Clinical Journal of Plastic and Reconstructive Surgery

Reconstruction of a Post-Oncologic Knee Defect using Negative Pressure Wound Therapy and Acellular Dermal Matrix: A Reconstruction 2.0 Approach

Mon, 22 Dec 2025 00:00:00 +0530

Reconstruction of lower-extremity defects following oncologic resection is challenging, particularly around mobile joints such as the knee. The reconstructive approach must ensure oncologic safety while preserving limb function, durability of coverage, and acceptable aesthetic outcomes. Recent advances advocate a non-linear, individualized reconstructive strategy consistent with the principles of Reconstruction 2.0.

Management Strategies of Major Burns and Learning Curve

Vijay Kumar, Sandhya Pandey, Bhavya Naithani — Mon, 22 Dec 2025 00:00:00 +0530

Large total body surface area burns can have a substantial impact on morbidity and mortality, but with early management and intervention by a skilled surgical team, outcomes can be favorable. The purpose of our study is to discuss the management of extensive burns and review the experience at our center. A review of patients admitted to this hospital in the previous two years, with burns greater that 50% was done. From July 2022 to July 2024, 43 patients with burn sizes more than 50% TBSA were admitted. Female: male ratio was 1.047:1 and with average age of 28.674 ± 9.37 years (range 9 to 58 years). There was an average delay of 2.053±2.19 days between the burn and arrival at our centre (Range of 3 hours to 9 days). Esharotomies and fasciotomy was done in 20 and 8 patients, respectively. All patients expired in the hospital except one, who went LAMA. 20 patients survived for 2 to 5 days. Major cause of death in most of the patients was Sepsis. The two most significant risk variables affecting a burn victim's survival and clinical outcome are burn size and depth. Because donor sites are insufficient for the necessary grafting procedures, burns with a size greater than 80% of the total body surface area (TBSA) provide daunting surgical obstacles. Comfort care may be the best choice when clinical predictors indicate no likelihood of success.

Trends in the Causes and Severity of Household Burns during the COVID-19 Pandemic: A Longitudinal Study

Smitha S Segu, Peddi Manjunath, Vishnuram Venkataramanan — Mon, 22 Dec 2025 00:00:00 +0530

Background: Burn injuries remain a global public health challenge with significant morbidity, mortality, and socioeconomic burden. The COVID-19 pandemic, through nationwide lockdowns and lifestyle alterations, influenced patterns of domestic accidents, including burns. While earlier studies examined short-term effects of lockdowns, limited literature exists on longitudinal outcomes in a metropolitan burn centre.

Objective: To assess the impact of the COVID-19 pandemic on burn epidemiology, clinical severity, and outcomes, and to compare findings across pre-COVID, COVID, and post-COVID periods

Methods: A retrospective observational study was conducted at a major burn centre in Bengaluru from September 2018 to December 2022. The study period was divided into three 17-month intervals: pre-COVID (Sept 2018–Jan 2020), COVID (Feb 2020–Jun 2021), and post-COVID (Jul 2021–Dec 2022). Demographic data, type and etiology of burns, severity (total body surface area, TBSA), management, hospital stay, COVID-19 positivity, and mortality were analysed.

Results: A 30% reduction in burn admissions occurred during the COVID period. A reversal in gender distribution was observed, with females outnumbering males. Age distribution showed reduced incidence in extremes and increased incidence among middle-aged adults. Thermal burns significantly increased, while scald, electrical, chemical, and cracker-related burns decreased. Severity of burns, measured by TBSA, increased during the pandemic. Accidental burns predominated, whereas suicidal and homicidal burns declined. Mortality rates increased substantially, particularly among COVID-positive burn patients who also experienced longer hospital stays. Elective burn surgeries decreased during the pandemic due to restricted healthcare capacity.

Conclusion: The COVID-19 pandemic significantly altered the epidemiology of burns in metropolitan India. Fewer admissions masked higher burn severity and mortality, underscoring gaps in access to timely burn care. Preventive measures, community education, and resilient burn management protocols are critical for safeguarding vulnerable populations during future crises.

