Microsurgery: Transplantation and Replantation by Harry J. Buncke, MD, et al.
  Table of Contents / Epilogue
 
  The rabbit's ear will routinely survive transfer to the opposite side or to the neck when mobilised on the intact isolated central artery and vein (Fig. 8, A and B). Complete amputation and reimplantation as a free graft without vascular repair is followed routinely by death and necrosis of the ear (Fig. 9, A and B). Total survival has been achieved when just one vessel of the vascular pedicle has been repaired leaving the other vessel intact. It is therefore felt that the degree of survival is directly proportional to the mechanical efficiency of the anastomosis itself. The problems are those of micromanipulation and instrumentation and do not depend on the acquisition of particularly unusual skills by the operator. With the continued perfection of techniques and instruments these repairs will be performed with ease in a reasonable period of time by any surgeon who is interested in this phase of reconstructive surgery. The successful transplantation of a block of composite tissue by reanastomosing the microvascular pedicle has untold experimental and clinical possibilities. A few of these are now under study on primates.

A, Complete amputation of ear, vessels tied. B, Two weeks after reimplantation as a free graft without vascular repair. The ear is necrotic throughout.

SUMMARY

The instrumentation and technique for the anastomosis of vessels less than 1 mm. or 0.040 in. in external diameter is presented. The external ear of a rabbit has been successfully reimplanted utilising such microminiature vascular repairs.

 

We wish to express our appreciation to Dr Kirk H. Prindle, Chief of Surgery, San Mateo County General Hospital, for his assistance in acquiring space and equipment for this experiment. We would also like to acknowledge the generous help of Dr Robert O. Holmes, Pathologist, Mills Hospital, and Dr Arthur Lack, Pathologist, San Mateo County General Hospital.

REFERENCES

BUNCKE, H.J., and BLACKFIELD, H.M. (1963). Plast. reconstr. Surg., 31, 353

CHACE, P.M., and SCHWARTZ, S.I. (1963). Surg. Gynec. Obstet., 117, 44.

CHUNG-WEI, C., and YUN-CHING, C. (1963). Case Report, Department of Surgery, Sixth People's Hospital, Shanghai.

CONWAY, H., NICKEL, W.F., and SMITH, J.W. (1959). Plast. reconstr. Surg., 23, 469.

DOUGLAS, B., and FOSTER, J.H. (1963). Ann. Surg., 157, 944.

ESSER, J.F.S. (1917). N.Y. med. J., 106, 264.

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