CRC Handbook of Microsurgery Volume II Editor Waldemar L. Olszewski, M.D., Ph.D. Professor of Surgery Department of Surgical Research and Transplantology Polish Academy of Sciences Medical Research Center Warsaw, Poland Boca Raton London New York CRC Press is an imprint of the Taylor & Francis Group, an informa business CRC Press Taylor & Francis Group 6000 Broken Sound Parkway NW, Suite 300 Boca Raton, FL 33487-2742 Reissued 2019 by CRC Press © 1984 by Taylor & Francis Group, LLC CRC Press is an imprint of Taylor & Francis Group, an Informa business No claim to original U.S. Government works This book contains information obtained from authentic and highly regarded sources. Reasonable efforts have been made to publish reliable data and information, but the author and publisher cannot assume responsibility for the validity of all materials or the consequences of their use. The authors and publishers have attempted to trace the copyright holders of all material reproduced in this publication and apologize to copyright holders if permission to publish in this form has not been obtained. If any copyright material has not been acknowledged please write and let us know so we may rectify in any future reprint. Except as permitted under U.S. Copyright Law, no part of this book may be reprinted, reproduced, transmitted, or utilized in any form by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying, microfilming, and recording, or in any information storage or retrieval system, without written permission from the publishers. For permission to photocopy or use material electronically from this work, please access www. copyright.com (http://www.copyright.com/) or contact the Copyright Clearance Center, Inc. (CCC), 222 Rosewood Drive, Danvers, MA 01923, 978-750-8400. CCC is a not-for-profit organization that provides licenses and registration for a variety of users. For organizations that have been granted a photocopy license by the CCC, a separate system of payment has been arranged. Trademark Notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe. A Library of Congress record exists under LC control number: Publisher's Note The publisher has gone to great lengths to ensure the quality of this reprint but points out that some imperfections in the original copies may be apparent. Disclaimer The publisher has made every effort to trace copyright holders and welcomes correspondence from those they have been unable to contact. ISBN 13: 978-0-367-21171-4 (hbk) ISBN 13: 978-0-429-26584-6 ( ebk) Visit the Taylor & Francis Web site at http://www.taylorandfrancis.com and the CRC Press Web site at http://www.crcpress.com THE EDITOR Waldemar L. Olszewski, M.D., Ph.D., is Professor of Surgery and Director of the Department of Surgical Research and Transplantology Medical Research Center, Polish Academy of Sciences in Warsaw, Poland. Dr. Olszewski graduated from the Medical Faculty, Medical Academy in Warsaw, receiving the M.D. degree in 1954 and the Ph.D. degree in 1962. He obtained his surgical training in the Surgical Division, Warsaw City Hospital and then the Department of Surgery, Medical Academy, Warsaw. He served as an Assistant Professor at the Medical Academy and the Medical Research Center from 1962 to 1968 and Associate Professor from 1968 to 1978. In 1978 he became Professor of Surgery. From 1962 to 1965 he was Deputy Director of the Department of Surgical Research, Medical Research Center and it was in 1975 that he assumed the position of Director. Since 1974 he is associated with the laboratory of Hematology and Lymphology, Norwegian Radium Hospital in Oslo, Norway. Dr. Olszewski was a Research Fellow at the Royal Postgraduate Medical School in London from 1962 to 1963 and at the Peter Bent Brigham Hospital, Harvard Medical School, Boston in 1968 and 1969. Dr. Olszewski is a member of the European Society for Surgical Research, International Lymphological Society, International Microsurgical Society, and the Interna tional Transplantation Society. He served as President of the European Society for Surgical Research from 1977 to 1978 and as a member of its Executive Committee until 1982. He is a member of the Executive Committee of the International Lymphological Society, National Delegate to the International Microsurgical Society, Associate Editor of Lymphology, Zeit- schrift fiir Experimented Chirurgie, and the Journal of Microsurgery. He has received awards from the Polish Society of Surgeons, Polish Academy of Sciences, International Lymphological Society, and the Purkynje Medical Society. Dr. Olszewski is the author of more than 150 papers and has been the author or co-author of 5 books. His major