2990 Microsurgery.qxd - O'Brien Institute

Overview of Research
Bernard O’Brien Institute of Microsurgery
Following trauma nerves as well as blood vessels
are commonly injured and microsurgery is used
to repair them. Nerves which function in a very
similar way to electric cables are composed of
long fibres which are direct extensions from the
nerve cells housed in the spinal cord. When a
nerve is cut in the same way that tadpoles’ tails
regrow, so too the nerve will grow out again
from its point of injury. We are experimenting
with ways to enhance the outgrowth of nerves
following injury, particularly using a special
growth factor ‘Leukaemia Inhibitory Factor’.
Ministerial Visit: Dr Alastair Stewart, Chief Scientist; Ms Tamara Konopka, BSc Hons Student;
The Hon. Rob Knowles, Minister for Health and Human Services; and Mr Geoff Renton, Executive Director.
WHAT IS MICROSURGERY
RESEARCH?
Microsurgery literally means operating through
the microscope. In our field of Plastic and
Reconstructive Surgery we use the microscope
to connect small blood vessels (microsurgery)
for the purpose of restoring circulation to
amputated parts (replantation), or to tissues
or parts that have been transferred from some
other part of the body (transplantation) such
as skin, muscle, bones, joints, toes, etc.
This experimental research is widely applied to
clinical reconstructive microsurgery in trauma,
cancer, burns and congenital abnormalities. This
spectrum of activity covers all ages from infancy
to the elderly and illustrates one of the most
important developments in modern surgery.
Currently we can join 0.5 mm diameter blood
vessels using stitches one half the thickness of
a human hair but there is still a risk that these
vessels will clot. When the circulation is reduced
or ceases to a tissue, a condition known as
ischaemia, that tissue will atrophy or die. The
most familiar example of this is an ischaemic
heart attack, but the same process occurs in
strokes and gangrene of the limbs.
At the Bernard O’Brien Institute of Microsurgery
we are involved in research to understand
the normal process of blood flow and factors
which decrease it (ischaemia) or enhance it
(angiogenesis). This will lead to new ways
of reducing the effect of injury to tissues and
to safer and more effective techniques of
replantation, tissue transplants and even
storage of tissue or tissue banks.
By a better understanding of the process of
blood flow and new blood vessel formation we
will be able to help the healing of wounds, such
as chronic ulcers, and be able to promote and
manipulate the growth of tissues so that new
parts can be manufactured in the body. This
process has been termed ‘tissue engineering’
and we have recently used this technique in
humans to grow ears and noses.
Cancer growth is dependent on new blood
vessels and by understanding how this process
works we can potentially inhibit the new blood
vessel formation which is essential for cancers
to grow and spread. In breast cancer and
melanoma models in mice we have been able
to manipulate the cancer growth by using
drugs which we have shown to be important
in switching on and off the angiogenic process.
The work of this Institute is broadly based and
links many surgical disciplines and areas of
applied science. Much collaborative work is
in progress with other research institutes and
departments, both in Australia and overseas.
With the support of several trusts, industry and
individuals the Bernard O’Brien Institute of
Microsurgery has now been able to equip and
staff dedicated laboratories to pursue our major
areas of interest relating to microsurgery. There
is close collaboration between laboratories with
projects of common interest.
The laboratories comprise:
• Trauma Research Laboratory
• The Jack Brockhoff Foundation Nerve
and Muscle Laboratory
• Helen M Schutt Vascular Research
Laboratory
• The Henry and Miriam Greenfield Trust
Molecular Biology Laboratory
• Respiratory Laboratory
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