Sandhana Karma: The Ayurvedic Roots of Plastic Surgery by Sushruta

concept of plastic surgery in ayurveda - a literary review

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Journal name: World Journal of Pharmaceutical Research
Original article title: Sandhana karma
The WJPR includes peer-reviewed publications such as scientific research papers, reports, review articles, company news, thesis reports and case studies in areas of Biology, Pharmaceutical industries and Chemical technology while incorporating ancient fields of knowledge such combining Ayurveda with scientific data.
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Subtitle: concept of plastic surgery in ayurveda - a literary review

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Author:

Poonam Rathore, Rajesh Gupta and Sachin Mittal


World Journal of Pharmaceutical Research:

(An ISO 9001:2015 Certified International Journal)

Full text available for: Sandhana karma

Source type: An International Peer Reviewed Journal for Pharmaceutical and Medical and Scientific Research

Doi: 10.20959/wjpr202316-29599

Copyright (license): WJPR: All rights reserved


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Summary of article contents:

Introduction

The article discusses Sandhana Karma, a traditional Ayurvedic practice outlined by Acharya Sushruta, which parallels modern plastic and reconstructive surgery. Sushruta, renowned as the father of surgery, authored the Sushruta Samhita, a foundational text in ancient medicine that details various surgical techniques and procedures. The research aims to compile historical Ayurvedic concepts and align them with contemporary surgical practices, emphasizing the relevance of Sushruta's teachings in modern medicine.

Concept of Nasa Sandhana (Rhinoplasty)

Nasa Sandhana refers to the surgical procedure aimed at reconstructing the nose, which can be broken down into four distinct stages: flap assessment, skin flap collection, preparation of the recipient site, and postoperative care. In the initial stage, the necessary measurements are made using leaves from specific plants, which help in determining the flap dimensions. The skin flap is then harvested, ensuring a pedicle is maintained for attachment. Following this, the recipient area is prepared, and the flap is sutured into place. Postoperative care involves specific treatments to promote healing before the flap is separated from its original site.

Concept of Karna Sandhana (Otoplasty)

Karna Sandhana involves reconstructing the ear and is categorized into three main steps: Poorvakarma (pre-operative preparation), Pradhana Karma (main operative procedure), and Paschat Karma (post-operative care). Poorvakarma begins with an assessment of the ear injury, determining the necessary flap size. The Pradhana Karma includes suturing the live pedicle flap after preparing the recipient site. Sushruta describes 15 operative methods for ear reconstruction, each suited to specific types of injuries or deformities. Post-operative care, such as the application of medicated oils, facilitates recovery and enhances results.

Concept of Oshta Sandhana (Lip Reconstruction)

Oshta Sandhana focuses on reconstructing damaged lips, paralleling the techniques used in Nasa Sandhana, but without the insertion of a supporting tube (Erandanala). This procedure is structured into three phases: Poorvakarma (evaluation and preparation), Pradhana Karma (the primary surgical technique), and Paschat Karma (healing treatment). During Poorvakarma, an assessment and preparation of the lip area are performed, followed by the main surgical intervention where lip tissues are sutured together. Post-operative treatment includes wound care to promote healing.

Conclusion

Acharya Sushruta's contributions to surgical techniques, known as Sandhana Karma, underscore the methodological principles that form the foundation of modern plastic surgery, including meticulous planning, precision, and hemostasis. The practices he documented have incredible relevance today, showcasing the enduring legacy of Ayurvedic surgical knowledge. Thus, Sushruta is rightfully honored as a pioneer in the field, with his insights continuing to inform contemporary practices in plastic and reconstructive surgery.

FAQ section (important questions/answers):

What is Sandhana Karma in Ayurveda?

Sandhana Karma is an ancient surgical technique in Ayurveda described by Acharya Sushruta, comparable to modern plastic or reconstructive surgery, focusing on reconstructing mutilated or lost body parts.

Who is considered the father of plastic surgery in ancient texts?

Acharya Sushruta is recognized as the father of plastic surgery, having authored the Sushruta Samhita, which details comprehensive surgical procedures including plastic surgery techniques.

What types of surgeries did Sushruta describe?

Sushruta described various surgeries including Nasa Sandhana (rhinoplasty), Karna Sandhana (otoplasty), and Oshta Sandhana (lipoplasty), along with methodologies and principles of surgical practice.

How is Nasa Sandhana performed according to Sushruta?

Nasa Sandhana involves four stages: flap assessment, collection of skin flap, preparation and placement of the flap on the recipient site, followed by post-operative care.

