Plastic Surgery/oral surgery

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Question
sir, iam dr.rajesh- oral surgeon. recently after doing neck dissection we placed suction drain( the black mark is completly inside) but the drain is not holding.there is a air leak somewhere. how to identify it & correct it. what are the measures to prevent such air leak in future

Answer
hello rajesh,
i suppose you have used a romson type of suction drain with a collapsible container,air leak is mainly due to lack of air tight closure in the main wound or from the site of exit,it can be managed bu connecting the tube to suction machine and observe whether the wound is collapsing,listen for the hissing noise better still pour some saline on the wound,if the leak is from drain site tighten the skin tube junction,if the leak is from the main wound add some sutures from the site of leak.
all said i prefer a corrugated drain for effective drainage,if i anticipate drainage.hope this solves the problem.do let  me know what happened

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Dr.Ayyappan.Thangavel

Expertise

CAN ANSWER:Dr.Ayyappan has more than 20yrs of professional experience in Cosmetic&Plastic Surgery.He has been teaching and training Plastic Surgeons in a prestigious teaching institute in India.Dr.Ayyappan can answer ALL TECHNICAL QUESTIONS,Give SECOND OPINION,Perform REVISION SURGERIES,He is an Expert in managing ALL COSMETIC&PLASTIC SURGERIES including complications by vitue of his huge experience in a University teaching institute attached to Government Hospital.Presently he is Director&Head SAL Hospitals International an accredited premier private hospital group.Dr.Ayyappan is gentle,kind and gives time to answer all your questions.

Experience

At present, I am Head ,Department Of PlasticSurgery SAL HOSPITAL&MEDICAL INSTITUTE& Director LaDiva Center ofExcellence for Cosmetic,Plastic,Laser&HairTransplant,MY FOCUS IS ON COSMETIC SURGERY WITH SPECIAL EMPASIS ON LIPOSUCTION,BODY CONTOURING,ANTIAGING SURGERIES,COSMETIC SURGERIES OFBREAST FACELIFT,RHINOPLASTY ETC.I HAD BEEN A CONSULTANT WITH APOLLO HOSPITALS FOR 4YEARS. Prior to that I was an Associate Professor with the Department of Burns & Plastic Surgery at B.J.Medical College & Civil Hospital, Ahmedabad, India. This institute is a 2000 bedded Government funded University Teaching Hospital. The Department has a30 bedded Burns Centre and a 70 bedded Plastic Surgery unit, performing a wide range of Plastic & Reconstructive Surgery including Acute Burns and Post Burn reconstructions ,Polytrauma, lower limb reconstruction , Hand ,Micro & Brachial plexus surgery, Congenital anomalies including Cleft surgery . I was on a sabbatical for a year, working as a Plastic Surgeon with Division of Plastic Reconstructive & Surgery, Prince of Wales Hospital (Chinese University of Hong Kong).During this period I had attended teaching programmes /academic activities and was appointed twice as an Examiner (Undergraduates) for the Chinese University of Hong Kong..I participated in a Curriculum Retreat ( Chinese University of Hong Kong) with the focus on the New Curriculum ,Clinical Assessment Methods& Quality Improvement (Sep 2005). I am Co-investigator for a research project titled “Towards skin reconstitution:a study of epithelial-mesenchymal(bone marrow)cell interactions in a three dimensional acellular dermal matrix” submitted to Research Grants Council (2006/2007). I have gained significant experience on the use of Autologous Bone Marrow in varied clinical situations which I had pioneered and in the process of publishing my experience over a period of 4 years.

Organizations
BJMEDICAL COLLEGE &CIVIL HOSPITAL(INDIA),Associate Professor Department Of PlasticSurgery. PRINCE OF WALES HOSPITAL(HONGKONG),Chinese University of HongKong,Specialist/ClinicalTutor,Division of PlasticSurgery. APOLLO HOSPITALS INTL,SeniorConsultant,Department Of PlasticSurgery. SAL HOSPITAL&MEDICAL INSTITUTE Head ,Department Of PlasticSurgery Director LaDiva Center ofExcellence for Cosmetic,Plastic,Laser&HairTransplant.

Publications
INTERNATIONAL JOURNAL-PUBLICATIONS: • ANTIBIOTIC PROPHYLAXIS -HOBSON’S CHOICE? IN BURNS MANAGEMENT. PUBLISHED IN BURNS JOURNAL (U.K) JULY/AUG1998 • AXIAL APONUERO –FASCIO- CUTANEOUS GROIN FLAP -,AN EXTENDED CONCEPT PUBLISHED IN JOURNAL OF CRANIO FACIAL SURGERY(U.S.A) SEP/2001. • SUPER SURAL FLAPS IN ACUTE TRAUMATIC HEEL RECONSTRUCTIONS PUBLISHED IN PLASTIC&RECONSTRUCTIVE SURGERY JOURNAL(U.S.A) JUNE/2002 • "MICROSURGICAL RECONSTRUCTION IN PAEDIATRIC BURNS .THE BRITISH JOURNAL OF PLASTIC SURGERY(2006) IN PRESS. • PEDIATRIC BURN PREVENTION:AN EPIDEMIOLOGICAL APPROACH Burns, Mar 2006. • DECOMPRESSION NOT ESCHAROTOMY IN ACUTE BURNS Burns, May 2006 . NATIONAL JOURNAL-PUBLICATIONS • NUEROFIBROMATOSIS –AN UNSOLVED RIDDLE PUBLISHED IN THE INDIAN PRACTITIONER.FEB/2001. • TOPICALLY APPLIED AUTOLOGOUS BONE MARROW IN HEALING OF CHRONIC NON HEALING RAW AREAS-INDIAN JOURNAL OF BURNS VOLUME 12/Issue 2001/Dec 2004.

Education/Credentials
Professional Qualification Title M.B.B.S {Bachelor Of Medicine & Bachelor Of Surgery} University University Of Madras Country India Month /Year April 1987 Speciality Professional Qualification Title Master Of Surgery{General Surgery} University Gujarat University Country India Month /Year January 1993 Superspeciality Professional Qualification Title {1} Master Of Chirugiae {Plastic Surgery} University Gujarat University Country India Month /Year March 1996 Superspeciality Professional Qualification Title {2} Diplomat Of National Board{D.N.B}{Plastic Surgery} University National Board Of Examinations Country New Delhi , India Month /Year December 1995 Superspeciality Professional Qualification Title {3} Member National Academy Of Medical Sciences{Plastic Urgery} University National Board Of Examinations Country New Delhi , India Month /Year December 2002

Awards and Honors
GOLD MEDAL CLINICAL SURGERY MADRAS UNIVERSITY 1985 MEMBER NATIONAL ACADEMY OF MEDICAL SCIENCES AWARDED IN 2002 GOLD MEDAL CLINICAL SURGERY MADRAS UNIVERSITY 1985 TOPPER OF MCh(PLASTIC SURGERY)UNIVERSITY EXAMS UNIQUE DISTINCTION OF BEING AWARDED “MEMBER NATIONAL ACADEMY OF MEDICAL SCIENCES(PLASTIC SURGERY)”IN 2002 REVIEWER OF REPUTED INTERNATIONAL JOURNALS…PRS(USA),BJPRAS(UK)

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