The fifth perforator flap harvesting course, a new advanced technique in reconstructive microsurgery for resident physicians and specialists, took place in Timișoara at “Pius Brânzeu” Center for flap surgery and microsurgery. During the first day of the course there was a training for this extremely thorough dissection technique on rats.
“This is an advanced reconstructive surgery technique, during which we minimize, as much as we can, the effects on patients when reconstructive surgery is needed. It is known that for these surgeries, certain tissue parts must be harvested from the patient’s healthy areas.These parts must be transplanted afterwards for reconstructive purposes. With the help of this dissection techniques, of the vessels that irrigate the tissue parts which must be harvested as very smooth branches” said Mihai Ionac, Chief of Vascular Surgery, Spitalul Judetean Timișoara, manager of Pius Brânzeu Center.
“We leave a very small insignificant suffering to the donor area. It is a very hard, complicated technique, with exceptional benefits for the patient. It is actually the most recent trend in reconstructive microsurgery. We currently are the only center in the world which organizes these types of courses. The course is held on pig’s living tissue. The pigs are anesthetized. This way we reproduce the intraoperative human conditions. We are very close to them because the anatomy of the dissected tissues, at this course is very close to the human anatomy”, said Mihai Ionac, Chief of Vascular Surgery, Spitalul Judetean Timișoara, manager of Pius Brânzeu Center.
These flap harvesting techniques on perforators are used for reconstructive purposes on the inferior limbs.
“These flap harvesting techniques on perforators are used for reconstructive purposes on the inferior limbs after traumas, after infections, after tissue loss because of vascular diseases. It is one of the most frequently used techniques nowadays in breast cancer reconstruction, in the reconstruction of inferior limbs, head and neck, allowing a more delicate, attentive adjustment and a more precise remodeling of the area that needs to be reconstructed”, said Mihai Ionac, Chief of Vascular Surgery, Spitalul Judetean Timișoara, manager of Pius Brânzeu Center.
These training courses are appreciated by foreign specialists, who say that in the future will strengthen the collaboration.
“I think this course is very important for the training of young surgeons because with this kind of possibility that this course offers to them, they have the capability to do a very precise dissection and the can learn new techniques. This type of course should be recommended to understand the fact that microsurgery is one of the possibilities of plastic surgery”, said prof. dr. Paolo Persichetti, specialist in Plastic and Reconstructive Surgery Rome.
“For me is the first time I participate in this course, but many of my residents have participated and I was very interested to visit this center and now, the opportunity has arrived. In the future, I will try and collaborate with more universities from Europe and the center from Timișoara is going to be one of the training centers for residents”, said prof. dr. Paolo Persichetti, specialist in Plastic and Reconstructive Surgery Rome.
The advantage of reconstruction with own tissue has beneficial effects on patients, because there is no more need of implants.
“ We, as reconstructive surgeons always prefer to reconstruct the body with the body’s own tissue. Interventions like this can last from one or two hours, for local defects, up to ten even twelve hours, when complex reconstructions of multiple tissues, bone, soft tissues, muscles, vessels are needed.”, said dr. Alexandru Nistor, specialist in Plastic Surgery.
“The main advantage is that at the end of this intervention, the patient benefits from his own tissue which repairs the defect that existed before or the one that we created by removing a tumor, a part of the body that had to be removed. Afterwards, the patient can continue his activity and he can be cured by using his own tissue. There is no need of implants or materials from different species. For now, reconstructive surgery is based heavily on these types of interventions. “, said dr. Alexandru Nistor, specialist in Plastic Surgery.
The course is an opportunity for resident physicians to deepen the new techniques so they can apply them afterwards in practice.
“I am at my first participation as a student at this course. I’ve attended the course before as n observer, but as a student everything is different, the feeling is different and the knowledge is at another level than that of an observer.”, said Vlad Pieptu, medical resident Plastic Surgery, Iași.
„My opinion concerning this course is a positive one, it was a good opportunity to further my knowledge of the animal dissection and at the same time to put in clinical practice this type of dissection. I’ve learned to be careful with the blood vessels, to do a careful dissection and most of all, to be delicate.”, said Beatrice Tavagnialo, Plastic Surgery, Cesena.
The news doesn’t stop here. The specialists want to be able, in the future, to reconstruct tissues, even whole organs.
“We hope that in the near future, thanks to the big steps that were taken by our colleagues, researchers in this field, to benefit from new technologies that will allow us not to harvest a part of a tissue but to make it ourselves,t o be able to cultivate it in the laboratory, to print it with a printer that instead of ink prints cells and to reconstruct for patients tissues, even whole organs.”, said dr. Alexandru Nistor, specialist in Plastic Surgery.
Pius Brânzeu Center represents a center of training which is world renowned. Over time it was visited by over 1000 course participants, surgeons, both Romanians and foreigners. The resident physicians, participants at this course are from Italy, Greece, Switzerland, Austria, one from Romania and one from Thailand.