Terra Rosa e-magazine, No. 7 (March 2011)
minutes so that the surgical team were not disturbedduring their work. Surgeries were performed either witha garrot (a stick used for tightening a bandage, in orderto compress the arteries of a limb), which allows ratherdull observation in terms of colour, or without a garrotwhich gives more lively images but is disturbed by bloodextravasation (leakage). Then after, we extend to skinflaps and abdominal surgeries.I don’t know why this has not been done previously butsome of my experiences can explain that. For many years, I have performed microsurgery transplants and Ihave used microscope very often. Moreover, surgery isperformed without bleeding using a tourniquet, so theobservation is easier, and finally I love to understandthe processes that have been going on.
What are the challenges in making these pic-tures using endoscopic camera?
The main challenge is to understand how tendon andskin are sliding, but also all these fascinating imageshave to be shared. They look so beautiful with their aes-thetics, colours, varied and sparse shapes. Sharing themseems to be a good way to arouse the interest of peopletoday.
What is the scale (magnification) we are lookingat?
Generally magnification is 25 times.
In ‘Strolling Under the Skin’, you described theSliding system and architecture of the connec-tive tissue that looks chaotic in organisationcomposed of microvacuoles that are able toadapt itself to various stress. Can you briefly describe about this microvacuole form?
All the tissues observed were developed within theframework of multifibrillar architectures and resultingfrom the intertwining of fibrils : there are the mi-crovacuoles which in fact are intra fibrillar micro vol-ume, and which are the basic elements combining apolyhedral fibrillar frame enclosing multiple microvacuolar spaces of varying sizes between 10
m and 100
m, with a gel inside.
* Note: 1
m or micro meter is a millionth of a meter.
These microfibrils have a diameter of about ten totwenty microns and are made up predominantly of col-lagen type I and III. By intertwining, in an irregularfractal manner, they determine the volume of the micro-vacuole, which is filled with a glycosaminoglycan gel. By accumulation and superposition, these multi micro-vacuolar polyhedral patterns will build an elaborateform.
In ‘Muscle Attitudes’, you proposed that there isa global tissue continuity around or inside themuscle. Can you tell us the implication of this.
The essential implications of these microsopic and en-doscopic observations are the fibrillar continuity. Thereis no break in the tissue continuity, be it within muscle,tendons, or around the arterial and venous structuresand the structures surrounding the adipocytes. All thesestructures are formed in the same manner and are con-tinuous.We have discovered the same continuity of tissue withinthe sub-cutaneous tissue in
Strolling Under the Skin
,the epidermis and dermis and the muscles. The conceptof the organisation of living matter into stratified layers,hierarchical layers of sheaths, lamellae and strata can-not satisfy an anatomist who studies precise, endo-scopic, functional anatomy. Even though they may be of different colours, textures and shapes, they are all
Interview with Dr. Guimberteau
Pictures taken from Muscle Attitudes, courtesy of Endovivo.