What are the benefits of studying Ayurveda's surgical techniques today?

Studying Ayurveda's surgical techniques can offer insights into ancient practices that still hold relevance in contemporary plastic and reconstructive surgery, emphasizing planning and precision.

What does Karna Sandhana involve in Sushruta's methodologies?

Karna Sandhana includes analyzing injuries to the ear, measuring flap requirements, and utilizing various operative methods, with specific indications corresponding to the nature of the ear injury.

Glossary definitions and references:

Scientific and Ayurvedic Glossary list for “Sandhana Karma: The Ayurvedic Roots of Plastic Surgery by Sushruta”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.

1) Sandhana (Samdhana):
Sandhana refers to the concept of surgical reconstruction in Ayurveda, especially related to the restoration of lost or damaged body parts. This ancient practice has parallels in modern plastic surgery, illustrating its importance in historical context and contemporary relevance. It showcases the depth of surgical knowledge in ancient Indian medicine.

2) Karma (Karman):
In Ayurveda, Karma signifies actions or processes, particularly concerning therapeutic practices. In this context, it relates to the medical procedures performed to repair or reconstruct body parts, highlighting the procedural aspect of healing and the skilled actions of the practitioner in restoring health.

3) Karna:
Karna translates to 'ear' in Sanskrit and refers specifically to the surgical procedures concerning ear reconstruction known as Karna Sandhana. These techniques are essential in addressing congenital or acquired deformities, illustrating the intricate surgical knowledge well-established in ancient Ayurvedic practice.

4) Samhita:
Samhitas refers to the classic texts of Ayurveda that compile knowledge about medicinal practices and surgeries. They serve as key references for practitioners, preserving the procedures and philosophies informing Ayurvedic medicine over centuries.

5) Ayurveda (Ayus-veda):
Ayurveda is a traditional Indian system of medicine focusing on holistic health. It incorporates various treatments, including surgical techniques like Sandhana Karma. The system emphasizes balance in body, mind, and spirit, underpinning its therapeutic approaches, including diet, herbal remedies, and surgical interventions.

6) Rathore:
Poonam Rathore is the primary author of the reviewed article, contributing to the scholarly discussion on Sandhana Karma. Her affiliation with prominent Ayurvedic institutions lends authority to her research, highlighting the importance of understanding ancient techniques and correlating them with modern practices in medicine.

7) Nasa (Nasha):
Nasa means 'nose' in Sanskrit and refers to nasal reconstructive surgery (Nasa Sandhana) described by Sushruta. This illustrates the advanced understanding of facial reconstructive procedures in ancient Ayurveda and their relevance in today’s surgical practices, particularly in fields like rhinoplasty.

8) Post:
Post in this context refers to post-operative care following a surgical procedure. Effective post-operative care is crucial in Ayurveda, as it ensures proper healing and reduces complications, emphasizing the importance of follow-up care in achieving successful surgical outcomes.

9) Sushruta-samhita (Susruta-samhita):
Sushruta-samhita is a foundational Ayurvedic text authored by Acharya Sushruta, recognized as the father of surgery. This text provides comprehensive insights into surgical techniques, principles, and ethics, serving as a reference for practitioners and highlighting the advances in medical knowledge during ancient times.

10) Paschat-karma:
Paschat-karma translates to 'post-operative procedures' in Ayurveda. This phase comprises the care and treatments undertaken after surgery, vital for wound healing and recovery. Understanding these procedures reflects the holistic approach of Ayurveda toward patient care post-surgery.

11) Shalyatantra (Salyatantra, Shalya-tantra, Shalyatamtra):
Shalya-tantra refers to the branch of Ayurveda focused on surgery. It encompasses various surgical techniques, including reconstructive and therapeutic surgeries, demonstrating the sophisticated level of medical understanding and practices that existed in ancient Indian medicine.

12) Rajasthan:
Rajasthan is a state in India known for its rich cultural heritage, which includes traditional medical practices like Ayurveda. The state's historical ties to Ayurvedic medicine and its preservation through texts like Sushruta Samhita underline its significance in Indian medical history.

13) Lekhana:
Lekhana refers to a technique of scraping or excising tissue in Ayurvedic surgery. This process is crucial for preparing the recipient site for flaps or grafts during reconstructive surgeries, showcasing the precise surgical techniques utilized in ancient practices.

14) Surface:
Surfaces pertain to the exterior layers of the body involved in surgeries. Understanding the characteristics and conditions of these surfaces is crucial for successful surgical interventions, highlighting the careful consideration given to the anatomy in Ayurvedic practices.

