Sushrutha Institute. Activity Report Elite Mission Hospital. of Plastic. Thrissur,Kerala. Reconstructive & Aesthetic Surgery

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1 Sushrutha Institute of Plastic Reconstructive & Aesthetic Surgery Elite Mission Hospital Thrissur,Kerala Activity Report Department of Plastic, Cosmetic, Hand, Reconstructive Microsurgery & Burns Surgery Activity Report

2 Then... Sushrutha Institute of Plastic Reconstructive & Aesthetic Surgery Thrissur,Kerala Now... To transform the quality of life is the highest of arts Department of Plastic, Cosmetic,Hand, Reconstructive Microsurgery & Burns Surgery Activity Report

3 In this millennium we are witnessing an explosion in changes in all facets of Health Care Service. Science and Technology has made earlier creations obsolete. Acceptance levels of performance all over are increasing and the concept of professionalism is now a major norm. The shift from ISI to ISO s makes this evident. Creation of Sushrutha Institute In such a scenario created by people, options are limited and there cannot be a compromise on quality and performance. Our institution strongly believe in this concept and stands for a set of values and principles apart from its business purpose. Message Elite Mission Hospital has been in the forefront of Health Care Services since its inception in Started with minimal facilities, it has grown up steadily and reached the present stage. Today Elite Mission is a 350 bedded Multi Super Speciality Hospital with all Basic departments and Major Super Specialities. Sushrutha Institute of Plastic, Reconstructive and Aesthetic Surgery was started in the year 2007, Within a short span of time Sushrutha became very popular with five consultants viz. Dr. Aniljith, Dr. Anto Francis, Dr. Pradeep Kumar, Dr. Shaji Mathew, and Dr. Pradeoth working together as a TEAM. The success of this team is the sincerity, dedication, competency and hard work. On behalf of the institution I have great pleasure to complement the entire TEAM for bringing up Sushrutha Institute as a Tertiary Referral Centre. I am very happy to note that Sushrutha Institute is bringing out an activity report during the 4th Annual Conference, which is organized in association with the Annual Conference of Kerala State Plastic Surgery Association. Your ideas and suggestions for the improvement will be highly appreciated. Dr. K. K. MOHANDAS Med. Supdt. & Mg. Partner ELITE MISSION HOSPITAL The urge to form partnerships, to link up in collaborative arrangements, is perhaps the oldest, strongest & most fundamental force in nature Inauguration of our Institute ( ) Lewis Thomas We, our Sushrutha team 2 Activity Report Activity Report

4 Our journey 2007 to 2010 Sushrutha Institute of Plastic, Reconstructive & Aesthetic Surgery is a part of Elite Mission Hospital, Thrissur, Kerala, which is an ISO 9001 institution having a varied heritage of 31 years of glorified service. Our goal is to develop Sushrutha Institute as a centre of excellence providing the highest standard of quality care & service to every patient. Realization of our goals By providing best service & most appropriate treatment available at affordable cost By ensuring that staff in the hospital is specially trained to take care of the kind of patients it serves By making re-habilitation and post operative care a key to ensure speedy & perfect recovery We ensure the feedbacks with photographs to the referring doctors there by maintaining a close co-operation and better follow-up for patients We thank the Management of Elite Mission Hospital, Thrissur... Dr. K. K. Mohandas Medical Superintendent & Managing Partner, Elite Mission Hospital 4 Activity Report By being part of Elite Mission Hospital, which means being able to share resources and service of other super speciality services, helping to put the cost of treatment within reach Sushrutha institute has been accredited by National Board of Examinations to conduct the post-graduate course in plastic surgery leading to the award of the degree DNB in plastic surgery To keep in pace with the latest surgical practices and procedures, we have a well kept library, subscription to various journals and Wi-Fi internet facilities to access the journals online We consider plastic surgery as an art with inspiration from the quotes of Aristotle Art indeed consists in the conception of the result to be produced before its realization in the material....for being the driving force behind setting up of our institute and our success Dr. K. C. Prakasan Managing Partner, Elite Mission Hospital Activity Report

