R P Chowdary

Lehigh Valley Health Network, Allentown, Pennsylvania, United States

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Publications (8)10.86 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Macrovascular bypass procedures and microvascular free tissue transfer have resulted in dramatic improvements in lower limb salvage. Although vascular steal is a well-documented phenomenon in the surgical literature, there is a paucity of information on its potential impact in microvascular surgery, particularly in relation to lower extremity reconstruction in the elderly patient with peripheral vascular disease. We report three cases of lower extremity reconstruction using microvascular free tissue transfer in which the free flap survived but the distal extremity suffered progressive ischemic necrosis. A retrospective analysis of these cases defines the conditions in which microvascular steal phenomenon may adversely influence lower limb salvage.
    Annals of Plastic Surgery 04/1995; 34(3):336-9; discussion 339-40. · 1.38 Impact Factor
  • R M Kimmel, R X Murphy, R P Chowdary
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    ABSTRACT: Vascular graft infections demand serious attention due to the potential for mortality or limb loss. Management modalities range from conservative wound debridement and drainage to graft resection and extra-anatomical revascularization. A retrospective chart review was conducted to evaluate wound complications in patients who underwent inguinal vascular bypass in an attempt to define the incidence of wound complications and guidelines for their management. Vascular operations involving femoral anastomoses were performed on 1,637 patients; 58 wound infections occurred in 57 patients (3.5%) over an 8-year period at our institution. There were 16 graft infections in 15 of these 57 patients (0.92%). Ten patients were treated with local muscle flaps, 1 with a fasciocutaneous thigh flap, and 5 with graft excision and either extra-anatomical bypass or amputation. Local flap coverage appears to be as effective as graft excision for the treatment of inguinal vascular graft infections. An algorithm for optimal management of these infections is presented.
    Annals of Plastic Surgery 07/1994; 32(6):623-9. · 1.38 Impact Factor
  • Raj P. Chowdary, Robert X. Murphy
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    ABSTRACT: Although denervated muscle and myocutaneous free flaps atrophy over a period of time, when used for surface coverage they may remain bulky, resulting in a less than optimal aesthetic result. With the availability of a number of donor sites, soft tissue defects can often be reconstructed with like tissue in a single stage. Even though the goal of all plastic surgeons is to achieve a good cosmetic result, special circumstances might dictate that need take precedence over form. We have had six cases where a bulky muscle was used to achieve well vascularised coverage. After wound closure had been successfully accomplished, a secondary debulking procedure was performed safely for a final acceptable aesthetic result.
    British Journal of Plastic Surgery 02/1992; 45(1):38-41. · 1.29 Impact Factor
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    ABSTRACT: A free radical forearm flap was salvaged from a nonreplantable amputated extremity and banked on the ipsilateral chest wall. Later, the flap was simply rotated to provide coverage of the proximal humeral stump, eliminating the need for a second microvascular procedure.
    Annals of Plastic Surgery 11/1991; 27(4):361-3. · 1.38 Impact Factor
  • R P Chowdary, M A Chernofsky, W J Okunski
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    ABSTRACT: A series of 12 patients with deep burns resulting in exposed bones, joints, and tendons, in whom temporoparietal free flaps were used for reconstruction, are presented. Flap loss was 8.3%; good and satisfactory results were achieved in 91.7% of healed defects. Patients with large total body surface area burns are severely compromised, and the use of free flaps requiring prolonged periods of anesthesia and surgery should be a judicious decision. Prior to the availability of free flaps, most of these patients are left with chronic wounds and compromised functional results. Although our experience is limited, we think that in well-selected cases a one-stage reconstruction with free tissue transfer is expeditious, safe, and economical.
    Annals of Plastic Surgery 10/1990; 25(3):169-73. · 1.38 Impact Factor
  • R P Chowdary, M Stefan, M Chernofsky
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    ABSTRACT: Vein-patch angioplasty is a well-established technique in vascular surgery to reduce the critical narrowing of the arteriotomy site. In microsurgical end-to-side anastomosis, although the arteriotomy is not closed, it is not known if anastomosis through a sclerotic segment contributes to narrowing at the anastomotic site. It is certainly technically difficult to perform a microanastomosis with fine sutures through a sclerotic segment. Two cases are illustrated in which vein-patch angioplasties were successfully used for microsurgical anastomoses.
    Annals of Plastic Surgery 04/1990; 24(3):289-92. · 1.38 Impact Factor
  • R P Chowdary
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    ABSTRACT: Temporoparietal fascia free flap is an excellent source for resurfacing soft tissue defects of the hand and fingers. Because of the reliable anatomical bifurcation of the superficial temporal vessels, this flap can be very useful in simultaneous reconstruction of more than one digit without having to create a temporary syndactyly.
    Annals of Plastic Surgery 01/1990; 23(6):543-6. · 1.38 Impact Factor
  • W J Okunski, R P Chowdary
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    ABSTRACT: Polyurethane-coated breast implants are used more frequently in recent years both in augmentation and reconstruction. Postoperative infection may lead to serious complications with formation of foreign body granulomas. A case is presented with such a complication that required multiple operations and wide excision of reconstructed breasts necessitating major myocutaneous flaps to salvage the breasts.
    Aesthetic Plastic Surgery 02/1987; 11(1):49-51. · 1.26 Impact Factor