Chirurgie Plastica

DOINA DUMITRESCU - IONESCU

Nascuta la Sibiu, 1949, absolventa a Universitatii de Medicina si Farmacie Cluj 1974, practica real chirurgia experimentala in toti anii de studentie, lucrarea de diploma efectuata chirurgical de autoare, demonstreaza “Regenerarea hepatica in intoxicatiile cu alcool dupa hepatectomii subtotale largite 80-85% pe soareci de laborator” Literatura de specialitatea a lumii relata supravietuire la 60-65%. Traverseaza prin concurs toate treptele ierarhice si profesionale pe linie de universitate si spital. Medic intern chirurgie la Institutul Oncologic Cluj – Prof. DR. Ioan Chiricuta si preparator anatomie stomatologica 1973-1975. 1976-1979 specializare in Chirurgia Plastica Reparatorie la Prof. DR. Agrippa Ionescu. In cadrul Universitatii de Medicina si Farmacie Carol Davila Bucuresti, autodidact, initiaza, coordoneaza si dezvolta incepand cu anii 1977-1979 noua specialitate chirurgicala in Romania, Microchirurgia Reconstructiva, in toate ramurile ei internationale, experimental (vase, nervi), clinic (nervi periferici, plexuri brahiale, replantari - revascularizari, transferuri libere de tesuturi compuse, miscellaneous), cercetare, invatamant, intr-un interval extrem de scurt, 1977-1987, la o dimensiune onorabila fata de oricare din tarile lumii. In 1988 este confirmata Teza de Doctorat : « Reconstructia microchirurgicala a nervilor periferici postraumatici » sustinuta in 1986. Sef de Lucrari 1993, Conferentiar in 1996, Profesor in 2000 (27.000 puncte) la Universitatea de Medicina si Farmacie Carol Davila Bucuresti, specialitatea Chirurgie Plastica –Microchirurgie Reconstructiva. Are contributii esentiale in conceptia microchirurgiei reconstructive internationale, cu implicatii teoretice fundamentale, clinice, sociale ; a schimbat handicapul postraumatic neuromotor reconstruit in conceptia microchirurgiei reconstructive in recuperarea acestei categorii de pacienti, in parametrii impusi international si mai mult; peste 3,000 de pacienti operati numai microchirurgical, peste 1.800 de autotransplante, o serie de premiere nationale, 6 brevete de inventii, peste 300 de lucrari stiintifice, peste 90 publicate, a creat o noua scoala, de microchirurgie reconstructiva, in care conceptia microchirurgiei reconstructive a fost permanent baza, in care niciodata microchirurgia reconstructiva nu a fost anulata la o simpla tehnica. 59 de medici specializati sau competente sunt reteaua extensiei noii conceptii reconstructive « in ploaie », amplificata la numarul de pacienti al fiecarui medic format. Conceptia reconstructiei microchirurgicale a determinat abordarea mult mai eficienta si a celor peste 17,000 de pacienti operati in domeniul chirurgiei plastice reconstructive.

Master in Managementul sistemului de sanatate 2005.

Rol decisiv in crearea Societatii Academice Romane de Chirurgie Plastica Microchirurgie Reconstructiva SARCPMR (delimitata zonal la Bucurestiul universitar) si a Asociatiei Chirurgilor Plastici Romani (extensia SARCPMR la nivelul tarii).

PREMIERE NATIONALE MICROCHIRURGIE RECONSTRUCTIVA recunoscute national si international: clinic, experimental, cercetare, organizare :

1. Revascularizare - prima Mai 1979, zona VI, vase diametru 2mm.

2. Organizarea si utilizarea Laboratorului de Microchirurgie Experimentala pe animal de laborator, Oct.1980-1989

3. Replantare de segmente de membru -prima 15 Ian. 1982 ; din 24, 23 cu succes

4. Anastomoza experimentala 100 artere, vene pavilion auricular iepure, diametru 0,2-1mm, rata de succes 90,2% demonstrata clinic, histopatologic 1980-1985

5. Coaptarea directa experimentala 70 nervi pavilion auricular iepure 1980-1985, verificate histopatologic, comparind cu nevroamele post sutura clasica a 500 de

nervi periferici umani.

6. Coaptare directa fasciculara pe grupe fasciculare de nerv periferic, din 1980 peste 8.500

7. Proiectarea, constructia de masa, in doua variante, pentru extremitatea de operat microchirurgical, colaborare cu Ing.Achile Dumitrescu, 1981-1982, inventie

omologata OSIM

8. Coaptare indirecta – grefa interfasciculara de nerv- , prima martie 1981, peste 2.500

9. Contributie la grefarea nervului periferic, martie 1981 inventie omologata OSIM

10. Anastomoza arterei principale a nervului, dec.1982, diametru 0,2-1mm, inventie omologata OSIM

11. Grefa interfasciculara vascularizata de nerv, 23 Mai 1985; 29

12. Reconstructia microchirurgicala a paraliziilor postraumatice de plex brahial din 1985, 91.

13. Transfer liber microchirurgical de tesuturi compuse functionale, cu pedicul vasculonervos, 1987, peste 53 ; gracillis, latissimus dorsi, serratus anterior, etc.