5 Cosmetic Surgery Burns Cancer Reconstruction Hand Surgery Sushrutha Institute The problem solving centre Microvascular & Microneural surgery Facial Surgery Brachial Plexus Surgery Hand Surgery You all will agree with us when we say that even a small injury to the fingertip can lead a great amount of disability in the present competitive world. This department caters to all types of hand injuries from all of central Kerala mostly on a referral basis; in fact it accounts to 2/3rd of our total trauma work. The variety encompasses from simple crush injury tip to multilevel amputations, blasts and burn injuries. We insist on the best treatment for the injury at hand without considering any other bias. We have state of the art facilities for handling whatever type of hand injuries that come to us. We have access to fully fledged operation theaters with Microscopes (Leica, Carlzeiss), Pneumatic Micro Drills, Titanium small fragment fixation system and an enthusiastic hand Physio unit. Apart from trauma, we treat large number of congenital hand anomalies of varying magnitude. We also have good number of primary and secondary procedures done for post nerve injury hand as well as for hand infections. We consider ourselves humbled to see such a large amount of patients suffering from chronic renal failure and whenever called upon to create an Arterio-Venous Fistula for the purpose of Haemodialysis, we always extend a helping hand not only as a Surgeon but also with our charity. We have initiated a programme to educate patients and workers about the need of proper hand care in the industries and common man regarding blast injuries and other home injuries to hand through our Hand Friendly Society. The alarming observation of young children having their hands injured by unsupervised use of crackers and non-skilled laborers working on unprotected machinery was disheartening to see. The magnitude of loss of part and function of this important organ of the body and the relief we have provided in these instances is depicted below with few examples. The patient is the centre of the medical universe around which all our works revolve and towards which all our efforts trend. - J.B Murphy Our Aim To provide best quality care and service with an aim of pursuing the functional as well as aesthetic perfection to patients who entrust their care to our team Our Vision To be recognized by our patients and referring doctors as the best in the provision of service within our field of expertise. Our standard will be to provide service of a comprehensive, sensitive & professional nature. We aspire to be the best by providing the best. Patient with congenital thumb hypoplasia (underdeveloped). Hypoplastic thumb was removed and index finger was used to create the thumb as thumb bears 50% of hand functions. Activity Report

6 Hand Surgery Vascular malformation Hand Blast injury, its consequences and treatment Patient with traumatic loss of right thumb. Second toe from the left foot utilized to create the thumb. Groin flap for Right hand defect Functional restriction of movements occur due to thickening of tissue beneath the palmar skin (dupuytrens contracture) for which the thickened fascia is removed and function is restored. FDMA flap for thumb defect 8 Activity Report Activity Report

7 Reconstructive Microsurgery Sushrutha Institute microsurgery unit is a purpose built facility to manage and treat all range of microsurgical problems. It is facilitated by the team of plastic surgeons, anaesthesiologist and availability of dedicated operation theaters. The assistance of a very skilled orthopedic service is also available for the management of major bony injuries. Three operation theatres are available round the clock and it enables us to reduce the waiting time for the procedures. Microsurgery is a surgical technique with a various application from head to foot reconstruction that uses microscopic assistance to repair and treat structures (artery, vein, nerves etc.) that are small to naked eye with perfection. Patient with loss of hair bearing tissue over the head due to trauma for which the entire tissue was reconstructed with omental tissue was taken from abdomen. Traumatic loss of tissue over the forehead region was reconstructed with radial forearm flap. Later hair transplantation was done to recreate eyebrow. Traumatic loss of tissue from left upper limb. Rectus muscle and skin tissue was taken as separate unit for both function and cover of the lost tissue in the upper limb 10 Activity Report Activity Report

8 Obstetric Brachial Plexus Injury We provide pamplets to parents of children who are suffering from brachial plexus birth palsy to educate their mother about the care and physiotherapy required before and after surgery. Brachial Plexus Surgery Case of late obstetric brachial plexus palsy with Gilbert III shoulder. Managed by L-episcopo procedure. Latissimus Dorsi and Teres major muscle transfer with subscapular muscle release. Sushrutha Institute has been in forefront for treatment of brachial plexus injuries. We use advanced microsurgical techniques (including nerves and muscle transfers) to repair damaged brachial plexus nerves, muscles and tendons. A panel of surgical specialties including orthopaedic surgeons, neurosurgeons, neurologist and physical medicine specialist work together to repair the damage and to restore as much functions as possible. Overview Brachial plexus is a network of nerves that starts in our spinal cord and controls muscle movements in our shoulder, arm and hand and provides sensation to these areas. Brachial plexus injuries most commonly occur after an accident, sports injury or during child birth can leave the limb without function/ sensation. Adult brachial plexus injury Patient with traumatic injury subclavian vessels and brachial plexus injury. Managed initially by vascular repair, subsequently by combination of peripheral nerve transfers and nerve grafts. Peripheral Nerve Surgery Peripheral nerve surgeries encompass acute nerve injuries, entrapment neuropathies and nerve tumors. Multidisciplinary care for patients with peripheral nerve disorders makes Sushrutha Institute the obvious choice for peripheral nerve surgeries. A case of peripheral nerve sheath tumor arising from the branch of median nerve excision done in toto 12 Activity Report Activity Report

