Fig . 3 Acland ’ s Video Atlas of Anatomy and The Acland Microvascular Clamp and fine suture used in anastomosing a 1-mm . vessel .
Fig . 2 : Bob Acland , Bette Levy , the rustic cabin , outhouse and bridge .
Bob ’ s rebellious personality emerged at times along his educational pathway , where he “ specialized in breaking the rules ” ( his own description ). He graduated from the London Hospital Medical College in 1964 , with an MBBS from London University in 1969 . After internships in the UK and in Tanzania , he entered a plastic surgery residency in Glasgow , Scotland , which had then achieved world leadership in studies of flap tissue transfers . There , Acland pioneered the transition from conventional local flap transfers on intact blood vessels to free tissue transfer by microvascular anastomoses to vessels at remote sites of the body . These new techniques of microvascular anastomoses would need substantial refinement to achieve reliability , and Bob ’ s enduring engagement with this frontier technology began .
In Louisville , Dr . Harold Kleinert and Dr . Joseph Kutz had similar interests , and they invited Bob and his wife , Dr . Sarah Acland , to immigrate and bring his interests , microfabrication skills and teaching talent . Bob set up the microsurgery laboratory in the Division of Plastic Surgery at the University of Louisville . His teaching protocol and the many discoveries generated in the lab contributed greatly to the academic leadership of U of L Plastic Surgery and the Kleinert-Kutz Hand Care Center , which both built international reputations that resonate to this day . Using Acland ’ s teaching methods , the lab is currently managed by Dr . Gustavo Perez-Abadia , and it continues to serve University Plastic Surgery , the Kleinert-Kutz Hand Fellowship and other students of microsurgery . Although reduplicated , no finer microvascular teaching program has emerged in any other world facility .
Standout contributions from Acland ’ s early work include the Acland Microvascular Clamp ( Fig . 3 ), an ingenious device for occluding and stabilizing tiny arteries and veins so they could be sewn into receiving vessels . Also , he engineered an unprecedented tiny needle and attached nylon thread for substantially enhanced microsuturing reliability . As a demonstration , the needle and 10-0 thread can be passed through the center of a human hair .
In the early 1980s , a door opened that would serve many and profoundly change Acland ’ s career . Dr . Harold Kleinert was looking for unembalmed upper extremities to best teach his fellows hand anatomy ; I was looking for fresh cadaver tissues to identify new flap transfers based on muscle and skin units ; and Bob was looking for sources of new microvascular flaps . A retired surgeon and passionate anatomist , Dr . Herbert Wald , asked each of us to contribute $ 1000 from our research funds to construct a large , walk-in refrigerator to preserve unembalmed anatomic specimens essential for our interest . Thus , the U of L Fresh Tissue Laboratory was born . Although immediately serviceable , it initially resembled a dungeon cell deep in the basement of a U of L medical instructional building . However , upon Dr . Wald ’ s full retirement , Dr . Acland assumed the directorship and energetically pursued support for substantial expansion and improvements . His relentless efforts created a spectacular facility , which is now directed by the U of L anatomist , Nicole Herring , Ph . D . Like the microvascular laboratory , the Fresh Tissue Lab has been a model for reduplication elsewhere . However , neither facility has been surpassed and they remain treasures for teaching and research at U of L .
For Dr . Kleinert and his associates , the facility gave hundreds of hand fellows greatly enhanced anatomic knowledge . The facility also provided me with research opportunities that resulted in over 60 medical publications on new flaps , a priceless gift for beginning an academic career . For Acland , however , the facility ultimately changed his entire career , as he became inspired to pursue a transition from microvascular surgery to new vistas in anatomic instruction .
As Acland became progressively engaged in anatomic studies , he conceived of a teaching breakthrough that would reach far beyond the conventional pictures and drawings in books , and beyond dissections of tissues embalmed to extreme and unnatural rigidity . He embarked upon producing a video-taped anatomic atlas that would present human anatomy in much improved dimensional perspective , with the realistic appearance of tissues and structures capable of natural motion appropriate to show function . He pursued this goal with the same intense focus as in his previous microsurgical projects , and he produced an elegant , 7-volume video atlas ( now converted to DVD ), which he considered to be his “ Sistine Chapel ”. It has become an acclaimed anatomic teaching tool in over 200 institutions worldwide .
The historic conjunction of a unique person in a place of great opportunity at a most favorable time generated enormous contributions to the fields Acland embraced and enhanced . Bob Acland left indelible memories among his friends , colleagues and students , and his efforts created enduring legacies in microsurgery and anatomic teaching that will serve many generations .
- Gordon Tobin , MD
MAY 2016 15