RESUMO
Se explica el origen de los términos cirugía plástica y rinoplastia, así como los inicios de la especialidad y de esta cirugía nasal. Se exponen cuáles fueron las necesidades que atendieron y qué lugar ocuparon la reparación y la reconstrucción en la historia y la filosofía de la medicina. La cirugía plástica se instaló como la disciplina quirúrgica encargada de buscar la recuperación de la identidad perdida. (AU)
The origin of the terms of "plastic surgery" and "Rhinoplasty" is explained, as well as the beginning of the specialty and this nasal surgery. It explains what his need was and how he filled that gap, the repair and reconstruction in the history and philosophy of medicine. It was installed as the surgical discipline in charge of seeking the recovery of the lost identity. (AU)
Assuntos
História Antiga , História Medieval , História do Século XV , História do Século XVI , História do Século XVII , História do Século XVIII , História do Século XIX , História do Século XX , Rinoplastia/história , Procedimentos de Cirurgia Plástica/história , Filosofia Médica , História da MedicinaRESUMO
Nasal reconstruction is considered the historic foundation of facial plastic surgery, and the forehead flap remains the workhorse of repair. To recreate both the aesthetic contour and function of the nose, all anatomic layers must be addressed-covering, lining, and structural support. This article reviews the noteworthy history underlying the development of the paramedian forehead flap as the primary tool in reconstruction of large nasal defects while highlighting its implications on modern nasal repair. Current developments in the use of 2-staged paramedian forehead flap reconstruction are examined and a modern technique is presented.
Assuntos
Nariz/cirurgia , Procedimentos de Cirurgia Plástica/história , Rinoplastia/história , Retalhos Cirúrgicos/história , Testa/cirurgia , História do Século XVIII , História do Século XIX , História do Século XX , História do Século XXI , História Antiga , Humanos , Procedimentos de Cirurgia Plástica/métodos , Rinoplastia/métodosRESUMO
BACKGROUND: In 1964, faced with the challenge of traumatic amputation, a team of surgeons at Clinica Guayaquil was convinced that the transplantation of a hand could significantly improve function and quality of life for the recipient. With a current but basic understanding of immunosuppression, the surgeons identified a recipient and waited for the correct donor. A human hand transplant had never been performed to date. METHODS: The surgeons' criteria for the recipient included a young healthy individual who had sustained a traumatic amputation at the distal forearm level with full motion of the proximal joints. Communication with receiving hospitals and military facilities identified what they perceived to be a feasible donor for an allograft transplantation. Consent was obtained from the family in conjunction with the local military medical authorities and the clergy. Iced saline solution and Heparin irrigation were to be used to prepare the donor extremity. The immunosuppression regimen, limited at the time, consisted only of intravenous cortisone, Imuran, and a single dose of radiation. RESULTS: A member of the Ecuadorian marine sustained a limited blast injury that amputated his dominant hand but spared the forearm. He was transferred to the emergency department of Clinica Guayaquil. A donor who had recently died in a nearby hospital was identified not long after. A successful technical surgical transplantation was achieved. Consultants from major hospitals around the world (including Peter Bent Brigham Hospital) convened at the patient's bedside to observe the results. Despite all efforts, the patient suffered an irreversible rejection at 21 days post-transplant. CONCLUSION: This was the first allograft transplantation of a hand. The surgeons embarked on an intervention never tried before, firmly believing that better function and quality of life would result. The bravery of this surgical team was commendable. This early surgical endeavor opened the way for future successes in transplant surgery today.
Assuntos
Amputação Traumática/história , Antebraço/cirurgia , Rejeição de Enxerto/história , Transplante de Mão/história , Terapia de Imunossupressão/história , Procedimentos de Cirurgia Plástica/história , Adulto , Amputação Traumática/fisiopatologia , Amputação Traumática/cirurgia , Equador , Antebraço/fisiopatologia , Rejeição de Enxerto/fisiopatologia , Transplante de Mão/métodos , História do Século XX , Humanos , Masculino , Qualidade de Vida , Procedimentos de Cirurgia Plástica/métodos , Falha de TratamentoRESUMO
Historicamente, as guerras foram um dos maiores catalisadores para o avanço da Medicina, e especialmente da cirurgia. Sem dúvida, a maior autoridade da Cirurgia Plástica nas primeiras décadas do século XX foi o neozelandês radicado na Inglaterra Sir Harold Delf Gillies, que se destacou pelo tratamento de pacientes com lesões faciais no contexto da I Guerra Mundial. Nosso artigo faz uma análise da vida pessoal e do legado que Gillies deixou para a cirurgia plástica e reconstrutiva moderna; muitos de seus ensinamentos são atemporais e servem de reflexão para cirurgiões da atualidade.
