Professional paper

Development of microsurgery and reconstructive surgery at the Clinical Hospital Centre in Rijeka

Ivan Kirin
Hrvoje Štalekar
Davor Jurišić
Darko Ekl
William Klarić

Abstract

Clinical microvascular surgery was first affirmed with replantations of amputated digits and limbs. From the literature it is very difficult to determine exactly when the first microvascular replantation took place. The basic replantation activities began in 1975 by Dr Chen of the 6th National Hospital in Shanghai, China. The first successful forearm replantation at the Clinical Hospital Centre in Rijeka was performed in 1983. Since then many of digit and upper limb parts' replantations have been done. In a successful replantation the results are satisfactory both functionaly and esthetically. During replantation, operative reconstructive grips are performed in the following order: osteosynthesis, anastomosis and reconstruction of vascular elements, reconstruction of nerves, reconstruction of tendons or muscles, reconstruction of soft covering (direct sutures, free skin transplants and skin and subcutaneous tissue transfers in form of free flaps or island groin flaps). In order to avoid collar necrosis in replantation, especially in the upper arm and the forearm, during reconstruction of osseous elements a shortening of up to 8-10 cm was performed, without considerable functional and aesthetic defects. The same methods were used in the reconstruction of defective nervous elements, because the compared results of direct epineural sutures of nerves and interfascicular transplantation are in favour of direct epineural sutures. The real value of microsurgery (replantation) is understood when comparing successfully treated patients with the disabled people with amputated extremities from the time when replantations were not performed or as a result of an unsuccessful reconstructions.

Keywords

Microsurgery; Reconstructive surgery

Hrčak ID:

190454

URI

https://hrcak.srce.hr/190454

Publication date:

1.12.2000.

Article data in other languages: croatian

Visits: 1.190 *