15) Tantra (Tantrism, Tamtra):
Tantra translates to a system or technique. In Ayurveda, it highlights the structured approach toward medical practices and surgical procedures, indicating a sophisticated understanding of both theoretical principles and practical applications in ancient medical science.

16) Shalya (Salya):
Shalya refers to 'surgery' or the surgical branch of Ayurveda. This term encompasses various surgical methodologies aimed at treating diseases and injuries, reflecting the comprehensive nature of Ayurvedic medical practices aimed toward enhancing health through surgical interventions.

17) Oshtha (Ostha):
Ostha means 'lip' in Sanskrit and refers to reconstructive procedures for lips (Ostha Sandhana). This area of focus demonstrates the nuanced understanding of facial aesthetics and functionality within Ayurvedic surgical practices, emphasizing cultural and medical importance.

18) Science (Scientific):
Science in this context refers to the systematic study of surgical methods and medical practices, highlighting the structured approach taken by ancient scholars like Sushruta. This underscores Ayurveda as a progressive medical discipline, emphasizing empirical observation and methodical practice.

19) Pradhana-karma:
Pradhana-karma means 'main operation' or the primary surgical procedure to be carried out. This highlights the significant steps in the surgical process as delineated in Sushruta Samhita, signifying the importance of procedure order in reconstructive surgeries.

20) Knowledge:
Knowledge in this context relates to the extensive medical understanding codified in ancient texts like the Sushruta Samhita. It emphasizes the value placed on accumulated wisdom in healthcare practices, ensuring that modern practitioners can build upon historical foundations.

21) Abhyanga (Abhyamga):
Abhyanga refers to a traditional Ayurvedic oil massage that promotes healing. It serves as a preparatory and post-operative procedure to enhance tissue health and recovery in surgical practices, illustrating the integrative nature of Ayurvedic treatment methodologies.

22) Pradhana:
Pradhana means 'main' or 'primary,' highlighting the critical aspects of surgical procedures outlined in Ayurveda. This term emphasizes the structured approach and methodology inherent in traditional surgical practices, which prioritize core techniques integral to patient care and recovery.

23) Pradesha (Pradesa):
Pradesha translates to 'area' or 'region,' often specifying the location of surgical intervention within the body. It underscores the detailed anatomical awareness necessary for effective surgical outcomes, reflecting ancient Indian surgeons' sophisticated understanding of human anatomy.

24) Ashtanga (Astanga, Ashtan-anga):
Ashtanga refers to the 'eight limbs' or aspects of Ayurvedic medicine, which encompass various disciplines. This term highlights the holistic approach of Ayurveda, integrating surgery, herbology, and other therapeutic methodologies to provide comprehensive healthcare.

25) Medicine:
Medicine signifies the science of healing and treating diseases, highlighting Ayurveda's role in promoting health and wellness through herbal remedies, surgical techniques, and dietary practices. This term encapsulates the broad spectrum of healing practices within traditions like Ayurveda.

26) Elephant:
Elephant holds symbolic significance in Ayurveda, as illustrated in the myth of Ganesha, where an elephant's head was transplanted. This myth highlights ancient surgical concepts and techniques that aimed at restoring identity and function, symbolizing the advanced understanding of reconstruction.

27) Pradhan:
Pradhan means 'main' or 'chief,' emphasizing the central or leading role of specific techniques or procedures in Ayurveda, especially regarding surgical interventions. It reinforces the structured methodology inherent in ancient surgical practices.

28) Kumara:
Kumara, denoting youth or a boy, can refer to figures in mythology, particularly in Ayurvedic traditions where youthful figures may embody various aspects of health, vitality, or surgical prowess. This term reflects the cultural depth tied to Ayurvedic practices.

29) Utpala:
Utpala may refer to a type of lotus or a method concerning ear reconstruction. In the context of surgical procedures, the term illustrates the detailed classification of surgical techniques and their applications in ancient Indian surgery.

30) Indian:
Indian highlights the geographical and cultural context in which Ayurveda developed. It emphasizes the rich heritage of traditional medicine inherent to India's history, showcasing its global significance in holistic healthcare and ancient practices.

31) Taila (Thaila):
Taila means 'oil' and is often used in Ayurvedic therapies, including pre- and post-operative care. The application of medicated oils in surgeries underscores the integrative approach of Ayurveda, enhancing healing and recovery through traditional herbal practices.

32) Ganda (Gamda):
Ganda means 'cheek' or 'side of the face,' often referenced in reconstructive procedures. This term emphasizes the intricate understanding of facial anatomy and its relevance in surgical techniques within the Ayurvedic tradition, underscoring the detailed anatomical focus in procedures.

