Pawan Agarwal

Pawan Agarwal
Netaji Subhash Chandra Bose Medical College, Jabalpur · Department of Plastic Surgery

MS, MCh, PhD, DNB, FICS, MNAMS FRCS (Glasgow)

About

196
Publications
30,572
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665
Citations
Introduction
Pawan Agarwal currently works at the Department of Plastic Surgery, Netaji Subash Chandra Bose medical college Jabalpur. Pawan does research in Medicine and Plastic Surgery.
Education
April 1994 - October 1997
Grant Medical College
Field of study
  • Plastic surgery

Publications

Publications (196)
Article
Occipital pressure ulcers and wound gaping may occur in unconscious and malnourished patients. Most of the time, a large defect requires wound coverage by scalp flaps. This video describes a rotational occipital scalp flap for occipital pressure ulcer and wound gaping in a patient of operated midline posterior fossa mass & ventriculoperitoneal shun...
Article
Giant prepyloric perforation (i.e size > 2 cm) is a challenging surgical problem; options include repair with an omental patch or an omental plug. Alternative methods are more complicated. However, the leak rate and mortality is unacceptably high. This prompted us to combine the omental plug and patch for an effective repair. We present a case seri...
Article
Purpose Acquired brain injury causing spasticity, pain and loss of function is a major cause of disability and lower quality of life. Sacral 1 (S1) neurectomy claims promising outcomes in spastic hemiparesis. This cadaveric study was conducted to study the surgical anatomy, surgical approach and feasibility of S1 neurectomy and contralateral S1 (cS...
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We read with interest an article entitled "Preoperative Factors Predicting the Outcomes of Arteriovenous Fistula (AVF) Surgery" by Pogula et al. [1] It is a nicely written article about preoperative factors predicting the outcome of AVFs in chronic kidney disease patients. Authors rightly concluded that the diameter of vein, artery, and flow rate a...
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Surgicaltraining programs across the globe have the responsibility of preparing the future generation of surgeons while promoting quality and patient safety. Surgical training differs significantly between countries, which can be based on the requirements of local accrediting bodies, different patient populations, different healthcare delivery syst...
Article
After release of post burn flexion contracture and repair of soft tissue injury of digits, it is desirable to maintain the digits in full extension. This is conventionally done by insertion of Kirschner wires across the interphalangeal or metacarpophalangeal joints. We have been inserting a spinal or intracath needle in a dorsal supra-periosteal pl...
Article
Surgical Innovations are central to surgical progress, and have led to exponential growth in various fields of Surgery. Surgical Innovations in Lower and Middle Income Countries are the result of creativity of frontline health workers in search of simple, safe and ethical solutions for their unique challenges. The key lies in: 'simplifying the idea...
Article
Plasma is one of the mainstays of traumatic haemorrhage treatment. Fresh frozen plasma (FFP) is the commonest plasma formulation used. A recent in-vitro study showing significantly less growth factors (that play a role in angiogenesis, cell growth, and cell proliferation) and more pro-inflammatory chemokines in FFP, as compared to Never Frozen Plas...
Article
Giant cell tumour (GCT) of hand/feet is a rare tumour with locally aggressive biological behaviour. After excision of GCT of small bone, reconstruction is a major challenge. This article presents our experience of reconstruction following surgery for GCT of hand and feet. This retrospective study includes 9 patients of GCT (2 recurrent and 7 primar...
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We describe a low-cost simulation model for teaching core needle biopsy to surgical trainees in Low-and Middle-income countries (LMICs). Pre-session and post-session surveys showed that correct core sampling (ability to hit the beetroot) after training was 91.4% compared to 75.7% before demonstration and improved adequacy (68.5% before v. 85.7% aft...
Article
Background Surgery is the main modality of cure for solid cancers and was prioritised to continue during COVID-19 outbreaks. This study aimed to identify immediate areas for system strengthening by comparing the delivery of elective cancer surgery during the COVID-19 pandemic in periods of lockdown versus light restriction.
Article
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Orbital exenteration is a radical surgery which involves complete removal of the orbital contents along with all or parts of the eyelid. However, the eyelid complex can be totally spared in cases of necrotising disease such as mucormycosis without compromising on exposure, or fear of devascularisation of the lids. We describe a total eyelid complex...
Article
The work pressure, challenging environment, and the difficult terms/conditions of the course lead to several unique problems amongst general surgery trainees in India. Self-assessment of one’s strengths and weaknesses is essential to maximally avail the opportunities and combat professional threats. SWOT stands for Strengths, Weaknesses, Opportunit...
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Background: There is 5-12% chance of postoperative scrotal hematoma and seroma formation after Lichtenstein hernioplasty, which is attributed to complete hernia sacs, extensive dissection, and the foreign body reaction due to polypropylene mesh.
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The extensor tendons to the fingers were studied in dissections of 120 hands from 60 fresh cadavers, and the divisions of the tendons, as well as the intertendinous connection, were analyzed. One tendon of the extensor digito-rum communis (EDC) was present for the second finger in 88.33% of cases, one for the third finger in 55.8%, two for the four...
