History of microsurgery.

In the mid-1500s, the techniques of vascular ligature and vascular suture were developed sporadically by several pioneers in this field. However, vascular surgery became realistic experimentally as a result of the work by Carrel and Guthrie in the early 1900s, in which they performed replantations and transplantations of several composite tissues and organs, including amputated limbs, kidneys, and others using experimental animals. In contrast, the development of heparin by Howell and Holt in 1918 accelerated the rate of these types of operations being performed with increasing success in humans. Since the first use of a monocular microscope for ear surgery by Nylen in 1921 and a binocular microscope by Holmgren in 1923, in addition to the timely developments of the Zeiss operating microscope, microsurgical instruments, and suture materials, microsurgery was born in several surgical disciplines in the ensuing 50-year period. The application of microvascular surgery and microneurosurgery in the fields of hand, plastic, and reconstructive surgery resulted in revolutionary advances in clinical replantation and transplantation of composite tissues and more allotransplantations.