Microscopic precision

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When a California industrial worker had his hair caught in machinery on the job, his entire scalp was pulled off. Buntic was able to replant it.

When a California industrial worker had his hair caught in machinery on the job, his entire scalp was pulled off. Buntic was able to replant it.

By Michelle Pucci

“Most people who have thought about microsurgery a little bit think of it as operating with a microscope,” says microsurgeon Rudy Buntic, MDCM’90. “There’s much more to it than that.”

With microsurgery, it is possible to minimize scarring, nerve damage and muscle disfigurement. Although microsurgery is more complex than other methods, it’s also less expensive and requires less healing time.

During surgery, Buntic can reattach blood vessels and nerves in the case of amputations, or he can use small parts of donor tissue in the back to replace lost tissue.

The Buncke Clinic in San Francisco, where Buntic practices, pioneered the technique of using small parts of the latissimus muscle, which avoids changing the shape and function of the backs of patients.

In breast reconstruction following a mastectomy, Buntic uses the fat of the abdomen to rebuild. In one case, he was able to replant a severed tongue, the first reported case of a successful tongue replantation.

“When you look at it with a naked eye, it looks almost impossible to repair,” Buntic says about the injuries he treats. Using today’s microscopes, magnification and instruments, Buntic can reattach very small blood vessels.

When a California industrial worker (pictured above) had his hair caught in machinery on the job, his entire scalp was pulled off, including his ear and eyebrows. Buntic was able to replant the man’s scalp, which was retrieved from the machine, using microsurgery.

“All of it survived,” Buntic says. The man now has hair growing back. “It’s very hard to tell that he’s had the injury originally.”

In the past years, microsurgery has been innovating by using nerves from cadavers to graft nerve defects. Traditionally, nerve grafts have come from other parts of the patient’s body, sacrificing feeling in the donor sites.

“One of the things people who see it for the first time are surprised at is how complicated it is,” he says. “But that complexity has become routine because we’re practiced at it.”

 

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