9 Free surgery for cleft lip & palate patients Clefts of lip, alveolus and palate are the most common congenital anomalies of orofacial region. The ultimate goal in cleft lip and palate management is achievement of normal appearance and normal speech. Surgical techniques are aimed at restoring normal anatomy with emphasis on muscular reconstruction of lip and soft palate. Surgery for lip and palate patients are done free of charges, including medications and hospital stay. Following primary surgery, regular follow up by multidisciplinary team is essential. Elite hospital is fully equipped with all modern facilities to provide state of the art treatment for cleft patients with the help of our multidisciplinary team comprising Paediatricians, ENT Surgeons, Orthodontists, Prosthodontists, Speech Therapists, Oral & Maxillofacial Surgeons in addition to the team of Plastic Surgeons. After primary surgery, subsequent surgeries like pharyngoplasty, alveolar bone grafting, secondary correction of lip & nasal deformities and orthognathic surgery for jaw deformities are undertaken according to requirement. Lymphoedema Filariasis is the commonest cause of lymphoedema in our part of the world. According to WHO, filariasis is the most common cause after leprosy, of long term disability. Patients with lymphoedema often have recurrent infections leading to further fibrosis and increase in oedema. Most of the patients with lymphoedema can be managed conservatively with advice for limb elevation, use of pressure bandages, massage etc. Although lymphoedema is not curable, a lot of improvement can be achieved in the quality of life of these unfortunate patients by proper treatment and incidence of infection can be considerably reduced. Surgery in the form of debulking procedures is reserved for advanced cases. After surgery patients are advised to continue use of pressure garments or pressure bandages to prevent recurrence of oedema. Complete unilateral cleft lip lip repair done We in our unit give focus for proper identification of the disease process and plan the line of action accordingly. All patients are given proper education regarding the conservative line of management. Surgery is done on a selective basis followed by continuation of conservative line of management. Cleft palate palatoplasty done Filarial lymphaedema correction in right leg and scrotum 14 Activity Report Activity Report

10 Cosmetic Surgery Statistics Aesthetic plastic surgery involves technique intended for enhancement of appearance through surgery and medical techniques and is specifically concerned with maintaining normal appearance and restoring or enhancing at or beyond the average level towards the aesthetic ideal. The demand for cosmetic surgery is on the rise every day, the improved appearance has a positive effect on self confidence. In this modern era cosmetic surgery has become a necessity rather than a luxury because any physical disfigurement /unattractiveness whether from birth or acquired later, leaves behind a mental and emotional scar in one s life. Our department caters to all types of cosmetic surgeries like liposuction, abdominoplasty, breast augmentation and reduction, rhinoplasty, gynaecomastia, lip reduction, otoplasty, eyelid correction, hair transplantation, body contouring, chin and cheek augmentation, scar revision, dimple creation, fat injection. Apart from above, we also have solution for ACNE scars, wrinkles, unwanted hair growth removal (using VPL Energiest system, UK). We also handle chemical peeling, microdermabrasion, photorejuvenation, botox injection. Dimple creation Thumb replantation Hand Injuries We provide high quality reconstruction to our patients injured due to trauma or occupational hazards. We, at Sushrutha try to integrate the latest techniques and practices refining common procedures, wide range of reconstructive surgery including microsurgery and conventional plastic surgical procedures are employed which suits the patient condition and requirement. Lipoabdominoplasty Finger replantation Wrist replantation Gynaecomastia correction by liposuction Rhinoplasty - Correction of deformity of nose by harvesting bone from hip region Vascular injury right arm - Arterial segment reconstructed with reverse saphenous vein graft 16 Activity Report Activity Report

