A force jawan who was attacked by Naxals and got gun shot entry injury at the back which exits from the front of the abdomen and caused multiple bowel injuries and shattered the abdominal wall.Perforation of bowel repaired and ileostomy was done and debridement of exit wound for necrosis done in the same sitting by a plastic surgeon by which massive abdomen defect developed. Another debridement had to be done for rammer necrosis of muscle of rectus and lateral parietal wall muscle. The defect of 20 by 20 cm in both vertical and horizontal direction in maximum produced defect was above the level of the umbilicus.
To prevent evisceration of bowel and to keep it moist bag gotta bag applied customised in 3rd stage. After control of sepsis and control of infection and appearance of granulation tissue On 4th stage extended ALT flap fasciocutaneous flap pedicels done.On 5th stage, the same…