33) Shiva (Siva):
Shiva refers to a principal Hindu deity known for transformative actions, including the myth of Lord Shiva and Ganesha. This illustrates the cultural narratives around surgery and reconstruction, symbolizing divine intervention in ancient surgical practices.

34) Banda (Bamda):
Banda translates to 'joining' or 'binding,' and it pertains to the methods of rejoining body parts in surgical procedures. This term emphasizes the procedural aspect of surgical practices in Ayurveda that focus on restoring function and form.

35) Veda:
Veda refers to the ancient sacred texts of Indian philosophy and knowledge, including diverse fields of science and medicine. The Vedas form the foundation for Ayurvedic practices, encapsulating profound wisdom about health and healing that influenced subsequent traditions.

36) Nemi:
Nemi refers to specific terms or classifications in surgical practices, particularly concerning ear reconstructions. This term underscores the extensive taxonomies developed in ancient surgical literature to address diverse medical conditions.

37) Operative treatment:
Operative treatment refers to surgical interventions aimed at addressing medical issues. In the context of Ayurveda, it signifies the importance of precise surgical practices and techniques in managing ailments, reinforcing the discipline's historical credibility and sophistication.

38) Ashtangasamgraha (Astangasamgraha, Astangasangraha, Ashtanga-samgraha, Ashtanga-sangraha, Ashtangasangraha):
Ashtanga-sangraha is another foundational Ayurvedic text detailing medical knowledge and practices. Its inclusion alongside Sushruta Samhita highlights the richness and breadth of ancient Indian medicine, encompassing surgical, therapeutic, and holistic approaches to health.

39) Sarshapataila (Sarsapataila, Sarshapa-taila):
Sarsapa-taila refers to mustard oil, often utilized in Ayurvedic therapies, including surgeries. Its application in treatments showcases the importance of natural substances in enhancing healing processes and postoperative care within traditional practices.

40) Atharvaveda (Atharva-Veda):
Atharva-Veda is one of the four Vedas, encompassing a range of knowledge including medicinal practices. Its teachings contribute to Ayurvedic wisdom, emphasizing the ancient foundations of surgical and healing knowledge inherent to traditional Indian medicine.

41) Civilization:
Civilization refers to the complex societies that developed throughout history, including India, where Ayurveda thrived. The advancement of Ayurvedic practices reflects the sophistication of ancient civilizations in their understanding of health, medicine, and surgical techniques.

42) Measurement:
Measurement highlights the quantitative aspects involved in surgical practices, especially during reconstructive procedures. The importance of accurate measurement underlines the significant focus on precision and skill in ancient Indian surgical methods.

43) Ashvagandha (Ashva-gandha, Ashvagamdha, Ashwagandha, Asvagandha):
Ashwagandha is an important medicinal herb in Ayurveda known for its restorative properties. Its inclusion signifies the holistic nature of Ayurvedic practices, emphasizing the role of herbal remedies alongside surgical interventions in comprehensive health management.

44) Yashtimadhu (Yashti-madhu, Yastimadhu):
Yastimadhu, also known as Glycyrrhiza glabra, is used in Ayurveda for its soothing and healing properties. Its relevance in post-surgical care reflects the integral role of herbal medicine in conjunction with surgical methods within the Ayurvedic framework.

45) Shatavari (Satavari):
Shatavari is another significant herb in Ayurveda celebrated for its nourishing and healing qualities. It supports treatments related to women's health, illustrating how traditional remedies complement surgical practices in restoring health and vitality.

46) Rasanjana (Rasa-anjana, Rasamjana):
Rasanjana is a traditional Ayurvedic formulation known for its therapeutic properties. Its use in surgical contexts underscores the incorporation of herbal formulations in aiding recovery and healing processes, demonstrating the integrative approach taken by Ayurvedic practitioners.

47) Parisheka (Pariseka):
Parisheka refers to a method of bathing or applying a therapeutic liquid, often used in pre-and post-operative care in Ayurveda. This practice highlights the significance of purity and healing in surgical recovery, showcasing traditional practices that enhance recovery.

48) Upakrama:
Upakrama translates to 'treatment' or 'therapy' and indicates the approaches utilized in Ayurveda to address medical issues. Its relevance in surgical contexts underscores the comprehensive nature of Ayurvedic medicine in addressing various health conditions.

49) Samgraha (Sangraha):
Sangraha refers to a compilation or collection of knowledge, akin to Samhita, and emphasizes the systematic documentation of medicinal and surgical practices in Ayurveda. This term highlights the importance of preserving ancient wisdom for contemporary healthcare.