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Qualitative studies in Surgery are important because they contextualize the previously missing social facets of the surgical narrative and inquire into the crucial issues of quality of life/well-being, gender and other discriminations and biases faced by surgeons and patients, surgical education/training, mental issues and burnout, etc. This has re...
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Clinical trials in Surgery are central to research; however, very few surgical clinical trials are conducted in India. Such paucity of surgical trials is a cause for concern, and prompted us to explore the recent landscape of surgical trials in India. We reviewed all clinical trials from general surgery or subspecialties of general surgery register...
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Complex soft-tissue defects of the distal third of the leg, foot and ankle with exposed bones/joints, tendons and implants need a flap for their closure. Distally based sural flap is commonly used, but it has a high partial necrosis rate due to venous insufficiency. We addressed this issue with AV supercharging by dorsalis pedis artery with short s...
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Violence at work is becoming an alarming phenomenon worldwide affecting the millions of health care workers. This study was conducted to assess the violence towards Resident doctors in Indian teaching hospitals. Google forms questionnaire was developed and circulated electronically to resident doctors working in India. Data were collected and manag...
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Background Split-thickness autografts offer the best form of wound coverage, but limited donor sites and donor site related morbidity have resulted in the search for alternatives in the form of microskin graft.Methods Twenty-five consecutive patients with post burn, post traumatic, and post cellulitis raw area were included in this study. After app...
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Background The purpose of this study was to evaluate the functional outcomes of a modified technique of double rectangle pattern for correction of severe ptosis. Methods This is a retrospective study over a period of 8 years including patients who underwent correction of ptosis by double rectangle using autologous fascia lata sling. Surgical outcom...
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Background: Loss of sensations in the sole following diabetic sensorimotor polyneu- ropathy (DSPN) leads to diabetic foot ulcers and its sequelae. We hypothesized that sensory reinnervation of sole by transfer of saphenous nerve (SN) to sensory fascicles of posterior tibial nerve (PTN) in these patients may reverse the neuropathy. Methods: This pro...
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Awareness of second victim syndrome and available support systems in South Asia is quite limited. We conducted this survey to assess its prevalence and impact among the surgeons from South Asia. A multiple choice pattern web-based cross-sectional Google forms questionnaire was developed which focused on demographics of respondent, prevalence, impac...
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Background: Measurement of two-point discrimination (2-PD) is used in clinical practice to evaluate the severity of nerve injuries, neuropathy, and recovery of patients following nerve repair. Commercially available 2-PD testing devices are costly and therefore not available everywhere. Methods and material: We made an economical indigenous 2-PD...
Conference Paper
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Conference Paper
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Article
Background Loss of sensations in the sole following Diabetic sensorimotor polyneuropathy (DSPN) leads to diabetic foot ulcers and its sequelae. We hypothesized that sensory reinnervation of sole by transfer of Saphenous nerve (SN) to sensory fascicles of posterior tibial nerve (PTN) in these patients may reverse the neuropathy. Methods This prospe...
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Diabetic sensorimotor polyneuropathy (DSPN) is the commonest form of neuropathy which leads to insensate sole, diabetic foot ulcers (DFU) and its complications. We share our experience in recovery of sensation in the sole after prophylactic surgery such as nerve decompression (ND) or sensory neurotization by nerve transfer (NT) in patients having D...
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Tracheostomy tubes are commonly needed airway devices. Not infrequently, these tubes may get blocked, which may be life-threatening. The authors hypothesize to build a standalone flow sensor that can sense and raise an alarm when the tracheostomy tube gets blocked or flow changes. The hypothesized flow sensor for the tracheostomy tube will sense an...
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This study was conducted to assess outcomes of propeller flaps for reconstruction of small- to medium-sized defects in the distal third of the leg. Of 53 lower third leg defects covered using the propeller flap, 43 survived without complications. Only minor complications were seen and no flap was lost completely. The propeller flap is thus a safe o...
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Personal protective equipment (PPE) plays a fundamental role in the prevention of spread to Health Care Professionals (HCP) ; especially in a surgical setting. This scoping review of surgery guidelines was performed to appraise the quality of appropriate PPE recommendations and propose a strategy to optimize the PPE usage. This rapid scoping review...
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Shortage of plastic surgeons is well known in the developing countries, and this leads to denial of plastic surgery facilities to a very large population especially in the rural area. We report a retrospective review of our experience with 60 rural plastic surgery camps in Central India over 16 years. A total of 4317 patients were operated, and maj...
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It is well known that in resource-constrained settings (RCS), clinical research is significantly hindered. Constraints are various combinations of sub-optimal human resources, poor technological backing (especially online), limited research or library facilities, limited and unequipped secretarial assistance and lack of reserved time for research w...
