1
10	Ulnar claw hand	Zancolli's Lasso Procedure	1
11	Scaphoid #	Vascular Bone Graft	1	At Dashputra Hospital
12	Dupuytren's contracture	Palmer Fascia Excision	1
13	Nerve injury	Primary repair / Sural nerve graft	6
14	Replantation	Amputed digit or limb	4	2 cases at Sparsh Clinics
		Genito Urinary Surgery
S No	Diagnosis	Procedure	Cases	Remarks
1	Short Penis	Penile lengthening	1
2	Amputed penis	Penile reconstruction	-
3	Hypospadias	MAGPI/ASOPA/ Cecil Culp	6	I case had history of multiple surgeries
4	Anal incontinence and recto vaginal fistula	Graciloplasty	1	At IGGMC with Dr S. Nisal.  Pt regained continence
5	Vaginal tightening / Hymenoplasty		-
6	Vaginal reconstruction	-	-
7	Post Vasectomy / Tubectomy Pts	Vasectomy / Tubectomy Recanalization or reversal	-
		Oculoplastic surgery
S No	Diagnosis	Procedure	Cases	Remarks
1	Ptosis	Silicon sling	1
2	Lid reconstruction/Repair	Trauma	3
3	Facial Palsy	Temporalis sling	2
		Pediatric plastic surgery
S No	Diagnosis	Procedure	Cases	Remarks
1	Syndactyly / Polydactyly	Release	5
2	Cleft palate	Palatoplasty	3
3	Voice Deformity	Pharyngoplasty	-
4	Microtia	Ear reconstruction	1
5	Phimosis	Circumcision	3
		Burn Management
S No	Diagnosis	Procedure	Cases	Remarks
1	Post Burn Raw Area	Grafting	11	Collagen sheet dressing Followed by SSG in 4 cases
2	Post Burn Raw Area	Flap	2
3	Post Burn Raw Area	Conservative	5

                I am associated with following hospitals and senior plastic surgeons at Nagpur.

Dr Shailesh Nisal , Sparsh Clinics

Dr Syed Ilyas , Pioneer  Nursing Home

Radha Krishna Hospital

Shrawan Hospital

Kunal Hospital

Prestige hospital

Metro hospital

Medicare Hospital

Lotus Hospital

Abhiyog Hospital

PrestoMadan Hospital

Gaikwad Critical care and Eye hospital

Auro Critical Care

Rahate Surgical Hospital

Lifeline Hospital & Others

                Dear sir / madam,

                 I am thankful to my patients, senior plastic surgeons of Nagpur city and all the associated  hospitals who have given me the opportunity to operate at their setup. I am also looking forward and hope to continued & new association with your hospitals, clinics, and patients.

                Again I wishes for a happy new year to you and your family.

Date                                                                                                                      From

Place Nagpur                                                                                                Dr Amol K Patel
                                                                                      Plastic Surgeon, Shrawan Hospital, Nagpur,(09)
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