14. Primele comunicari, lucrari stiintifice, publicatii din Romania in domeniile enuntate, national si international.

15. Contracte de Cercetare cu UMF “Carol Davila” 1980-1989 in domeniul microchirurgiei reconstructive,pe fiecare componenta a noii specialitati, in fapt singurele

contracte ale Clinicii in acel interval.

16. Contract cercetare stiintifica cu Academia de Stiinte Medicale privind grefele interfasciculare de nerv 1984- 1986

17. Organizarea Compartimentului Clinic de Microchirurgie Reconstructiva, 20 de paturi 1981, recunoscut MS din 1984.

18. Scrisori metodologice privind replantarea, nervii periferici si reconstructia plexului brahial 1984

19. Cazuistica clinica si experimentala mare pentru un singur microchirurg comparand cu standardele internationale, peste 3.000 de pacienti, inafara sutelor de ore de

microchirurgie experimentala;

20. Abordarea intregii specialitati de Microchirurgie Reconstructiva de la bun inceput ca o noua conceptie reconstructiva si nu ca o simpla tehnica, in cele sase

componente internationale: experimental, nervi periferici, replantari-revascularizari, plexuri brahiale, transfer liber de tesuturi compuse, miscellaneous in intervalul

1980-1987, in conditii putin comparabile cu cele impuse si existente in Centrele Internationale ;

21. Urmarirea cazuisticii operate, notificare de observatii pre, intraoperatorii, postoperatorii lunare pana la completa recuperare, conform standardelor internationale

ale Societatii Internationale de Microchirurgie Reconstructiva, a permis contributiile la imbunatatirea tehnicii, rezultatelor dar si :

22. Concluziile privind microchirurgia reconstructiva a nervilor periferici, replantari, plexuri brahiale care nu se suprapun in cea mai mare parte

cu cele internationale publicate si comunicate in 1983, 1986, 1987, 1988, 1992, 1997.

23. Reconstructia cavitatii orbitale, pleopa superioara mobila, pleoapa inferioara 1991, inventie omologata de OSIM

24. Reconstructia paraliziei vechi de nerv facial intr-o singura etapa : transfer liber dublu microchirurgical de nerv si de muschi serratus anterior inervat 1995-

1996 ; procedeu modificat

25. Reconstructia cavitatii orbitale, pleoapa superioara mobila, pleopa inferioara, spranceana, Inventie Omologata OSIM 1991

26. Transplantul in conceptie microchirurgicala a unui segment de nerv troncular in cadrul aceluias individ, Doina Dumitrescu-Ionescu

Contract VIASAN 29.10.2001-15.10.2003

Premiere nationale in domeniul chirurgiei plastice reconstructive:

27. Pensa pentru modelarea intraoperatorie a sanului 1991, inventie omologata OSIM

28. Reconstructia unui defect important toata grosimea de obraz, 1991, inventie omologata OSIM

29. Reconstructie in necroza avasculara de cap femoral cu grefon osos din creasta iliaca transpozat si vascularizat prin artera circumflexa iliaca

profunda, 9 mai 1996, cu Dr. Fundulea, Spital Colentina, Ortopedie

30. Tratamentul fracturilor complexului cranio-facial cu microplaci-microsuruburi, grefon osos, 1998.

31. Program de chirurgie plastica in obezitate – suprapondere din 1998

32. Procedee complexe reconstructive post excizii tumori de parti moi 1999- 2008

33. Urgenta extremitatii profund traumatizate 1978-2010

34. “Obţinerea de epiderm artificial prin cultivarea în laborator a keratinocitelor de la pacienţi, pentru tratamentul eficient al unor boli de piele, al

arsurilor şi al politraumatismelor”, 2005-2008 Autor Academician Laurentiu Popescu; Partener 5 eu

35. Melanom cutan program de cercetare in protocol international 2005 pdv chirurg plastic reconstructiv;

PREMII NATIONAL SI CINCI INTERNATIONALE

36. Film Stiintific realizat de Studioul Al.Sahia 1985 : “Circuite Refacute”–“Microchirurgia nervului periferic”, coordonator stiintific si personaj

principal, 1985 – 1989, cinci Premii Internationale si Premiul I National Cupa de Cristal.

Premiere nationale si internationale in domeniul chirurgiei experimentale hepatice :

37. „Regenerarea hepatica in intoxicatia cu alchool” 1973-1974 demonstrata prin hepatectomie subtotala largita 80-85% din volumul hepatic al soarecelui alb de laborator (70 soareci operati, mortalitate 1).EHP efectuat de Prof.DR.Gelu Simu, Lucrare de Diploma 1974. Lucrare efectuata in 1973 si 1974.

BREVETE INVENTII OMOLOGATE

1. Metoda microchirurgicala de refacere a continuitatii nervilor periferici. Certificat de Inventator Nr.93261, 21 aug.1987. Doina Ionescu

2. Metoda microchirurgicala de sutura a nervilor periferici. Certificat de Inventator Nr.90515,23 iulie 1986. Doina Ionescu

3. Masa pentru operatii microchirurgicale. Certificat de Inventator Nr.92485,31 ian. 1987.Doina Ionescu, Achile Dumitrescu

4. Pensa pentru modelarea intraoperatorie a sinilor. Certificat de Inventator Nr.5/1234/30.11.1995 Doina Ionescu, Achile Dumitrescu

5. Metoda de reconstructie a unui defect de obraz Certificat de Inventator Nr.5/1088/30.06.1995,brevet Nr.109911. Doina Ionescu