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Background Injury to the pudendal nerve leads to bowel/bladder incontinence which compromises the quality of life in these patients. Many peripheral nerves have been used to neurotize the pudendal nerve in order to regain bladder continence. The aim of this study was to assess the anatomic feasibility, by ultrasound, of transfer of the femoral nerv...
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A recent study evaluating ability to obtain a 4:1 suture to wound length ratio in a surgery residency program could achieve it in only 76/100 study patients; showing the difficulty in integration of theory into practice. 1e4 This led us to use ink marking of rectus sheath (for correct distance between suture bites and distance from the edge) in a p...
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Closed rupture of the FDP tendon is rare. However, whenever they occur the most common site of rupture is the tendon-bone insertion, less frequent site is at the musculo-tendinous junction. Midsubstance ruptures are even more unique and are usually due to underlying pathology such as fracture, cystic degeneration, rheumatoid arthritis, or sequel fo...
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Introduction: 5-26% of patients develop incisional hernia (IH) after midline laparotomy. We hypothesized that a simple ‘herring bone’ stitch repair can provide secure abdominal wall closure and minimize the incidence of IH in patients undergoing emergency midline laparotomy. Methods: This prospective observational study was done from March 2015 to...
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Master of surgery (MS) is awarded after the successful completion of 3 years of general surgery residency training. We conducted a Google forms, an online survey of various teaching institutes in Central India. Eighty-nine (23 2nd year residents, 26 3rd year residents, and 40 passed out surgeons within last 3 years) responded, and summary of their...
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Background Surgical correction of ulnar drift of metacarpo-phalangeal joint (MPJ) due to Rheumatoid arthritis (RA) is conventionally done by silicon joint arthroplasty which is expensive and may be associated with many complications. We report the outcome of low-cost autologous interpositional arthroplasty. Material and methods Five patients (8 ha...
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Disruption in surgical training during the COVID-19 pandemic has prompted many innovative "virtual" modules to address the loss of learning exposure during these difficult times. We suggest "GRASP" (Gain, Recognize, Analyze, Simulate, and Perform) module of self-assessment with virtual mentoring for uninterrupted surgical training. This idea merges...
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The theoretical danger of virus transmission during laparoscopic surgery (LS) via surgical smoke and laparoscopy gas has led to the formulation of many guidelines during the COVID-19 pandemic. This rapid scoping review of these guidelines was done to assess the quality of their evidence and appraise them for their impact on surgical services from t...
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Reconstruction of posterior trunk defects can be challenging due to lack of reliable axial pattern flaps on back, poor elasticity of skin, large three-dimensional wound and a shortage of recipient vessels for microsurgical reconstruction. The idea by An L et al. “Design of a reliable surgery process for large back defects: Jigsaw puzzle flap concep...
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Background: Internet has become the major source of health-related information, leading to a growing trend toward unsupervised self-medication using internet. This survey was conducted to assess the extent of internet use to obtain health information/self-medication, their perception regarding side effects of drug used, types/quality of information...
Technical Report
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Acontractile bladder is very common after spinal cord injury which may lead to morbidity and even renal failure. The standard treatment options to facilitate bladder emptying include clean intermittent catheterization (CIC) or indwelling catheter (IC), which is also not free of complications. The purpose of this article is to review the treatment o...
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Original Article
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Temporo-mandibular joint (TMJ) ankylosis is characterized by a decreased mouth opening which affects mastication, speech, and facial aesthetic. Interpositional arthroplasty using autologous tissue is accepted treatment for TMJ Ankylosis; however, harvesting autologous tissue is associated with additional morbidity. In this article we report our res...
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The theoretical danger of virus transmission during Laparoscopic Surgery (LS) via surgical smoke and laparoscopy gas prompted several academic/ national associations to issue many rapidly emerging guidelines for laparoscopic during COVID‐19 pandemic. Conventional appraisal tools like GRADE and AGREE II, which assess the quality of evidence and meth...
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Background Contraction in a skin flap is unavoidable after it is raised because of its elastic content and despite the best of planning a flap may fall short which may lead to some necrosis. This study was conducted to ascertain the extent of contraction of flaps and the factors that might influence this contraction. Methods This prospective study...
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Introduction Commonest cause of brachial plexus injury in adults is traction injury sustained in motorcycle accidents. This article reports the results of first 50 cases done in a tertiary referral center with a brief review of literature. Material and methods First 50 patients (46 male; 4 female, age from 12 to 45 years) with post traumatic brach...