11 Statistics Hand Surgery Hand injuries Blast injuries Local /free flap Head & Neck Finger injuries Suturing Nail bed repair Nail bed graft FTSG SSG Terminilisation Ray amputation Tumor excision I & D Hematoma evacuation Replantations Arm Forearm Hand / Wrist Thumb Fingers Ring Avulsion We, in collaboration with the Onco-Surgical team headed by Dr. Sreekumar Pillai and Dr. Anil S Krishna undertake oncoplastic procedures. Revascularisation Digital Artery Ulnar artery Radial artery Brachial artery Axillary artery Femoral artery Popliteal artery Posterior tibial artery Anterior tibial artery Vein Graft Cancer growth over the left cheek involving both the skin and mucosal aspect. Radial forearm flap from the left hand folded to form both the layers for reconstruction Traumatic injury right mandibular region managed by stabilization of mandible with plate and screws. Full thickness laceration repaired in layers. 18 Activity Report Activity Report

12 Statistics Facio-Maxillary Injury Panfacial fractures Nasal bone Zygoma Fracture elevation Wiring Maxillary fracture Mandible fracture Naevus excision Tracheostomy Parotidectomy Facial nerve surgery Dermoid cyst Vascular malformations Ear lobe repair Biopsy Tongue tie release Sebaceous cyst/ Lipoma excision Blowout fractures Osteotomy Lower Limb Cancer growth over the left jaw bone involving both the skin and mucosal aspect. Free fibula flap with skin tissue used for reconstruction of mucosal aspect and jaw bone. Pectoralis musle with skin flap used for reconstruction of skin loss. Sushrutha Institute has emerged in the past 4 years as a leading centre for trauma care and a tertiary trauma referral centre. Committed 24 hour surgical team has enabled to provide quality care and to ensure better results even in complicated trauma cases. Statistics Lower Limb Trauma Lower limb injuries This patient - resident of Coimbatore had an electric shock over his forehead. Presented with loss of forehead tissue and bone. Bony deformity was corrected by harvesting bone from iliac bone and skin was reconstructed by radial forearm flap from the left forearm. Statistics Head & Neck Suturing SSG Local Flaps Free flaps Major degloving injuries SSG Micro Surgical Flaps Rectus abdominis LD Gracilis flap Parascapular ALT Free Style Lateral arm Toe transfer Activity Report Activity Report

13 Mangled foot was stabilized with external fixator and latissimus dorsi muscle flap was used to cover the foot. Patient could carry out his day to day activities following recovery. 8 months old baby had come with an accidental injury to foot which was reconstructed with latissimus dorsi flap cover As part of limb reconstruction in cases of high velocity trauma with bone loss, we do limb reconstruction with LRS and ilizarov systems. Statistics Other lower limb flaps Sural artery flap Fasciocutaneous flap Gastrocnemius muscle flap Soleus muscle flap Abductor hallucis flap Adipo fascial flap Patient came with an injury over the right ankle region where the foot was disrupted from the leg. Blood supply to the foot was re-established with a vein graft. Tissue defect was reconstructed with gracilis free flap from thigh. Heel pad region was reconstructed by reverse sural artery flap from the leg. 22 Activity Report Activity Report

14 Congenital Deformity Correction Constriction bands over the bilateral leg was corrected by Z plasty and tendon lengthening Congenital problems provide a major challenge to the reconstructive surgeon. To bring back the smile to the face of cleft lip child, to bring back function to the congenitally deformed hand remains our primary goal. Statistics: Congenital problems Cleft lip Cleft palate Radial Club hand Pollicisation Congenital trigger thumb, finger release Macrodactyly Constriction Ring Syndrome Syndactyly separation Thumb duplication Cleft hand Polydactyly Cleft lip secondary correction Hypospadias Failure of separation of fingers in utero may lead to syndactyly of fingers for which release is performed Cosmetic/ Aesthetic Surgery The contemporary approach to restoring and enhancing the face and body is the signature of Sushrutha Institute. Our Plastic Surgeons are skilled in the state of the art surgical procedures. Statistics Unilateral cleft lip repair Bilateral cleft lip repair Cosmetic Surgery Rhinoplasty Secondary rhinoplasty Tip Plasty Activity Report Activity Report

15 Reduction Mammoplasty Liposuction Abdominoplasty Body Countouring Fat Injection Laser Microdermabrasion Chemical Peel Brest augmentation Hair transplant Gynaecomastia Genioplasty Photo rejuvenation Brachial Plexus Surgery Statistics Brachial Plexus Surgery Oberlin s transfer Shoulder Arthrodesis Muscle transfer Obstetric brachial plexus palsy Otoplasty - Correction of ear deformity Reduction of abdomen with liposuction and abdominoplasty C5, 6/ C5, 6, 7 injuries managed by peripheral nerve transfers. Postoperatively patients with good elbow flexion and external rotation 26 Activity Report Activity Report