6. Metoda de reconstructie pleoapa superioara mobila. Certificat de Inventator Nr.5/1042/31.05.1995,brevet Nr.109810 Doina Ionescu

PUBLICATII IN TRATATE SI CAPITOLE RECUNOSCUTE NATIONAL SAU INTERNATIONAL

1. Monografie: Microchirurgia nervilor periferici, Doina Ionescu, Editura Medicala, Bucuresti,1989, pag.176.

2. Leziunile nervilor periferici si Replantarile de membre, subcapitole in Tratat de Patologie chirurgicala, vol.III,coordonator Prof.Dr.Denischi A, Autor Doina Ionescu, Editura Medicala, Bucuresti, 1988

3. Microchirurgia reconstructiva in Romania, Doina Ionescu,Editura Vinea, Bucuresti, 1995, pag.130,

4. Monografie: Microchirurgia reconstructiva, Doina Dumitrescu-Ionescu, Editura Medicala, Bucuresti, 1999, pag.344

5. Curs chirurgie plastica reconstructiva, Doina Dumitrescu-Ionescu, UMF-Carol Davila 1999,pag.300

6. Conceptia, principiile si tehnicile microchirurgiei reconstructive si Replantarea si Revascularizarea extremitatilor, subcapitole in Principiile Cchirurgiei Plastice si Microchirurgiei Reconstructive, pag. 156-217, National, 2005

7. Microchirurgia Reconstructiva a Replantarilor-Revascularizarilor, Doina Dumitrescu-Ionescu, subcapitol in Patologia Aparatului Locomotor, vol. I, Autor Dinu Antonescu, Editura Medicala, 2005

8. Reconstructive Microsurgery – A New Conception, BookSurge, LLC, 2006, Translator Iulian Cananau, Rodica Mihaila

9. Recent Conclusions Regarding the Reconstructive Microsurgery of Peripheral Nerves, Doina Dumitrescu-Ionescu Coautor, Innovations in Plastic and Aesthetic Surgery, Editors M. Eisenmann-Klein, C. Neuhann-Lorenz, Springer, 2008, Traslator Rodica Mihaila

GRANT

1. AUTOR Refacerea continuitatii nervoase in defectele de nerv, prin tehnici microchirurgicale. Doina Ionescu, Contract de Cerecetare Stiintifica doua etape, I si II cu Academia de Stiinte Medicale 1985-1986

2. AUTOR Transplantul in conceptie microchirurgicala a unui segment de nerv troncular in cadrul aceluias individ, Doina Dumitrescu-Ionescu Contract VIASAN 29.10.2001-15.10.2003

3. PARTENER 5 la Cercetare de excelenţă, Tipul proiectului P-CD,

CONDUCATOR PROIECT Academician Laurentiu Mircea Popescu

“Obţinerea de epiderm artificial prin cultivarea în laborator a keratinocitelor de la pacienţi, pentru tratamentul eficient al unor boli de piele, al arsurilor şi al politraumatismelor”, 2005-2008

4. PARTENER Consortiu PNCDI 2 - Program 4 - "Parteneriate in domeniile prioritare" Avram Marioara „Biochip microfluidic pentru caracterizarea reologica a

fluidelor biologice ne-newtoniene cu aplicatii in diagnoza si tratament medical” 2008-

5. PARTENER Consortiu PNCDI 2 - Program 4 - "Parteneriate in domeniile prioritare" Avram Marioara „Sistem micro - electro - mecanic cu aplicatii in

reconstructia microchirurgicala a nervilor periferici” 2008-

LISTA COMUNICARI (conferinte, rapoarte, comunicari propriu-zise, postere la manifestari stiintifice nationale si international) ARTICOLE 300 de lucrari stiintifice, peste 90 publicate

Publicate in reviste si aditionale Congreselor nationale:

Chirurgia, Ortopedia, Neurologia, Romanian Journal of Diabet, Noutatea Medicala; si internationale: Acta Chirurgiae Plasticae, Roumanian Progress inMicrosurgery The 8-th International Symposium of the Reconstructive Microsurgery Society Paris,1985; Conclusions Microchirurgie in der Rekonstruktiven und Plastischen Chirurgie, Jena, 1988; Up Date , Dec. 1999; Brain Aging International Journal 2002 ; Journal of Cellular and Molecular Medicine International Journal 2002;

RECUNOASTERE INTERNATIONALA : PREMII, DISTINCTII

1. Citata in bibliografia internatioanala “The Peripheral Nerve” J.K. Terzis; Raven Press, 1990, New York, monografie

2. Cotata pe locul doi in lume pentru rezultate si contributii originale in microchirurgia reconstructiva in Anuarul Italia 1992.

3. „Stem cell (p63+) in keratinocyte cultures from human adult skin” 2003, Proiect realizat de Academician Laureniu Popescu. Partener 5, Premiu la Sectiunea

Original Articles pentru coautor la lucrare

2. Aprecieri ale unor personalitati internationale care au creat MR in anii 1968-1974: J.K.Terzis,W. Shaw, Hanno Millesi, Allen Gilbert, Narakas.

