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Official Journal of the Italian Society of Maxillofacial Surgery
Online ISSN 1827-1901
Politi M., Toro C.
Department of Maxillofacial Surgery, University-Hospital of Udine, Udine, Italy
Microsurgery was developed in the 20th century. Microsurgical techniques are utilized by all specialties today, especially those involved in reconstructive surgery (reconstructive microsurgery) such as: plastic surgery, general surgery, orthopedic surgery, otolaryngology, and maxillofacial surgery. Microsurgery is a culmination of achievement in vascular surgery, started in 1902 with Alexis Carrel, that was awarded the Nobel Prize in Medicine and Physiology (the first America’s Nobel prize in Medicine) in 1912. In 1954 Murray, Merrill and Harrison performed the first successful human organ isograft, a kidney donated between identical twins. For his pioneering work, Murray became the only plastic surgeon to receive the Nobel Prize in Medicine. After that starting period, multiple donor tissues have been successfully used to reconstruct complex composite tissue defects of the head and neck, limbs, abdomen, chest and breast. Heterotopic autotransplantation with microvascular free flap is nowadays the gold-standard in head and neck reconstruction. In the last 20 years reconstructive microsurgery became crucial in oro-maxillofacial reconstruction, because of the obvious and fundamental aspects of the face and of the oral functions in human life. In 2005, the first successful partial facial allo-transplantation was performed in France. Immediately after, other partial facial allo-transplantations have been performed. The indications for oro-maxillofacial microvascular surgery are in continuous expansion. With the introduction of prefabricated microvascular flaps, modern reconstructive microsurgery has moved from the age of flap development through technical refinement and donor-site selection to the current era of critical assessment of functional outcome.