Acharya Sushruta- Father of Plastic Surgery

January 29, 2021

#2 Acharya Sushruta

- Father of Plastic Surgery

Blog #2 in series of

#10 reasons why Acharya Sushruta is called Father of surgery

Word 'plastic' is derived from the word to mold or to create the required shape'. Accordingly, the definition of plastic surgery is as follows

'Restoration, reconstruction, or alteration of the human body to improve function for approximate normal appearance is called Plastic Surgery.'

Reconstructive plastic surgery is an attempt to reduce the disfigurement of any part of the body due to trauma, burns, acid burns, or diseases such as cancer.

1. Distorted look of the statue without a nose

The plastic surgeon has to be brave-hearted to wield a weapon on the living body while at the same time keeping a soft corner recognizing the beauty of a person in the mind. In addition to regaining the body's normal shape, the surgeon has to face various challenges such as preventing excessive bleeding, preventing infection, preventing wounds elsewhere, and healing wounds without any defects. Surprisingly not only in India but also in the whole world, Sushrutacharya is considered the Father of Plastic Surgery.

Sushrutacharya successfully completed more than 300 different difficult and skilled surgeries and quoted them in his Sushrut Samhita with a view to creating the next generation of successful surgeons.

The 16th chapter in the Sutrasthana- Karnavedhabandhavidhi Adhyaya of the Sushruta gives an apt description of plastic surgery of the ear and nose. This chapter describes not just one or two, but 15 different methods of sewing a torn earlobe. The main purpose of these many methods was to make the torn part of the ear look normal after the surgery and to perform the surgery in such a way that the defects and differences in it could not be recognized.

The same chapter describes the successful Nasal reconstructive plastic surgery under Nasasandhan procedure. f the nose or part of the nose is deformed as a punishment for cutting the nose due to trauma, disease or to disfigure a previous offender.

Sushrut Samhita Sootrasthana Chapter number 16 verse number 27-31

During the surgery to reattach the broken nose, the steps described for the successful surgery were carefully planned, skillfully performed [taking care of all the rules and techniques of anesthesia, sterilization, dressing methods of that time].

1. Using a tree leaf or paper to make the right shape like a nose on the skin around the nose [on the cheeks or] on the forehead

2. Draw marking on the skin

3. Properly separate the fleshy skin flap

4. To keep the unilateral blood supply of that fleshy skin intact from the base

5. Stich the piece of skin in the right place of injury without leaving the deformity

6. Wound healing without leaving behind major marks or deformities

Since the nasal portion is having an end arterial supply, it is difficult to accept a completely isolated skin graft at that point. As a solution to this, Sushrutacharya did not cut the blood supply of the skin part completely. Instead used the approach of using autograft having its unilateral blood supply patent. [which is explained in surgical steps hereafter in the same blog]

Surprisingly, even today, very similar steps that of Sushrutacharya are followed in Modern Paramedian forehead flap surgery. [Reference Menick FJ Nasal Reconstruction: Forehead Flap Plastic Reconstructive Surgery 2004 May; 113(6):100E]. These steps are simplified and quoted hereafter

[Warning: Some of the pictures given in order to explain surgical steps may be disturbing for some people, readers are requested to access them with caution.]

Step 1- Examining patient & wound inspection

Step 2- Surface marking of surgical site

Step 3- Template making

Step 4- Unilateral dissection of live auto-graft maintaining its blood supply from its base

Step 5- Placing auto-graft on desired debrided wound surface & cosmetically closing graft site

Step 6- Regular dressing & allowing auto-graft to get accepted & wound to heal

Step7- Cutting a proximal portion of the graft after the distal portion being accepted & healed

Step 8 - Suturing remaining portion of auto-graft for maximum approximation

Step 9 - Wound care for complete recovery

Image showing complete recovery & maximum aesthetic look as a result of surgery [Ref. 3,4]

From the above description, you will notice that this difficult and complex process of surgery has been successfully completed despite the lack of the latest modern advanced technology, superfine instruments, supreme anesthesia techniques, disinfectants & higher antibiotics. Some of the major stages that were carefully planned and adopted by Acharya Sushruta are still being followed even in today's modern era. This proficient surgical excellence makes surgeon Sushrutacharya The Father of Plastic Surgery and makes Ayurveda OMG Amazing Ayurveda ....!