3. Solicitare si aparitia in volume pe diferite teme ale Who’s Who International

4. Aprecierile la Reconstructive Microsurgery - A new Conception, publicata in editura BookSurge, 2006; este recunoscuta ca valoare originala incontestabila, in tari si de catre personalitati cu traditie in domeniu

5. Invitata cu doua capitole in Tratatul reprezentativ al Confedereatiei Internationale al Chirurgiei Plastice, Reconstructive si Estetice Internationale, IPRAS, pentru a prezenta rezultatul cercetarilor, experienta in zona mea de expertiza, pentru a aduce contributii semnificative la comunitatea internationala, ca si in noile descoperiri, aplicatii si subtilitati in domeniu

6. Invitatii internationale in parcursul a 25 de ani din partea celor mai competente foruri internationale privind MR

IMPACTUL NATIONAL SI INTERNATIONAL AL Microchirurgiei Reconstructive MR REALIZATE

Initiativa, introducerea, organizarea si dezvoltarea Microchirurgiei Reconstructive ca Specialitate MR in Romania, realizata autodidact, conform planului propriu rezultat din suma studiului literaturii de specialitate a lumii si in timp din experienta acumulata ca student activ in chirurgia experimentala, ca medic intern de chirurgie trei ani, ca preparator anatomie unde disectia unui plex brachial era lectia de baza, ca elev al genialului Profesor Ioan Chiricuta, al gigantului Profesor Agrippa Ionescu dar si educatiei esentiale primite in sensul de a respecta omul, a avea datoria sa lasi ceva in urma.

Componentele MR realizate sunt pe scara mare si echivalente cu componentele ei internationale,: microchirurgie experimentala (a nervilor periferici si artere-vene pe pavilion auricular de iepure si examene histopatologice de verificare), microchirurgie clinica - nervi periferici, plexuri brahiale, replantari-revascularizari, transfer liber de lambouri compuse, miscellaneous, s-au dezvoltat conform programului autoimpus, in anii 1979-1987 marcand seria premierelor nationale niciodata ca eveniment si tehnica, totdeauna ca o noua conceptie reconstructiva, dar si international. In anul 1979 prima revascularizare microchirurgicala, 1981 primele autotransplante de tesuturi compuse microchirurgicale in Romania, in 1982 – primul autotransplant microchirurgical de segment de membru, prima replantare de mana-antebrat, din care moment autotransplantul microchirurgical devine rutina in clinica.

Nici un moment MR nu a insemnat o tehnica bine pusa la punct, un eveniment, episodic, publicitate, un pionerat de dragul pioneratului in care se pune cate o floare din fiecare si se mentioneaza numai ce a rasarit. Nu. MR a fost dezvoltata in mod constient, constiincios, conform unui plan adecvat timpului, cu scop clar de a schimba radical soarta pacientilor din aceasta categorie, deci in toate ramurile sale internationale, pentru a dovedi importanta si necesitatea specialitatii prin volum, urmarire fara defect pre, intra, postoperator, ca si prin toate formele timpului din domeniul stiintific prin care se prezentau note, etape, concluzii si nu in ultimul rand, pentru a plasa Romania in Lume, acolo unde ii era locul, in loc de frunte. In anul 1984 Romania era intre primele patru tari europene care abordau aceasta specialitate. URSS incepuse cu numai patru ani in urma si nu era inaintea noastra ca abordare „in tot unitar”. In lume a aparut ca eveniment disparat intre anii 1962-1974, in 1968-1970 s-au intalnit cei opt pioneri ai MR Internationale si au traversat „de la o tehnica” la „o noua gandire-conceptie reconstructiva”. In Romania in intervalul 1985-1989 filmul stiintific despre MR din Romania a luat cinci premii internationale si primul premiu national si era suma a 500 de cazuri operate, evaluate din toate campurile MR in intervalul 1979-1984. In 1992 eram cotati pe locul doi pentru rezultate si contributii originale la MR, cand erau deja aproape doi ani de somaj ai medicului roman care a realizat MR si care brusc a devenit dusman al poporului in dec 1989. In 2006 s-a publicat o carte intr-o editura internationala si in 2008 un capitol intr-un tratat esential de Inovatii, in care suntem singurul reprezentant roman din domeniul chirurgiei plastice-microchirurgiei reconstructive, invitat sa scrie doua capitole.

Cazuistica mare, deocamdata unica in tara pentru un singur microchirurg, data fiind abordarea sistematica a intregii specialitati de acelas microchirurg (in lume microchirurgii sunt axati pe cate o ramura, cel mult inca una tangenta, iar cazuistica cifric vorbind, depaseste datele relatate international referitoare la activitatea unui singur microchirurg reconstructiv) in intervalul 1979-2002, se refera la peste 3,000 de pacienti operati numai microchirurgical peste cei 17.000 operati in domeniul chirurgiei plastice reconstructive, (ceea ce inseamna peste 2.500 de autotransplante, reconstructii microchirurgicale de nervi periferici 8.500, 24 de replantari din care 23 cu succes, o serie de revascularizari, 53 de transferuri libere microchirurgicale de lambouri compuse, 91 de reconstructii in paraliziile postraumatice de plex brahial), a facilitat si etapele de cercetare stiintifica pe perioade de cate patru ani cu lucrari de etapa anuale. Analiza, sinteza intregii activitati reconstructive microchirurgicale, continua, riguroasa, notata, fotografiata si filmata, respectand criteriile internationale de evaluare a rezultatelor specialitatii. Cercetarea stiintifica a permis ajungerea la concluzii care nu se suprapun in mare parte cu cele internationale, dar si la inventii brevetate de OSIM, publicarea de carti si capitole pe plan national si international, citari in literatura internationala ca si realizarea unui film profesional stiintific care atesta valoarea Romaniei in acest domeniu intr-o etapa si internationala de pionerat. Recunoasterea Romaniei este dovedita prin plasarea pe loc extrem de bun in acest domeniu pentru timpul la care se refera, pentru contributii esentiale si originale, rezultate si volum de munca dovedit, prin premii nationale si internationale pentru film stiintific (1985-1989).

