Throughout Europe, since the early 1970% several teams have been interested in microsurgery and have contributed to the development of this field. In the technical domain, Gilbert developed a series of single, straight, and soft clamps of varying sizes, which simplified microvascular suturing. Later, Acland' developed the doubly-adjustable microvascular clamps, which include small wires fixed to the jaws of the clamps that facilitate the placement of microsutures and reduce operating time.
The origins of microsurgery date back to the invention of the compound microscope by the Dutch scientist Zacharia Janssen. This invention was used for paraclinical investigation until 1921, when the Swedish surgeon Carl-Olof Nylen' used it experimentally to operate on labyrinthine fBtulae in rabbits. A few months later, a binocular microscope was designed and used for the first time in a case of chronic otitis.
MICROSURGERY IN UPPER AND LOWER UMB RESTORATION
It was only in 1969 that C0bbett3 (Sussex, England) used the microscope for a successful transfer of a big toe for the reconstruction of an amputated thumb. Ever since this accomplishment, many European surgeons have conducted research in anatomy to determine new donor sites for different tissue transfers, thus creating new possibilities for surgeons to recover lost tissue. At the same time, Horn4 (England, 1969) reported a series of ten limbs replanted after complete amputation and described the procedure and the technique of the operation. After considerable experimental work and follow-up on dogs with functional replanted legs, Lapchinsky5 (Russia) determined the conditions of preservation of amputated segments particularly with cooling to 4Β°C. In 1972, Baudet et (France) reported the first case of replantation of a completely amputated thumb and, in From the Hopittlr du Tondu,