Fractured nose reconstructed by doctors regains usual sense

Mariecar Jara-Puyod, Senior Reporter

Plastic surgeons do not randomly pick any skin of a patient for grafting but must select the most appropriate.

Gulf Today learnt about this interesting side of skin grafting as a 24-year-old Nepali in Dubai underwent a two-phase reconstructive surgery of his nose due to a freak accident on June 6.

The complex two-phase nose job on Nishan Gurung was done on June 7 and July 5, three weeks apart.

On Thursday, Dr. Rajkumar Ramachandran explained to this reporter for his choice of a “skin flap from the forehead of the storekeeper. A skin flap from the forehead is the best for reconstructing a nose. It is an internationally-accepted treatment modality. It is because the skin of the forehead is the best match for the skin of the nose and it delivers the best results.”

“If we take skin from other parts of the body, for example, the thigh or hand, hair will grow on that skin. So ideally, the forehead is the best for reconstructing a nose,” he continued.

Ramachandran has 15 years of experience in his field of expertise. Gurung is his first case in the UAE while he had performed over 100 similar surgeries in his home country of India for patients who also met accidents.

Gurung was shifting accommodation on June 6 when he missed a step while descending down the staircase of his previous apartment building and “a sharp object,” among the several kitchenware and utensils he was carrying in a bag, punctured and eventually sliced off his nose.

He recalled: “Blood was oozing out from the wound. I sat on the stairs and tried to stop the bleeding with my T-shirt. It took me some time to realise what had happened. I called up my friend for help. Even then, I did not realise that (it was the tip) of my nose that got cut off. My friend came, took me to the room. It was then I realised that my nose had detached.”

For first aid, ice was applied on his nose. He went to the Aster Hospital in Mankhool, Dubai for consultation on June 7. He was referred to Ramachandran who holds clinic at the Aster Hospital in Al Qusais.

According to Ramachandran, while Gurung sought him “within 24 hours of the surgery,” his nose was “already collapsing” for “he had lost the central portion of his nose including the nasal septum (the cartilage and bone in the nose) that “we had to reconstruct it entirely.”

He was asked about Gurung’s breathing as the accident might have caused him difficulties: “We managed to treat him on time. He did not experience any breathing difficulty. But naturally, there were some feeling of congestion but not shortness of breath.”

The surgery was two-phased because on June 7, taken from Gurung’s forehead was the skin flap “moulded into the shape of his nose that matches him.” On July 5, the moulded nose was “fixed on to (Nishan).”

“The sutures (had been) removed. The blood supply to the reconstructed portion and the nose had been reinstated,” said Ramachandran.

He approximated that healing time would be maximum six months: “Within this time, the reconstructed portion of the nose will start behaving like an original nose and (Nishan) would be able to feel the touch and everything.”

In another news, the Aster Volunteers of the Aster DM Healthcare began its “Mission Barmer 2022” health caravan for women in the Barmer village of northern state Rajasthan in India on July 23. It is in partnership with the Ruma Devi Foundation and Human Welfare Foundation.

The Ruma Devi Foundation is a not-for-profit organisation based in Barmer. Its founder is Ruma Devi, a social activist-master artisan and recipient of the Nari Shakti Purasakar, the highest civilian honour by the Ministry of Women and Child Development for women in India. The Human Welfare Foundation is a public charitable trust that help emancipate the poor and marginalised through livelihood programmes.

Devi expressed gratefulness to the realisation of the free medical screening-health education project for women empowerment, carried out by various segments of the Aster DM Healthcare in the UAE and India.

Aster DM Healthcare founder-chairman Dr. Azad Moopen said: “We hope this will help to increase the healthcare awareness among the rural womenfolk which will in turn impact the women most. Women’s education and empowerment is recognised to be the single most important tool for (the) health and well-being of the family, especially children.”