Cazuistica este importanta pentru fiecare pacient in parte, dar si pentru Universitatea de Medicina si Farmacie. Mai importanta este insa pentru societate, lumea stiintifica internationala, suma observatiilor, concluziilor, modificarile propuse privind reconstructia postraumatica a nervilor periferici, plexurilor brahiale, a oricarei extremitati, fie distala, fie proximala, fie cefalica ca si standardele rezultatelor care pot fi atinse daca exista si se practica in conceptia recontructiva de ultima ora.

Ceea ce este mai important decat pioneratul intr-o noua specialitate si decat volumul de operatii reconstructive individualizate atat experimental cat si clinic, este schimbarea stiintei fundamentale referitoare la degenerare regenerare a nervului periferic postraumatic si „refacut” prin conceptia reconstructiei microchirurgicale, prin concluziile derivate din observarea pre, intra si postoperatorie a recuperarilor, ca si la aducerea unor noi idei si solutii practice reconstructive care cresc sansa recuperarii maxime in timp si mai scurt.

Pe masura dezvoltarii Microchirurgiei Reconstructive MR, s-a raspandit specialitatea de MR prin Scoala romaneasca de Microchirurgie Reconstructiva creata si dezvoltata de DR. Doina Ionescu Dumitrescu odata cu specialitatea; au fost specializati medici romani si dinafara tarii. Sunt 59 de medici care au urmat aceste specializari mai mari sau mai mici. Odata cu dezvoltarea MR nationale a dezvoltat reteaua de MR nationala, prin specializarea in acest domeniu a unor rezidenti-secundari in chirurgia plastica reparatorie sau reconstructiva. Practic sunt 59 de medici care fie s-au familiarizat cu tehnica microchirurgicala, ceea ce este prea putin, fie au inteles si adoptat conceptia reconstructiva microchirurgicala, in care tehnica microchirurgicala este numai mijloc si care la randul lor au schimbat soarta de handicap a pacientilor.

Pe plan social national impactul a fost net, clar, indiscutabil. S-a ajuns din primii pasi sa se transforme un pacient cu handicap major neuromotor periferic postraumatic, exclus profesional, social, familial pana la momentul MR, intr-un pacient sanatos, apt de munca, cu o viata normala ca si cand aproape nimic nu s-a intamplat, cu recuperari care vazute de cei cu experienta pareau incredibile si mai ales inscrise sau depasind criteriile internationale de evaluare. Rezultatele nu erau rodul unei abilitati de tehnica operatorie; rezultatele erau rodul unei conceptii reconstructive bazate pe o cantitate nemarginita de munca (studiu, experimental si clinic, fara pauze, concedii, weekand).

Douazeci de ani specialitatea de MR a fost renegata si considerata public inutila de majoritatea medicilor romani privitori. In schimb, personalitati importante ale medicinei timpului si personalitati speciale din alte domenii, au recunoscut valoarea si evaluat si incurajat in etapele de prezentare a lucrarilor de etapa sau a celor finale din cadrul programelor de cercetare ale IMF- UMF, ale contractelor cu Academia de Stiinte Medicale, din cadrul etapelor de Doctorat, a comunicarilor stiintifice nationale; dovada sunt capitolele scrise pentru tratate nationale si internationale de cea mai mare anvergura.

Ceea ce nu a fost util in parcursul a 30 de ani a fost oprobiul la care Microchirurgia Reconstructiva din Romania a fost supusa prin reprezentantul sau, oprobiu care a demolat pur si simplu in cateva ore tot ce se contruise in 12 ani in conditii de loc usoare, in cateva randuri, trasformand faptuitorul in dusman al poporului si plagiator, iar Microchirurgia Reconstructiva nenecesara; Nu se pot trece cu vederea cele patru etape ilogice de decizie de desfiintare, distrugere sau stopare si reorganizare a clinicii si specialitatii de Microchirurgie Reconstructiva in ultimii 18 ani, reorganizari de la zero, care in fapt puteau fi evitate. Timpul pierdut pentru fiecare reorganizare de la zero a fost extrem de pretios si se poate afirma ca a fost daunator interesului acestei tari. Nici un chirurg plastic roman nu a fost pus in aceste situatii repetate in intervalul de cand practica aceasta profesie. De fiecare data a luat-o de la capat si a reconstruit mai mult decat s-a distrus.. Dar de ce ? Era un bun national care aducea onoare acestei tari, macar cat aduce un sport in care suntem campioni. Dar spre deosebire de sport, MR schimba soarta pacientilor din handicapati neuromotori in normali, prin medicii formati a schimbat soarta inmultit a pacientior si Romania ar fi continuat sa fie coerent prezenta in lume, nu formal, ci la un standard cu totul special. Era o realizare semnificativa prin volum, moment al inceperii, continuitatate, dar mai ales prin rezultate si concluzii care semnalau dubiul la teorii fundamentale preluate automat in lume, fara a mai fi verificate sau completate.

