Dr. Alexander V. Bystrov, Head of the Center for Microvascular Surgery, is telling:

In 2004, the Center greatly changed after the tragic death of Dr. Konstantin Lebedev, one of the leading Russian microsurgeons, Head of the Department of Reconstructive Surgery. His death was a grave loss for us. And for the little patients, whom he constantly helped, operating them and giving them back their health. The loss of our dear friend is still painfully felt.

Nevertheless, life goes on, work goes on, and new patients appear in all our departments.
The Center of Microvascular Surgery at the RCCH is the largest such center in our country. It has no analogs in Russia.

Presently the Center consists of five departments:
1) Department of Microsurgery No. 1.
2) Department of Microsurgery No. 2.
3) Department of Maxillofacial Surgery.
4) Department of X-ray Endovascular Diagnostic Methods.
5) Department of Cryolaser Surgery (out-patient).
About 700 children annually receive treatment in each of these departments.

Our departments are never empty, always more than full. Sometimes there is even a waiting list of patients with some pathologies.
Work is most intense now at the former Department of Plastic Microsurgery. It was recently renamed: presently it is just the Department of Microsurgery. The majority of its patients are children that have received severe burns of the face and head, elecric injuries. Some children here suffer from consequences of car injuries. Of course, their treatment requires high-tech microsurgical methods.
Microsurgeons treat not only patients after various injuries but also children with serious congenital pathologies, such as benign vascular formations of various localizations, mainly those in the head and neck region. Large angiomata and lymphangiomata, whose growth affects great vessels and nerves. Of course, such situations require microsurgical operations.

I should say that our center uses all techniques presently known in microsurgery. For example, simultaneous transplantation of several tissues, transplantation of toes to the hand to replace fingers. We perform serious microsurgical operations to rebuild one or another organ or to replace its function via reconstruction. Our center specializes in reconstruction of virtually any outer organs that are absent or affected due to a congenital defect or injury. Children with congenital or acquired hand pathologies (absence of fingers, malformed fingers or hand, posttraumatic deformations) virtually fully restore their hand functioning. Another wide group of our patients are kids with severe electric burns. Treatment of these injuries is the most difficult of all, because deep-lying tissues are affected and it is sometimes a real problem to restore the functioning of the injured extremity or part of body. However, the doctors have good results in this field as well; moreover, we can achieve not only medical but also cosmetic effect. Among the worst aftereffects of severe burns, we can mention keloid scarring, which impairs the mobility of affected tissues. The doctors of our center successfully cope with this problem and cure severe keloid contractures of large joints of the upper and lower extremities, keloid deformations of the neck and trunk.

When a child has burns on his or her head, one of the frequent consequences is alopecia, i.e., hair loss. Just imagine a child's stress caused by such a defect! Fortunately, microsurgeons have learned to cope with this problem. A strip of the patient's own skin with hair is transplanted to the bald part of the scalp. After the engraftment, the children become even more hairy than before the injury!

Some kids that appear at our department have no auricles or malformed auricles since birth. As a result, their hearing is also impaired. The doctors perform unique operations and restore the auricles so that the child can hear again. Only Japanese microsurgeons have achieved better results in this field.

The same department treats patients with a congenital false joint of the shinbone. Treatment of this pathology is the most difficult of all, because false joints on other bones can be treated by ordinary techniques, whereas false joint of the shinbone requires transplantation of the patient's own vascularized bone with its inclusion into the general blood circulation. This technique provides fast union of the transplanted bone and adequate activation of the extremity. Observing patients operated five or six years ago, we can say that the results in this field are quite good.
What is a microsurgery? It is an operation that is performed using a surgical microscope, extremely thin suture material, and the technology itself is very intricate. An operation may last 6 ot 7 hours, sometimes even 20 hours, because we work on very small structures.

Now the Center of Microvascular Surgery develops state-of-the-art bioengineering technologies involving stem cells. This method is very promising in combination with microsurgery. Such technologies make it possible to treat children extremely efficiently, creating bone structures in their own organism. Although, on the whole, all departments of our Center of Microvascular Surgery are well-equipped, still introduction and development of these new technologies requires additional financing. We cannot perform sufficient volume of research work, because it involves serious expenditures. The hospital cannot provide money for the purchase of such materials, and therefore we encounter serious problems in getting cell preparations.

We have been cooperating with the Institute of Transplantology for about 5 years. As a rule, it is this institute that supplies the material needed by one or another child. Why are these technologies so expensive? Because the production of the material requires work in various spheres, including genetic engineering technologies, chemistry and biology; the tissues should be grown under definite conditions. Some things cannot yet be done in Russia, and so many components have to be imported.
But, in spite of all problems, new techniques develop and provide promising results.