clinical interest relate to vascular and lymphatic surgery, and research interests to the physiology of the lymphoid organs and immunoregulation. ADVISORY BOARD Sven-Erik Bergentz, M.D. Erminio Cariati, Prof. Dr. Chairman Cátedra di Chirurgia Torácica Department of Surgery Universita di Genova Malrno General Hospital Ospedale S. Martino and Genova, Italy Professor of Surgery University of Lund Malrno, Sweden Walter Brendel, Prof. Dr. Med., Dr. S. Karacsonyi, M.D., Ph.D. Med. h. c. Professor of Surgery Ludwig-Maximilians-Universitat München Semmelweis Orvostudomanyi Egyetem Klinikum Grosshardern I. SZ. Sebészeti Klinika Institut für Chirurgische Forschung Budapest, Hungary München, West Germany T. S. Lie, Prof. Dr. Dr. h. c. Chief and Professor Section of Transplantation Surgical University Clinic University of Bonn Bonn, West Germany CONTRIBUTORS Magnus Âberg, Ph.D. Jacqueline Blanchard, Ph.D. Associate Professor Research Assistant Professor Department of Plastic Surgery Department of Surgery University of Lund University of Illinois at the Medical Malmõ General Hospital Center Malmõ, Sweden Chicago, Illinois Stani$Taw Adamski, M.D. Inge B. Brekke, M.D., Ph.D. Professor and Head Assistant Professor Thoracic-Cardio-Vascular Department Transplant Unit Medical Academy Surgical Department B Bialystok, Poland Rikshospitalet The National Hospital Marco Baccarini, M.D. Oslo, Norway Assistant Institute of Surgical Pathology Hans Brynger, M.D., Ph.D. University of Ferrara Head of Transplant Unit Ferrara, Italy and Associate Professor of Surgery Carys M. Bannister, M.B., B.S., Department of Surgery I F.R.C.S. (E), B.Sc. (Oxon) Sahlgren's Hospital Consultant Neurological Surgeon Gothenburg, Sweden Department of Neurological Surgery North Manchester General Hospital Jurjen E. G. de Boer Manchester, England Department of Biochemistry Biomedical Center Lynn H. Banowsky, M.D. University of Limburg Chief, Section of Renal Transplantation Maastricht, The Netherlands and Professor of Surgery/Urology Department of Surgery/Urology Salvatore De Franco, M.D. University of Texas Health Science Fellow in Microsurgery Center Experimental Research Unit San Antonio, Texas University of Parma Parma, Italy Carlo Battistini, M.D. Professor of Experimental Surgery Enrico De Grazia, M.D. Istituto di Clinica Chirurgica e Terapia Associate Professor of Neonatal Surgery Chirurgica 2 Department of Pediatric Surgery University of Parma University of Palermo Parma, Italy Palermo, Italy Riidiger G. H. Baumeister, Priv.-Doz. Eberhard Deltz, Priv.-Doz. Dr. Med. Dr. Dr. med. habil. Oberarzt der Abteilung Oberarzt Allgemeinchirurgie Chirurgische Klinik und Polilinik der Zentrum Operative Medizin I Universitát München University of Kiel München, West Germany Kiel, West Germany Johan J. van Dongen Susanne Hoick, M.D. Ergonomist Chief Pathologist Laboratory for Experimental Department of Pathology Microsurgery Rigshospitalet Biomedical Center University of Copenhagen University of Limburg Copenhagen, Denmark Maastricht, The Netherlands K. Jaeger, M.D. Umberto Fox, M.D. Consultant Surgeon Assistant Professor Department of Surgery Department of Surgery University of Bonn 3rd Surgical Clinic Bonn, West Germany University of Milan Milano, Italy Gauke Kootstra, M.D., Ph.D. Professor of Surgery Akihiro Fukui, M.D. Department of Surgery Clinical Assistant University of Limburg Department of Orthopedic Surgery Maastricht, The Netherlands Nara Medical University Nara, Japan Will J. Kort, M.D. Head, Microsurgical Unit Hans J. Gerhardt, Professor, Dr. Sc. Laboratory of Experimental Surgery Med. Medical Faculty Klinik Direktor Erasmus University HNO-Klinik Bereich Medizin (Charité) Rotterdam, Holland Humboldt Universitát Berlin, German Democratic Republik Christen Krag, M.D. Roman Goral, M.D. Plastic Surgeon Director and Professor Department of Plastic Surgery Institute of Surgery Rigshospitalet Medical Academy — Poznan University of Copenhagen Poznan, Poland Copenhagen, Denmark Harry Heiner, Prof. Dr., Dr. Sc. Med. Velta A. Lazda, Ph.D. (Deceased) Director of Tissue Typing Laboratory Head and Clinic of Maxillo-Facial Surgery and Research Assistant Professor Plastic Surgery Department of Surgery Friedrich-Schiller-University University of Illinois at Chicago Jena, German Democratic Republic Chicago, Illinois F. Hess, M.D. T. S. Lie, Prof. Dr. Dr.h.c. Scientific Investigator Chief and Professor Microsurgical Department Section of Transplantation Laboratory for Cytology and Histology Surgical University Clinic University of Nijmegen University of Bonn Nijmegen, The Netherlands Bonn, West Germany Arthur S. M. Lim, F.R.C.S., Henri Martin, M.D. F.R.A.C.S., F.R.A.C.O. Professeur