Nu din mila pentru faptuitor aduc aminte sau spun unor persoane care nu stiu sau care nu au inteles ce s-a intamplat si mai ales, cei care au stiut, nu au facut nimic ca sa salveze ceva extrem de util. Era oare util ca intreaga aceasta patologie in proportie de masa sa fie tratata necorespunzator, ramasa cu handicapuri severe pe viata, sau sa fie trimisa in strainatate ca sa fie rezolvata? Unde era demnitatea si mandria nationala in acele etape ? Cand aici se ajunsese mult inainte decat acolo unde se platea din greu ? si cu ce rezultate s-au intors acei pacienti ? Aceste fapte le amintesc pentru impactul dezastruos adus medicinei romanesti care a fost umilita, coborata nedemn in fata altor medici nemeritorii din rezultatele vazute, impactul asupra medicului tanar care a trait aceste evenimente, care a inteles sigur ca nu are de ce sa fie cel mai bun pentru ca aceasta poate deveni o vina de neiertat. Ce putea intelege un tanar care vedea de cativa ani cine munceste, ce rezultate are si cum „haita” poate fii libera sa distruga tot. Faptuitorul a luat-o de la capat de cinci ori si de cinci ori a pus pe roate Microchirurgia Reconstructiva, din ce in ce mai bine. Cine a castigat din toate acestea inafara vanitatii ?

Nimic din MR romaneasca nu ar fi ajuns aici daca in spate sau ca fundatie nu ar fii fost scoala romaneasca de medicina, cea de la Cluj ca studenta si intern in chirurgie si cea de la Bucuresti, care a fost un factor deosebit de stimulativ; de a nu ceda si a realiza mereu de la capat, ceva pentru Romania.

CONTRIBUTIE SOCIALA IMPORTANTA SI PRIN

· Program national de preventie, profilaxie, tratament al pacientilor cu handicap postraumatic din domeniul chirurgiei plastice-microchirurgiei reconstructive.

CONTACT

Prof.DR.Doina Dumitrescu-Ionescu

Head of Plastic and Reconstructive Microsurgery Clinic

University Hospital

Str.Erou Iancu Nicolae 11-19 ALFA

Sat Pipera, Voluntari, Ilfov , Romania

Mobile: 0040-744677745

E-mail: ddi707@gmail.com

English version

Doina Dumitrescu- Ionescu

Born in Sibiu, in 1949, a graduate of the Institute of Medicine and Pharmacy in Cluj, she practices experimental surgery throughout her medical school years. Her 1974 graduation work is entitled “Hepatic Regeneration in Alcohol Intoxications Following Subtotal Extended Hepatectomy in 80-85% of Lab Mice”; at that time the medical literature of the world cited a 60-65% survival rate. She completes all the stages of the academic career. Between 1973 and 1975 she works as an intern surgeon at the Oncology Institute in Cluj under Professor Ioan Chiricuta’s supervision and as a teaching assistant in the field of stomatological anatomy. In 1976-1979 she is trained in Reparatory Plastic Surgery under Professor Agrippa Ionescu’s supervision. At “Carol Davila” University of Medicine and Pharmacy in Bucharest, between 1977 and 1979, she initiates, coordinates, and develops Reconstructive Microsurgery, a new surgical specialty in Romania, at all levels: experimental (vessels, nerves), clinical (peripheral nerves, brachial plexus, replantation – revascularization, free flap transfers, miscellaneous), research, education, bringing this field to what might be deemed a satisfactory level in any country in a very short period of time (1977-1987). In 1986 she defends her Ph.D. dissertation “Microsurgical Reconstruction of Posttraumatic Peripheral Nerves”. She becomes an assistant professor in 1993, an associate professor in 1996, and, in 2000, she becomes a professor in plastic surgery – reconstructive microsurgery at “Carol Davila” University of Medicine and Pharmacy in Bucharest. Her contribution to the international conception of reconstructive microsurgery is essential and has fundamental theoretical, clinical, and social implications; she changed the reconstructive microsurgery conception on the posttraumatic neuromotor handicap demonstrating that this class of patients are recoverable within the international parameters; over 3,000 microsurgically operated patients, over 1,800 autotransplants, multiple national innovations, 6 patented inventions, over 300 scientific works, over 90 of them published. She laid the foundations of a new school, that of reconstructive microsurgery, permanently improving the conception of reconstructive microsurgery, never reducing it to the status of a surgical technique. 59 doctors that have been trained in this specialty form an effective network implementing the new reconstructive conception. This conception has also led to a much more effective approach to the over 17,000 patients who have undergone reconstructive plastic surgery.

In 2005 she earns a master’s degree in Health Management.

She has played a decisive role in establishing the Romanian Academic Society of Plastic Surgery and Reconstructive Microsurgery - SARCPMR (in Bucharest) and the Romanian Plastic Surgeons’ Association (the national organization SARCPMR is part of).