16 Peripheral Nerve Surgery Statistics Peripheral Nerve Surgery Digital Nerve Medial Nerve Ulnar nerve Radial Nerve Nerve Graft Nerve transfers Neurolysis Peripheral nerve transfers Ischial pressure ulcer reconstructed with I-GAP propeller flap Statistics Miscellaneous Diabetic Foot Others Penile replant Tubal reconstruction Chest tube drainage Varicose veins Embolectomy Aneurysm Implant removal Radical neck dissection Ingrowing toe nail AV fistula Miscellaneous Statistics Patient with bilateral varicose veins multiple ligation and excision done Miscellaneous Pressure Sore Sacral Trochantric Ischial Heel Diabetic ulcer reconstructed with gracilis free muscle flap and skin graft 28 Activity Report Activity Report

17 Miscellaneous Burns Debridement Contracture release Tangential excision Skin Grafting Local Flap Free Flaps Blood Bank Services Elite Mission Hospital blood bank is recognized by Kerala Govt. as a regional blood bank. It supports the needs of Sushrutha Institute by providing blood and blood components as required. The staffs here are active in promoting voluntary blood donations Post burn contracture of the neck reconstructed with parascapular flap Department of Physiotherapy & Hand Therapy The Sushrutha Institute is supported by a team of dedicated physiotherapists. The team takes care of our patients and provide adequate instruction and rehabilitation required for normal movements and function after surgery. Post burn contracture causing difficulties in movement of both hands. Right hand reconstructed with free ALT flap harvested from the thigh. Left hand reconstructed by reverse radial forearm flap. 30 Activity Report Activity Report

18 Department of Intensive Care We have 10 bedded post operative ICU which is equipped with multi para monitors. We also have 6 bedded ventilator ICU with state of the art ventilators, portable ultra sound, bronchoscopy and separate plastic surgery ICU dedicated to post-op microsurgical patients. Department of Anesthesiology Anaesthesia department headed by Dr. Thomas Kunnath and ably assisted by Dr. Jayasree Menon, Dr. Indu Regunath, Dr. Uma Devi & Dr. Renjith. They provide 24 hours high quality anaesthesia support which is fundamental for the delivery of the elective and emergency care services. Statistics of Under GA & Regional Anaesthesia: cases cases Departmental Library & Journal We have a well kept library with plastic surgery books & journals to keep in pace with the latest surgical practices and procedures. Journals subscribed include Clinics in plastic surgery, Hand clinics, Journal of hand surgery, Plastic and reconstructive surgery. A Wi-Fi internet facility to access the journals online is also made available at our institute. Dr Pradeep Kumar and Dr Anto Francis with Dr PS Bhandari 32 Activity Report Activity Report

19 Diplomate of National Board (DNB) -Plastic Surgery Conferences attended Papers presented & published: The department of Plastic Surgery was accredited for super speciality training in Plastic Surgery by NBE in 2011, every year one candidate is selected. During this period the candidates are taken through a structured training programme which not only promotes educational activities but also better surgical techniques, care and services for our patients. Dr. Vamsi Krishna Undavalli. Our Staff team Dr. Aniljith. V. G M.S. (Gen. Surgery) M.Ch (Plastic surgery) Lectures delivered (From Oct 2007): Invited lecture Bed sore and its management - Orthoclub, Thrissur 2009 Invited lecture Cosmetic surgery IMA, Thrissur 2010 Attended conferences (From Oct 2007): 1 st annual conference SIPRAS Trauma care -Thrissur 2008 Basic hand course October 2008 Thrissur 15th KPSA instructional course Aesthetic surgery Trivandrum, 22nd August nd annual conference SIPRAS Nerve con 2009 Thrissur 2009 Haircon st annual conference of association of hair restroration surgeons India Ahamedabad, 18th 20th December 2009 NABICON 2010 Pondichery, January 2010 ISAPS ( Indian Association of Aesthetic Plastic Surgery)- symposium Port Blair, 2nd April 2010 AESURG 2010 Annual meeting of Indian association of Aesthetic Plastic Surgeons Port Blair, Andamans 2nd & 3rd April th KPSA instructional course & 3rd annual conference SIPRAS Head & neck reconstruction Thrissur th Annual conference of Indian Society of Facial plastic and reconstructive surgery - Kumarakom 2011 Indian Society of Facial Plastic & Reconstructive Surgery, February Kottayam 34 Activity Report Activity Report

