Reconstructive microsurgery

Excerpt

The history of microsurgery spans across most of the last century, with the introduction of vascular end-to-end or end-to-side anastomosis and autogenous vein grafts by Carrel, Guthrie and Eck between 1800 and 1900. In the 1960s, Jacobson and Suarez demonstrated that with the use of the operating microscope and refined techniques, the fine work necessary to facilitate the anastomosis of small vessels less than 1 mm in diameter was possible. The use of magnification along with micro-instruments and micro-sutures opened a new era in surgery, with the establishment a new discipline called microsurgery [1]. This marked the end of conventional surgery for cases of major trauma of the upper and lower extremities, such as complete or incomplete nonviable amputations, where a team consisting of both orthopaedic and vascular surgeons was required. Thus, it is with the introduction of the operating microscope along with micro-instruments and micro-sutures, the three “Ms” of microsurgery, that orthopaedic surgeons were able to achieve successful anastomoses of digital arteries in incomplete digital amputations [1, 2]. …