NATIONAL INNOVATIONS IN RECONSTRUCTIVE MICROSURGERY nationally and internationally acclaimed: clinical, experimental, research, organization:

1. Revascularization – the first one in May 1979, zone VI, 2mm diameter vessels.

2. Organizing and employing the Experimental Microsurgery Laboratory on lab animals, Oct.1980-1989

3. Limb segment replantation – first on January 15, 1982; 23 successful out of 24

4. Experimental anastomosis: 100 arteries, veins, rabbit ear pavilion, 0.2-1mm in diameter, 90.2% success rate, clinically and histopathologically proven 1980-1985

5. Experimental direct coaptation of 70 rabbit ear pavilion nerves (1980-1985), histopathologically proven, in contrast with neuromas resulting from conventional suturing of 500 human peripheral nerves.

6. Fascicular direct coaptation per fascicular group of peripheral nerves, over 8,500 since 1980

7. Designing and building a special table for the extremities to be microsurgically operated, in collaboration with engineer Achile Dumitrescu, 1981-1982, patented invention

8. Indirect coaptation (Nerve interfascicular graft) – the first on 16 March 1981, more than 2,500.

9. Contribution to grafting peripheral nerves- March 1981, patented invention.

10. Median nerve artery anastomosis, Dec.1982, 0.2-1mm in diameter, patented invention.

11. Vascularized nerve graft – the first on 23 May 1985, 29.

12. Reconstructive Microsurgery in post-traumatic lesions of brachial plexus, 1985, 91.

13. Free functional compound tisues transfers with vasculonervous pedicle, the first in 1987, more than 53; gracillis, latissimus dorsi, serratus anterior etc.

14. First lectures, papers, and publications in Romania in these areas.

15. Research Project Contracts with “Carol Davila” University (1980-1989) in the field of reconstructive microsurgery on every component of the new specialty, actually the only such contracts for the entire Department in that period.

16. Scientific research contract with the Academy of Medical Sciences on interfascicular nerve grafts 1984- 1986

17. Organization of the Reconstructive Microsurgery Clinical Department with 20 beds in 1981, officially acknowledged by the Ministry of Health in 1984.

18. Methodological letters regarding limb replantation, peripheral nerve and brachial plexus reconstruction 1984.

19. The large practice for only one microsurgeon as against the international standards, with more than 3,000 patients operated on microsurgery conception, besides the hundreds of hours of microsurgery carried out experimentally.

20. Approaching reconstructive microsurgery from the beginning not as a mere surgical technique, but as a new reconstructive conception, on all six components: experimental, peripheral nerves, replantation-revascularization, brachial plexuses, free composite tissue transfers, miscellaneous between 1980 and 1987, in conditions that were incomparable with those enforced in foreign centers;

21. Casuistic follow up in operated cases, pre, intra and postsurgically to the full recovery notification, in conformity with international standards of International Society of Reconstructive Microsurgery, which has contributed to the improvement of techniques, results as well as:

22. Conclusions on the peripheral nerve reconstructive microsurgery, replantations, brachial plexuses which, in most cases, did not overlap with those mentioned in the literature; published and presented in 1983, 1986, 1987, 1988, 1992, 1997.

23. Orbital cavity reconstruction, mobile upper eyelash, lower eyelash in 1991, patented invention

24. Palsied facial nerve reconstruction in one step: free microsurgical transfer of nerve and innervated anterior serratus muscle 1995- 1996; improved procedure

25. Orbital cavity reconstruction, mobile upper eyelash, lower eyelash, brow, 1991 patented invention.

26. Same-patient transplant of a troncular nerve segment in accordance with the microsurgical conception, Doina Dumitrescu-Ionescu VIASAN Contract 29.10.2001-15.10.2003

Pioneering Work in Romanian Reconstructive Plastic Surgery:

27. Intraoperative breast modeling forceps 1991, patented invention

28. Reconstruction of an important defect affecting the entire cheek thickness, 1991, patented invention

29. Reconstruction in avascular necrosis of femural head through a transposed vascularizated iliac crest. May 9, 1996 with Dr. Fundulea, Colentina Hospital. Orthopedics

30. Craniofacial fracture treatment with microplates-microscrews, bone grafts, 1998.

31. Plastic surgery program for obese-overweight patients since 1998

32. Complex reconstituting procedures following resection of soft part tumor 1999- 2008

33. Emergency treatment of deeply traumatized extremity 1978-2010

34. “Artificial skin production by keratinocyte cultures for the effective treatment of skin diseases, burns, and polytraumas”, 2005-2008 Academician Laurentiu Popescu, author; Doina Ionescu-Dumitrescu, associate author.

35. 2005 international protocol research program on cutaneous melanoma, a reconstructive plastic surgeon’s approach;

NATIONAL AND INTERNATIONAL AWARDS

36. Scientific documentary produced by Alexandru Sahia Studios in 1985: “Restored Circuits”–“Peripheral Nerve Microsurgery”, scientific adviser and protagonist, 1985 – 1989, five international awards and the “Crystal Cup” National Award.

Pioneering work in the field of experimental hepatic surgery (at national and international level):

37. “Hepatic regeneration in alcohol intoxication” 1973-1974 demonstrated by subtotal extended hepatectomy 80-85% of the hepatic volume of the lab white mouse (70 mice operated, mortality: 1). EHP carried out by Professor Gelu Simu, graduation thesis, 1974.

