Plastic surgery of the 19th century

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Plastic Surgery 19th century

consider that C oboj represented Plastic Surgery 19century.Despite all the above, one can not say that the results of plastic surgery at the time were excellent.In the absence of aseptic and antiseptic often had complications such as infection.While the surgeons were both dissector and directors of hospitals where autopsies were performed, lgnar Philip Semmelweis (one thousand eight hundred eighteen - 1 865) showed that there is a direct connection between rigor and suppuration substances.Through the work of Louis Pasteur had discovered the bacteria that cause suppuration.Based on this, Joseph Lister (1867) created an antiseptic operation mode, when the microorganisms are destroyed during the operation with the help of spraying carbolic acid.It should be noted that the surgeons who carried out such aesthetic surgery, were among the first who took antiseptic adopted.

parallel development

going anesthesia.G. Davy in 1799 received nitrous oxide - "laughing gas."Performing experiments on himself and on animals, he found that inhalation of the gas is lost sensitivity to pain.But then the scientist did not have thoughts about the use of his discoveries in medicine.Many years later, the dentist Horace Wells used the nitrous oxide for anesthesia during tooth extraction.It is for them recognized the primacy of the discovery of the anesthetic agent.Later, at the beginning of the XIX century, M. Faraday reported in the press that the inhalation of vapor of ether causes an effect similar to nitrous oxide.William Morton studied the analgesic properties of the ether, and in 1846, surgeon J. S. Warren first used ether anesthesia during surgery to remove the submandibular tumors.Almost simultaneously with chloroform it opened ether.Its anesthetic properties found obstetrician James Simpson.Thus, anesthesia became widespread.In 1880, a local anesthetic has been applied, namely cocaine in operations on eyes, and spinal anesthesia.

obtained scientific understanding of the nature of the infection, methods of dealing with them in conjunction with the development of methods of general and local anesthesia, as well as the achievement of the anatomy and histology of tissues formed the basis for the introduction of methods of plastic surgery in clinical practice.During this period, a number of trends which are now considered classics in plastic surgery.First of all, widespread non-free closing tissue defects of skin and fat flap on the pedicle.With the spread of the doctrine of regeneration, and began to apply a free transplant tissues from one body part to another.

Plastic Surgery of the 19th century.When we were offered free skin transplantation techniques?

have been proposed and developed by many surgeons.Transplant first epidermis fragments produced Jacques Louis Reverdin in 1869.He transplanted small, 2 - 6 mm2, grafts taken a special tool, which he put on healthy granulation.Thus he was able to close the long healing ulcer on his thumb.

Louis E. L. Oilier made changes to the way in offering to take a razor epidermis large, up to 8 cm, the formation through the entire layer.Free skin grafting method by Karl Thiersch (1886) consisted in the fact that a razor knife or amputation depth to the papillary layer of the skin cut strips of length and width is 2 - 3 cm (as stamps).Cut grafts transplanted directly onto the prepared surface.Bowl skin taken from the outer side of the thigh or upper arm.The surface pre-rubbed with gasoline, alcohol or ether, and pulled a knife sectioned sawing motion parallel to the surface.Skin pieces were placed so that one end of the other curtains (imbricate) to prevent sprouting granulations therebetween.This method is applicable not only to restore skin cover, but also to cover the inside walls of the cavities with the substitution of the missing mucosa, such lip mucosa.

Karl Thiersch (1822-1885)

Yanovich method - Chaynskogo is a modified method of J. L. Reverdin.Under local anesthesia, the sharp end of a round needle which captures hemostat, lifted the skin and cut it at the base of the cone formed.The resulting graft small rounded with the same needles on the transplanted tissue surface defect.In this way, we cover the entire exposed surface, wherein the distance between the pieces remained no more than 0.5 cm.

Subsequently, all these methods have been greatly improved.The world's first transplant of a complex transplant was performed in 1897 by KP Suslov.He took a curl ear piece consisting of skin and cartilage, and transplanted to the patient's nose in order to replace the defective wing.Mr. Konig has described a similar technique in 1923.

At the beginning of the XX century the first experimental replantation were held.The term "replantation", meaning "to turn over again," was introduced in the surgical literature E. Hopfner, who in 1903 published the data on the first successful replantation of limbs in dogs.Trunk vessels connected extravascular-absorbable prosthetic tubes E. Payr'a.In 1903, outstanding experimenters surgeon A. Carrel and S. Guthrie (France, then the United States) have been successful in reattaching limbs of a dog with the imposition of the original vascular suture.

Plastic Surgery of the 19th century.In 1889 S. Manchot (1866 - 1932) from Germany to the student's work «The Cutaneous Arteries of the Human Body» described the overview of the number, topography, sources of cutaneous arteries, which subsequently became a prerequisite for the creation of a new method - plastic complex skin flapswith axial blood supply.

S. Manchot just do not cross the blood supply to said areas.The work was published in Strasbourg, in limited numbers, so do not attract the attention of surgeons.In 1936, M. Salmon, not knowing the work of S. Manchot, studied the blood supply to the 15 cadavers by injecting into the arteries ink.Thus, with the help of X-ray examination and dissection of tissue he had mapped the area and cutaneous vascular anastomoses between them, which he described in his article «Arteries of the Skin».

comparing areas of blood supply to the groin on Manchot S. and M. Salmon


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