Microsurgical tissue reconstruction: complexities and features

Microsurgical techniques are among the most complex types of surgical interventions. In plastic surgery, microsurgical techniques are truly a piece of jewelry, which not every specialist can do. At the VII scientific and practical international conference "Complicated cases in plastic surgery", which was held in Kyiv, a report on the topic "Microsurgical tissue reconstruction" presented by the candidate of medical sciences, president of the Armenian Association of Plastic, Reconstructive and Aesthetic Surgery Hovhannisyan Armen Rafayelovich. For readers of estet-portal.com, the plastic surgeon spoke about the features of microsurgical tissue reconstruction.

Armen Rafayelovich, tell our readers if such events are held in Armenia?

Yes, absolutely. Since 2006, we have organized the Association of Plastic Surgeons of Armenia, and every two years we have international congresses. They are of approximately the same format, there are always many guests, all issues and current problems of plastic surgery, aesthetic medicine and reconstructive surgery are discussed. Vasily Vasilyevich comes to us every time, he is one of our honored guests, he always gives very interesting and rich lectures, so everything is mutual.

In your opinion, what is the level of plastic surgery in Ukraine?

In the post-Soviet space, the situation is approximately the same, because plastic surgery began to develop in the early 80s. Of course, some elements were made in the 70s, but the specialty began to emerge from the early 80s.

Ukraine – it is a European country with a large population, and the territory of Ukraine is evenly developed, because there are many large cities in both the eastern and western parts.

And therefore, in all cities, I know that there are good centers, good doctors, good specialists, which means that in general this specialty is well established and developing in Ukraine. I am aware that there are problems with education, because it is very important to get a good education, but these issues are also being resolved. The same problems were in Russia, and in Kazakhstan, and in Ukraine. Having good specialists, especially university teachers, this issue will also be slowly resolved over time.

You are making a presentation on "Microsurgical Tissue Reconstruction". Tell our readers what is the main difficulty of such operations?

The patients who end up undergoing microsurgical tissue reconstruction are not simple patients, but complex ones. Microsurgical reconstruction is required in cases where there are large defects in functional and anatomical structures, without the replacement of which the restoration of function, and sometimes even preservation, if it is on the limbs, is simply impossible. That is, this is a rather complex contingent of patients who need to be treated. Very often you have to work with related specialists, because defects can be of traumatic origin, after oncological operations, some kind of congenital problems, post-traumatic. We often work together with neurosurgeons, maxillofacial surgeons, urologists. Such voluminous complex operations can only be performed in large multidisciplinary centers, where there are many specialists, different departments,

When should microsurgical techniques be used for tissue reconstruction?

In exceptional cases, only when all other types of autoplasty are not applicable or the result will be worse, because these are the most difficult operations in terms of execution. These are high-tech operations, so they require special training, equipment and personnel, and are carried out only in exceptionally rare cases.

What is the reason for the impossibility of performing the operation using another method?

If the defect is very large in area, or several structures are involved in the defect at once, or radical removal of the tumor requires a wide excision, after which large tissue defects form. That is, if you do not have this method in service, often the operations are simply not performed.

What does attending today's conference mean to you?

Such scientific forums, in any case, are very welcome, because one must always learn. There is always something to see, something to find, something to learn, you need to show yourself and see others, there is always something to learn from specialists.

Such events are very important for young doctors, for beginners, because they need to see what they should strive for, where they should go.

This is a simple human communication, this is an opportunity to see your old comrade, colleague again, to communicate, it is very important to integrate into this process, because it has no boundaries. Science, medicine has no boundaries, we must always be in cooperation, we must work together, together.