PATENTED INVENTIONS

1. Microsurgical method to restore the continuity of peripheral nerves. Patent no. 93261, August 21, 1987. Doina Ionescu

2. Microsurgical method of peripheral nerve suturing. Patent no. 90515, July 23, 1986. Doina Ionescu

3. Microsurgical operation table. Patent no. 92485, January 31, 1987. Doina Ionescu, Achile Dumitrescu

4. Intraoperative breast modeling forceps. Patent no.5/1234/30.11.1995 Doina Ionescu, Achile Dumitrescu

5. Method of reconstructing a cheek defect. Patent no.109911. Doina Ionescu

6. Method of reconstructing the mobile upper eyelash. Patent no.109810 Doina Ionescu

SELECTIVE LIST OF PUBLICATIONS

1. Monograph: Peripheral Nerve Microsurgery, Doina Ionescu, Editura Medicala, Bucuresti, 1989, 176 pages.

2. Peripheral Nerve Lesions and Limb Replantation, subchapters in Surgical Pathology Treatise vol 3, coordinated by Professor Denischi A, Editura Medicala, Bucuresti, 1988.

3. Reconstructive Micorsurgery in Romania, Doina Ionescu, Editura Vinea, Bucuresti, 1995,130 pages.

4. Monograph: Reconstructive Microsurgery. Doina Dumitrescu-Ionescu, Editura Medicala, Bucuresti, 1999, 344 pages.

5. Reconstructive Plastic Surgery Survey, Doina Dumitrescu-Ionescu, UMF-Carol Davila 1999, 300 pages.

6. Reconstructive Microsurgery Conception, Principles, and Techniques and Extremity Replantation and Revascularization, subchapters in Principles of Plastic Surgery and Reconstructive Microsurgery, pp. 156-217, National, 2005

7. Reconstructive Microsurgery of Replantation-Revascularization, Doina Dumitrescu-Ionescu, subchapter in Musculoskeletal System Pathology, vol. 1, by Dinu Antonescu, Editura Medicala, 2005

8. Reconstructive Microsurgery – A New Conception, BookSurge, LLC, 2006, translated by Iulian Cananau, Rodica Mihaila

GRANTS

1. AUTHOR Restoring nervous continuity in nerve defects by microsurgical techniques. Doina Ionescu, Scientific Research Contract with the Academy of Medical Sciences 1985-1986

2. AUTHOR Same-patient transplant of a troncular nerve segment in accordance with the microsurgical conception, Doina Dumitrescu-Ionescu, VIASAN contract 29.10.2001-15.10.2003

3. PARTNER in a national research project coordinated by Academician Laurentiu Mircea Popescu

“Artificial skin production by keratinocyte cultures for the effective treatment of skin diseases, burns, and polytraumas”, 2005-2008.

4. PARTNER in a research project under the National Plan for Research, Development, and Innovation – “Key Area Partnerships” Avram Marioara, “Microfluidic Biochip for Rheological Characterization of Non-Newtonian Biological Fluids Applicable to Diagnosis and Medical Treatment” 2008-

5. PARTNER in a research project under the National Plan for Research, Development, and Innovation – “Key Area Partnerships” Avram Marioara, “Micro-electromechanical System Applicable to Peripheral Nerve Microsurgical Reconstruction” 2008-

300 SCIENTIFIC PAPERS (national and international conference participations, reports, keynote addresses, posters), over 90 ARTICLES published in journals, conference proceedings, and congress papers such as:

Chirurgia, Ortopedia, Neurologia, Romanian Journal of Diabetes, Noutatea Medicala (Romanian); Acta Chirurgiae Plasticae, The 8-th International Symposium of the Reconstructive Microsurgery Society, Paris,1985; Microchirurgie in der Rekonstruktiven und Plastischen Chirurgie, Jena, 1988; Up Date , Dec. 1999; Brain Aging International Journal 2002 ; Journal of Cellular and Molecular Medicine 2002.

FOREIGN AWARDS AND CITATIONS; INTERNATIONAL RECOGNITION

1. Cited in the monograph The Peripheral Nerve by J.K. Terzis; Raven Press, 1990, New York,

2. Ranked second in the world for best results and original contributions to reconstructive surgery in Annuario Italia, 1992.

3. “Stem Cells (p63+) in Keratinocyte Cultures from Human Adult Skin” 2003, a project coordinated by Academician Laureniu Popescu. Awarded as coauthor at the Original Articles Section

4. Acknowledged by such RM pioneers as: J.K. Terzis, W. Shaw, Hanno Millesi, Allen Gilbert, A. Narakas.

5. Several times mentioned in Who’s Who International

6. Positive reviews of Reconstructive Microsurgery - A New Conception, published by BookSurge, 2006; it is widely acknowledged as a valuable tool by distinguished specialists in the field

7. Invited to contribute two chapters in the treatise issued by the International Confederation for Plastic, Reconstructive, and Aesthetic Surgery (IPRAS) to write an update on the latest in research, give an account of my expertise in the area, and contribute significantly to the world’s RM literature

8. Invitations to participate in the most distinguished RM committees and organizations (for 25 years)

IMPORTANT SOCIAL CONTRIBUTION THROUGH:

· A national program of prevention, prophylaxy, and treatment of patients with posttraumatic disabilities in the field of plastic surgery - reconstructive microsurgery.

· “City Hall’s Objectives on the Capital Area Community’s Health and Welfare”, Doina Dumitrescu, 2000, Thesis for a Master’s Degree in Health System Management,2005