20 Dr. Anto Francis M.S. (Ortho) M.Ch (Plastic surgery) Dr. K. Pradeep Kumar, M.S. (Gen. Surgery) M.Ch (Plastic surgery) Lectures delivered (From Oct 2007) Diabetic foot - Thrissur2007 External fixators Kannur, 2008 Hand infections (Basic Hand Course ) Kannur, 2008 Pulp space infection, Flexor tendon sheath infection, skin graft - Kannur, 2009 Pediatric hand injuries & Splinting Kannur, 2009 Dupuytren s contracture Trivandrum Attended Conferences (From Oct -2007) Basic hand course Kannur st annual conference SIPRAS Trauma care Thrissur 2008 Basic hand course Thrissur 2008 Basic hand course Bangalore nd annual conference SIPRAS Nerve con 2009 Thrissur th Asian Pacific Federation of Societies for Surgery of Hand Taiwan th KPSA Instructional Course & 3rd Annual Conference SIPRAS Head & neck reconstruction Thrissur 2010 Ganga International Wrist Course 2011 Lectures delivered (From Oct 2007) Invited lecture possibilities in plastic surgery IMA Thrissur, 2007 Invited lecture possibilities in plastic surgery IMA Wadakkanchery, 2007 Invited lecture possibilities in plastic surgery IMA Irinjalakuda, 2007 Invited lecture possibilities in plastic surgery IMA Palakkad, 2007 Invited lecture possibilities in plastic surgery IMA Kunnamkulam, 2007 Invited lecture possibilities in plastic surgery IMA Thrissur surgical club, 2007 Invited lecture possibilities in plastic surgery IMA West fort clinical meeting, 2007 Invited lecture reconstructive microsurgery IMA Thrissur, 2007 Invited lecture reconstructive microsurgery Thrissur surgical club, Thrissur, 2007 Invited lecture VIDEO PRESENTATION free radial artery forearm flap, KPSA instructional course, Trivandrum, Invited lecture reconstructive microsurgery Thrissur ortho club, Thrissur, 2008 Invited lecture possibilities in resection & reconstruction of oral cavity and head and neck cancers Indian Dental Association, Thrissur, 2007 Invited lecture Facial contouring Thrissur ENT club, Thrissur, 2008 Invited lecture Adult brachial plexus injury Thrissur ortho club, Thrissur, 2008 Invited lecture Adult brachial plexus injury Thrissur neuro club, Thrissur, 2008 Experience with T-DAP flaps - Indian society of reconstructive microsurgery biennial meeting Delhi, feb Invited lecture, VIDEO PRESENTATION, PMMC FLAP, 31st annual conference of ASI, Thrissur, 2008 Invited lecture, aesthetic free tissue transfers in lower leg and foot defects, KPSA, Kottayam, 2008 Experience with T-DAP flaps, KPSA, Kottayam, 2008 Reconstruction of abdominal & perineal defects with pedicled flaps, KPSA, Kottayam, 2008 Faculty, free fibula harvest, cadaver flap dissection workshop, Organised by AIMS, Kochi, 2008 Invited lecture Adult brachial plexus injury Neuroyaan, state NSI conference, Thrissur, 2009 Case presentation Penis replant DIEP flap Toe transfer Clinical Meeting, Elite Mission Hospital, Thrissur 19th March 2009 Invited lecture Reperfusion injury Critical care society, Thrissur, 27th March 2009 Clinical case presentation Surgical club, Thrissur on 22/04/2009 Faculty, cadaver flap dissection workshop, Organised by AIMS, Kochi, 2008 & Anatomy, Thrissur Medical College June 13th & 14th 2009 Invited faculty Moderator on ALT & Pectoralis major flaps - Head & Neck Oncology Conference- 2009, Amritha Institute Of Medical Sciences, Kochi Invited lecture Oncoplastic Breast Surgery, Onco Club Kozhikode Clinical case presentation Doctors club, Elite Mission Hospital Faculty, Live workshop on Oncoplastic Breast conservation BCSCON Department Of Surgery Calicut Medical College On February 28th2010 Invited lecture - Spinal Accessory Nerve Injury- KPSACon-TVM. on April 2010 Free Paper - Composite Chimeric Tissue Transfer- KPSACon-TVM. on April 2010 Chair free paper Session - Brachial Plexus Injury- KPSACon,-Tvm. On April 2010 Clinical case presentation on Penetrating neck injuries, Surgical club, Thrissur, 19th Aug 2010 Clinical case presentation Doctors club, Thrissur, 31st Aug 2010 Faculty, cadaver flap dissection workshop, Organised by AIMS, Kochi, 4th July, Activity Report Activity Report