Historically, wars have been among the greatest catalysts for advances in medicine in general, and surgery in particular. Without doubt, the greatest practitioner of plastic surgery in the early decades of the twentieth century was Sir Harold Delf Gillies, a New Zealander living in England, who advocated the treatment of patients with facial injuries in the context of the First World War. This article examines Gillies' personal life and the legacy he left for modern plastic and reconstructive surgery; many of his teachings are timeless and serve as an inspiration for the surgeons of today.
Assuntos
Humanos , História do Século XXI , Cirurgia Plástica , Guerra , Ferimentos e Lesões , Procedimentos de Cirurgia Plástica , História da Medicina , Medicina , Cirurgia Plástica/história , Guerra/história , Ferimentos e Lesões/história , Procedimentos de Cirurgia Plástica/históriaRESUMO
Incredibly complicated multidimensional defects have always strained the ingenuity of the reconstructive surgeon. Secondary perhaps to vascularized composite allotransplantation as a solution to this dilemma, the compound flap has been developed to be a more useful and available alternative. Their greatest versatility has been proven by its subtype, the chimera flap. The chimera flap itself consists of multiple flaps, the latter possibly composed of bone, skin, muscle, and so on, where each part has an independent vascular supply, and each part is independent of any physical interconnection whatsoever with the other components, except where joined ultimately only to a common vascular pedicle. An appellation for this concept was first introduced a quarter century ago in this very journal, a time frame now the impetus for a recapitulation of its origin and subsequent history that proves that it has eventually withstood the test of time and has been successfully assimilated into the reconstructive repertoire.
Assuntos
Procedimentos de Cirurgia Plástica/história , Retalhos Cirúrgicos/história , Grécia , História do Século XX , História do Século XXI , Humanos , Mitologia , Procedimentos de Cirurgia Plástica/métodos , Retalhos Cirúrgicos/irrigação sanguínea , Retalhos Cirúrgicos/transplante , TurquiaRESUMO
Se describen los inicios -a finales del siglo XIX- de las técnicas de reconstrucción mamaria post-mastectomía. Se enumeran las técnicas más importantes que las continuaron y quiénes las crearon en el mundo. Se destacan los aportes de dos cirujanos plásticos argentinos, Julián Fernández (1965) y Enrique Gandolfo (1982), que utilizaron tejidos autólogos del abdomen, colgajos dermograso con abordaje vertical y musculo-cutáneo con abordaje horizontal, respectivamente.
Early (late nineteenth century) techniques post-mastectomy breast reconstructions are described. Techniques that continued and its creators in the world are listed. The contributions of two plastic surgeons from Argentina, Julian Fernandez (1965) and Enrique Gandolfo (1982), who used autologous tissue from the abdomen, dermofat flaps vertically approach and musculocutaneous flaps with horizontal approach, respectively stand.
Assuntos
Mamoplastia/história , Mamoplastia/métodos , Mastectomia , Neoplasias da Mama/cirurgia , Neoplasias da Mama/terapia , Argentina , Retalho Miocutâneo , Retalhos Cirúrgicos , História da Medicina , Procedimentos de Cirurgia Plástica/históriaRESUMO
Flap surgery is the art of transposing an autonomous vascularised tissue, from a donor site to a distant recipient site. It was born 2000 years ago in India, evolving from random flaps to microsurgical flaps with a skeletonised vascular pedicle. This evolution was possible through the knowledge of cutaneous vascularisation and allows today the spreading field of perforator flaps. Writing the story of any particular flap is, in fact, looking back to understand the global concept and evolution of flaps surgery. Therefore the authors detail every step of the development and technical improvement of the thoracodorsal flap from the classical musculocutaneous latissimus dorsi flap to one of its latest achievement, the thoracodorsal perforator flap. This story helps us to appreciate the armamentarium of thin and low donor site morbidity flap that perforator flaps offer to us.
Assuntos
Microcirurgia/história , Procedimentos de Cirurgia Plástica/história , Retalhos Cirúrgicos/irrigação sanguínea , Argentina , História do Século XIX , História do Século XX , História do Século XXI , História Antiga , Humanos , Índia , ItáliaRESUMO
Professor Ivo Pitanguy is Head Professor of the Plastic Surgery Departments of the Pontifical Catholic University of Rio de Janeiro and the Carlos Chagas Institute of Postgraduate Medical Studies. He also is a member of the Brazilian Society of Plastic Surgery, the National Academy of Medicine, and the Brazilian Academy of Letters, as well as Visiting Professor of the International Society of Aesthetic Plastic Surgery (ISAPS). He is a Fellow of the American and the International College of Surgeons (FICS, FACS). He also is the Honorary President of the Alumni Association of Professor Ivo Pitanguy, and has recently been declared the Patron of Plastic Surgery in Brazil through a unanimous vote by the Brazilian Society of Plastic Surgery.