de Clinique Visiting Consultant d'Oto-Rhino-Laryngologie et Ministry of Health d'Audiophonologie and Hôpital Edouard Herriot Ophthalmic Surgeon Lyon, France Mt. Elizabeth Hospital Lars Mjornstedt, M.D. Mt. Elizabeth Medical Center The Transplant Unit Singapore Department of Surgery I University of Gothenburg J. Limmer, M.D. Gothenburg, Sweden Department of Surgery University of Ulm Marco Montorsi, M.D. Ulm, Federal Republic of Germany Assistant Department of Surgery Giuseppe Li Voti, M.D. 2nd Surgical Clinic Associate Professor of Microsurgery University of Milan Department of Pediatric Surgery Milano, Italy University of Palermo Palermo, Italy Eugenio Morsiani, M.D. Assistant D. Louis, M.D. Institute of Surgical Pathology Director University of Ferrara Centre de Chirurgie Expérimentale et de Ferrara, Italy Microchirurgie K. J. Niehaus, M.D. Institut Pasteur de Lyon Fellow of Section of Transplantation Lyon, France Department of Surgery University of Bonn Jos M. Maessen Bonn, West Germany Medical Student University of Limburg L. Nieuborg, M.D. Maastricht, The Netherlands Surgeon Department of General Surgery Klaas W. Marck, M.D. Zuiderziekenhuis Resident in Plastic Surgery Consultant Lymphologist Radiotherapy Department of Plastic Surgery Institute University Hospital Rotterdam, The Netherlands Groningen, The Netherlands Minoru Numata, M.D., Ph.D. R. L. Marquet, M.D., Ph.D. Lecturing Professor of Surgery Immunologist Department of Surgery Laboratory for Experimental Surgery Shinshu University Erasmus University School of Medicine Rotterdam, Holland Nagano-ken, Japan Christian Martin, M.D. Michael Olausson, M.D. Professor The Transplant Unit Impasse Benoit Chazvet Department of Surgery I Hôpital Bellevue Sahlgren's Hospital St. Etienne, France Gothenburg, Sweden Waldemar L. Olszewski, Ph.D. Jürgen Seifert, M.D. Professor of Surgery Professor for Experimental Surgery Department of Surgical Research and Institut für Chirurgische Forschung Transplantology Universitàt München Polish Academy of Sciences München, West Germany Warsaw, Poland Alvin M. Siegler, M.D., D.Sc. Clinical Professor Robert J. Oostenbroek, M.D. State University of New York Department of Surgery Downstate Medical Center University of Limburg Brooklyn, New York Maastricht, The Netherlands Monika Skibbe, Dr. Med. Jochum Prop, M.D. Assistant Research Fellow Clinic of Maxillo-Facial Surgery and Department of Experimental Surgery Plastic Surgery State University Friedrich-Schiller University Groningen, The Netherlands Jena, German Democratic Republic Betty Riehl Peter B. Soeters, M.D., Ph.D. Laboratory Technical Assistant IV Staff Surgeon Division of Urology Department of Surgery University of Texas Health Science University of Limburg Center Maastricht, The Netherlands San Antonio, Texas Aristotelis C. Stavropoulos, M.D. Giuliano Romagnoli, M.D. Doctor of Medicine Assistant University of Athens Department of Surgery and 3rd Surgical Clinic Head, Division of Endoscopy and University of Milan Microsurgery LITO Milano, Italy Maternity Hospital Athens, Greece Thomas Ryffa, M.D. Grzegorz A. Szymczynski, M.D. Chief Technician Head, Department of Andrology Department of Surgical Research and Medical School of Poznan Transplantology Poznan, Poland Polish Academy of Sciences Warsaw, Poland Susumu Tamai, M.D. Associate Professor John R. Salaman, M.Chir. Department of Orthopedic Surgery Professor of Transplantation Surgery Nara Medical University The Royal Infirmary Nara, Japan Cardiff, Great Britain Jürg W. Tauber, M.D., Ph.D. Andrea San tini, M.D. Clinical Fellow Associate Professor of Surgery Transplantation Surgery Institute of Surgical Pathology Department of Surgery University of Ferrara University of Chicago Ferrara, Italy Chicago, Illinois Arnulf Thiede, Prof. Dr. Med. Jan B. Wieslander, M.D. O. A. der Abteilung für Allgemeine Resident in Plastic Surgery Chirurgie Department of Plastic Surgery Zentrum für Operative Medizin I University of Lund Kiel, West Germany Malrno General Hospital Malmõ, Sweden Anneliese Tilgner, Dr. rer. nat. Scientific Assistant Kazimierz Wojcicki, M.D., Doz. Dr. Clinic of Maxillo-Facial Surgery and habil. Plastic Surgery Institute of Surgery Friedrich-Schiller University Medical Academy — Poznan Jena, German Democratic Republic Poznan, Poland J. S. Valla, M.D. Oskar Zelder, Priv.-Doz. Dr. Med. Assistant Chef de Clinique Zentrum für Operative Medizin I Service de Chirurgie Pédiatrique Chirurgische Klinik Hôpital Debrousse Universitàt Marburg Lyon, France Marburg, West Germany Franz A. Zimmermann, Priv.-Dr. med. Dr. habil. Department of General and Abdominal Surgery University of Homburg/Saar Federal Republic of Germany