21 Faculty - lecture Reconstruction of tongue & floor of mouth defects -18th KPSA in instructional course & 3rd annual conference of Sushrutha Institute of Plastic, Reconstructive & Aesthetic Surgery, Sept. 11th & 12th 2010 Case presentation Disputed neurogenic thoracic outlet syndrome, Surgical club, Thrissur, 01st December Faculty, Panel discussion on congenital hand & brachial plexus, APLAST( plastic surgery tutorial), AIMS, Kochi, March 11th 13th, 2011 Faculty, Panel discussion on nerve injuries, tendon injury and replant, APLAST( plastic surgery tutorial), AIMS, Kochi, March 11th 13th, 2011 Invited lecture Brachial Plexopathy. What a surgeon looks for in electrodiagnostics and what can be achieved Thrissur neurological society. March CONFERENCES AND WORKSHOPS ATTENDED Annual conference of KPSA, Kochi, ST Instructional course in plastic surgery,tnpaps lower limb reconstruction Coimbatore, KPSA Instructional course in plastic surgery, head and neck reconstruction, Trivandrum, 2007 Annual conference of APSI, Pune 2007 Advanced head and neck cancers symposium, Amritha institute, Kochi, 2008 Indian society of reconstructive microsurgery biennial meeting Delhi, feb nd national workshop on Propellar flaps, Chennai, st annual conference of ASI, Thrissur, st annual conference KPSA, Kottayam, th international perforator flap course, Coimbatore st annual conference of ISSH & 2ND combined BSSH meet, Bangalore, rd biennial meeting, brachial plexus surgery group of India, Coimbatore,2009 APSICON 2009, Mahabalipuram, Chennai. 2nd annual conference, nervecon Peripheral nerve / Brachial plexus Repair & Reconstruction, Sushrutha Institute Of Plastic, Reconstructive & Aesthetic Surgery, Elite Mission Hospital, Thrissur C.M.E on Head & Neck surgery, I. M.A, Ernakulam Workshop Brachial plexus surgery, Chang Gung Memorial Hospital, Taiwan, th Asian Pacific Federation of Societies for Surgery of Hand, Kaohsiung, Taiwan, November 13 15, KPSACon - Tvm. April 2010 Cadaver flap dissection workshop, Organised by AIMS, Kochi, 4th July, th KPSA in instructional course & 3rd annual conference of Sushrutha Institute of Plastic, Reconstructive & Aesthetic Surgery, Sept. 11th & 12th 2010 Dr. Shaji Mathew M.S. (Gen. Surgery) M.Ch (Plastic surgery) APSICON 2010, Goa 4th Biennial meeting of brachial plexus surgery group of India, February 16th,17th & 18th 2011, Bangalore APLAST( plastic surgery tutorial), AIMS, Kochi, March 11th 13th, 2011 Neuro Update state meet of - Kerala Neurological Society, 20th March 2011 MEMBERSHIPS Life member: Indian Medical Association Life member: Association of plastic surgeons of India Life member: Indian society for surgery of hand Life member: Indian society of surgery for reconstructive microsurgery Life member: Indian association for facial, plastic & aesthetic surgery Life member: Kerala plastic surgeons association (K.P.S.A) Life member: Fellow of head & neck oncology Life member: Brachial Plexus Surgery Group of India Member: Thrissur surgical club. Lectures Delivered (From November 2008) Oman experience in Plastic Surgery Elite Mission Hospital monthly meeting - November 2008 Pressure sore management Elite Mission Hospital Meet 2009 Lymphoedema management IMA, Thrissur 2009 Embryology of hand & classification of congenital anomalies of hand - Instructional course Thiruvananthapuram April 23rd 2010 Attended conferences (From March 2008) 1st Annual conference SIPRAS Trauma care Thrissur 2008 Basic hand course Thrissur 2008 INDOCLEFT con th annual conference of Indian Society of Cleft Lip, Palate and Craniofacial Anomalies, 12th February Pondichery 15th KPSA instructional course Aesthetic surgery Trivandrum, 22nd August 2009 Annual CME Association of surgeons of India, Thrissur, 12th & 13th September 2009 Haircon st annual conference of association of hair restroration surgeons India Ahmedabad, 18th 20th December nd Annual conference SIPRAS NERVECON 2009 Thrissur Activity Report Activity Report

