Introduction and General Background

Abstract

The last years have registered an important activity in the specialty of plastic and reconstructive surgery. In particular, a real revolution in reconstruction has occurred. The not-so-old dream of restorative surgery, namely, the replacement of damaged parts of the body by new unharmed preformed tissues, has become a reality. The development of techniques aimed at transplantation of vascularised composite tissues (VCA, vascularised composite allografts) has provided clinicians with a new robust tool for the reconstruction of deformities that were, not so long ago, impossible to achieve. History, development and classical attempts for VCA are not a new one. More than four decades ago, doctors in Ecuador attempted the transplantation of a hand limb. The transplant failed, but the dream survived. Pioneering laboratory work in experimental animals showed the path to clinicians for the achievement of human VCA. The works of Dr. Siemionow and Dr. Butler are milestones of the development of this discipline. They showed how tissues could survive after transplantation and implemented the basis for the surgical technique in the clinical scenario. More than ever, this is a perfect example of translational research and implementation of bench work to the bedside.