Mandibular Fracture Trends in Chennai, India: A Retrospective Analysis

R Mowthikaruna, J J Lankaram, T Alia Hussain, Nellaiappar — Mon, 22 Dec 2025 00:00:00 +0530

Background: With the rising trend of speeding automobiles and violation of safety measures, there has been an increasing trend of facial bone fractures. This retrospective study is aimed at analyzing the incidence, anatomical pattern, etiology, age and gender-wise distribution of mandibular fractures.

Methods: Data of 123 patients belonging to different age groups, gender and etiologies with facial bone fractures visiting our center at Government Kilpauk Medical College Hospital, Chennai, between January 2023 and December 2023 were considered for the study. Patients who discontinued treatment and lost follow-up were excluded from the study.

Results: 81 patients presented with mandibular fracture with an incidence of 6.5%, with road traffic accident being the major etiologic factor. Most of the study population were men belonging to the age group of 20-40 years. Parasymphysis was the most common fractured site in the study. Most of the patients presented with bilateral involvement. 71 of 81 patients were managed surgically.

Conclusion: Road traffic accidents have been the major etiological factor. Most of the population were men between 20 and 40 years. Unlike the literature, parasymphysis was the most common anatomical site of injury found in my study. With the help of the data collected in this study, ergonomics for the safety measure in road traffic accidents and facial trauma can be formulated in the upcoming studies.

Robotics in Plastic Surgery

Vijay Kumar, Sandhya Pandey — Mon, 22 Dec 2025 00:00:00 +0530

Robotic surgery is being used successfully in various surgical specialities like Urosurgery, Neurosurgery, Vascular surgery, Cardiac surgery, Oncosurgery, Gynacology, general surgery, etc. Robotics has gained significant popularity in Plastic surgery over past few years. The spectrum of procedures is vast, including flap dissection, Flap harvest, vascular anastomosis, microsurgery, super microsurgery, etc.
The advantages are multifold, like enhanced precision, degree of freedom, flexibility, excellent control, better ergonomics, improved spatial configuration, lower complication rates, faster recovery, and overall improved surgical outcomes.

Management of Sizeable Arterio-venous Malformation after Infection Post-embolization: An Uncommon Complication of the Common Problem

Prakash Chandra Kala, Pawan Kumar Dixit, Pawan Kumar Garg, Sudeep Khera — Mon, 22 Dec 2025 00:00:00 +0530

Arteriovenous malformations are infrequent anomalies that are most commonly present in the head and neck region. Getting a satisfying functional and aesthetic result in large AVM in the craniofacial region is challenging. Most commonly, these lesions are treated by a combination of embolization followed by surgical resection. Infection after embolization is an infrequent complication. We present a large AVM that involved the upper lip, the floor of the mouth, tongue, and masticator space, which got infected after embolization. Management of this patient is presented and discussed, which led to satisfying functional and aesthetic results.

Invisible Intruders: Case Series of Missed Foreign Bodies

Prashali Chauhan, K T Ramesha, B C Sathyanarayana, Sriranjani Iyer — Mon, 22 Dec 2025 00:00:00 +0530

Missed foreign bodies in the limbs represent a frequent, preventable cause of delayed morbidity. Clinicians should maintain a high index of suspicion in all penetrating limb injuries and utilize appropriate imaging based on the suspected material to avoid oversight and complications.

Recurrent Paediatric Backer’s Cyst: Its Management and Comprehensive Literature Review

Mukta Verma, Sandhya Pandey, Vijay Kumar — Mon, 22 Dec 2025 00:00:00 +0530

Introduction: Baker’s cyst, also known as popliteal synovial cyst, is a rare benign cystic swelling found in popliteal fossa in children. In children, most often these cysts are not associated with meniscal tears and degenerative joint pathology, so the prognosis is good when managed properly.
Case Description: Here, we are presenting this rare case report of paediatric Baker’s cyst with failed conservative management. Finally, it was managed surgically with satisfactory aesthetic and functional outcome.