22 18th KPSA instructional course & 3rd annual conference SIPRAS Head & neck reconstruction Thrissur 2010 ISAPS ( Indian Association of Aesthetic Plastic Surgery)- symposium Port Blair, 2nd April 2010 AESURG 2010 Annual meeting of Indian association of Aesthetic Plastic Surgeons Port Blair, Andamans 2nd & 3rd April 2010 INDOCLEFTCON Annual conference of cleft lip, palate and craniofacial surgery, Chennai, February 2011 TANPAPS Annual conference of Tamilnadu Association Of Plastic Surgeons, Kodaikanal, February 2011 APSICON 2011 Annual conference of Association of Plastic Surgeons of India Goa 2011 Amrita Tutorials in Plastic & Reconstructive Surgery Kochi, March 11th 13th st Annual Conference Lectures delivered (from September 2009): Invited lecture- Aesthetic Plastic Surgery -IMA Thrissur 2009 Deep Vein Thrombosis - Elite mission hospital, Thrissur 2010 Vascular Malformation in the extremities KPSA Conference 2010 Trivandrum Inauguration of the CME by Dr. K.C. Prakasan, Managing Partner Attended conferences (from September 2009): 2nd annual conference SIPRAS Nerve con 2009 Thrissur Faculty: Dr. K. M. Pradeoth M.S. (Gen. Surgery) M.Ch (Plastic surgery) KPSACon 2010 Trivandrum 10th Biennial Conference of Indian Society for Reconstructive Microsurgery Hyderabad th KPSA instructional course & 3rd annual conference SIPRAS Head & neck reconstruction Thrissur 2010 APSICON Goa TANPAPS Kodaikanal 2011 Dr. Ravindra Bhat Dr. Ashok Koul Dr. Sudhir Warrier 4th Biennial meeting of brachial plexus surgery group of India, Bangalore 2011 Article Published: Perforator propeller flaps for sacral and ischial soft tissue reconstruction - Indian Journal of Plastic Surgery 2010 Jul Dec; 43(2): Journal Reviewer: University of Mauritius Research Journal, Mauritius 2011 Dr. Mukund Thatte Dr. Vijay Joseph Dr. E. Mohandas 40 Activity Report Activity Report

23 Prof. Dr. G. Balakrishnan Inauguration of the annual function Dr. K. K. Mohandas Medical superintendent & Managing partner 2nd Annual Conference Chief guest Dr. V. Chandramohan Vice Chancellor, Kannur University Gurupooja - Paying tribute to teachers Faculty: Inauguration of the CME by Dr. K.C. Prakasan, Managing Partner Dr. Sridhar Dr. P.S. Bhandari Dr. Gautam Biswas Dr. Mukund Thatte Dr. Krishnakumar Dr. Jayakumar 42 Activity Report Activity Report

24 Dr. Subramania Iyer Dr. Binu Thomas Dr. Anil Bhatia 3rd Annual Conference Dr. Ashok Koul Inauguration of the CME by Dr. K.C. Prakasan, Managing Partner Faculty: Inauguration - Dr. K. K. Mohandas Medical superintendent & Managing partner Guest lecture Prof.G. Lakshmipathi Dr. Sreekumar Pillai Dr. K. Pradeep Kumar Dr. Samir Kumta Chief Guest. Dr. V. K. Baby, District collector, Thrissur Entertainment Programme Dr. Krishna kumar Dr. Shivram Bharadwaj Dr. Devendra Kumar Gupta 44 Activity Report Activity Report

25 Visitors Dr. Usha Kim Dr. Antony Arvind Dr. Jayakumar Dr. Prabha Yadhav Dr. Subramania Iyer I am highly impressed by the Microvascular and Microneural work. Keep it up Dr. P. S. Bhandari High quality & excellent team effort. Let the Sushrutha Institute rises to still higher levels!! Dr. Lekshmi. M Asst. Prof. of Plastic Surgery Medical college, Kottayam Inauguration - Dr. K. K. Mohandas Medical superintendent & Managing partner Chief guest, Prof. Saramma Varghese Guest lecture - Mr. Nagesh prabhu, Chairman Aushadhi Entertainment Programme I enjoyed visiting the Elite Mission Hospital and impressed by your excellent work here Dr. Shyh Joh Shieh 46 Activity Report Activity Report

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