50) Incision:
Incision refers to surgical cuts made during procedures. This term emphasizes the fundamental surgical techniques utilized in Ayurveda, showcasing the detailed methodologies developed for effective patient treatment and reconstruction in ancient practices.

51) Visravya (Vishravya):
Visravya denotes 'evacuation' or the removal of bodily substances during surgical procedures. Understanding this term highlights the detailed and systematic approaches ancient surgeons took to manage wounds and other medical conditions effectively.

52) Nostril:
Nostril, the external opening of the nose, is significant in nasal reconstruction procedures. Precision regarding this anatomical feature is essential for successful outcomes in surgeries like Nasa Sandhana, reflecting awareness and detail in surgical practices.

53) Snehana:
Snehana refers to the application of oils or unctuous substances in Ayurvedic treatments. It plays a vital role in pre-operative and post-operative care, enhancing tissue health and facilitating recovery, demonstrating Ayurveda's integrative therapeutic approaches.

54) Mardana:
Mardana means 'massaging' and is often involved in Ayurvedic treatments for promoting blood circulation and healing. Its significance highlights the holistic aspect of Ayurveda, where both surgical and therapeutic practices are harmoniously integrated.

55) Jangala (Jamgala):
Jangala refers to the wild or forested regions, which are often associated with certain healing herbs used in Ayurveda. The inclusion of such elements reflects the importance of natural surroundings in procuring medicinal resources applicable to recovery and wellbeing.

56) Vriksha (Vrksa):
Vriksha means 'tree' and symbolizes nature's role in Ayurveda, where many healing herbs and ingredients are sourced. This term highlights the deep-rooted relationship between traditional practices and the environment in crafting effective medicinal solutions.

57) Sarshapa (Sarsapa):
Sarsapa translates to 'mustard,' a plant often used in Ayurvedic formulations. Its usage in therapies reinforces the importance of plant-based treatments integrated into surgical care, showcasing a holistic approach to health.

58) Writing:
Writing denotes the documentation of medical knowledge, essential for the transmission of Ayurvedic practices. It emphasizes the importance of preserving wisdom through texts such as Samhitas, allowing future generations to benefit from ancient healing methods.

59) Dealing:
Dealing refers to the management and treatment of medical conditions through specific interventions, illustrating the active engagement of practitioners in addressing patients' needs within the framework of Ayurvedic practices.

60) Account:
Account highlights the historical narrative surrounding surgical practices in Ayurveda, including significant figures such as Sushruta. It denotes the importance of documenting practices to inform and educate future practitioners about ancient medical traditions.

61) Ganesha (Ganesa, Gana-isha):
Ganesha, a revered deity in Hinduism, symbolizes the principles of transformation and wisdom. The acknowledgment of Ganesha's myth in surgical contexts showcases the intertwining of cultural narratives and ancient surgical practices in Ayurveda.

62) Dravya:
Dravya specifically refers to substances used in formulations and treatments. Its prominence in Ayurvedic texts highlights the diverse range of materials that practitioners utilize, indicating a comprehensive approach to health management correlating with surgical interventions.

63) Siddha:
Siddha means 'accomplished' or 'perfected' and refers to methods of preparation in Ayurveda aiming for efficacy. This term illustrates the precision involved in crafting Ayurvedic remedies, paralleling the meticulousness needed in surgical practices.

64) Ghrita (Ghrta):
Ghrita translates to 'clarified butter' or ghee, often used in Ayurvedic therapies. Its role in treatment emphasizes the importance of dietary and herbal components that complement surgical interventions, contributing to overall health restoration.

65) Bhedya:
Bhedya refers to 'incision' or 'cutting,' a fundamental concept in surgical practices. It highlights the various surgical techniques defined in Ayurveda, emphasizing the intricacies of executing precise incisions during operations.

66) Lekhya:
Lekhya translates to 'scarification' or a method of skin preparation in surgery. This term reflects the detailed techniques described in Sushruta Samhita for preparing the skin for surgical procedures, showcasing the advanced understanding of surgery in Ayurveda.

67) Vedhya:
Vedhya refers to 'puncturing' and signifies specific surgical techniques aiming to alleviate medical conditions through controlled interventions. This term relates to the comprehensive understanding of procedures incorporated within the Ayurvedic surgical domain.

68) Vaidya:
Vaidya means 'physician' or 'healer,' representing the practitioners of Ayurveda. This term underscores the honor and responsibility of Ayurvedic practitioners in employing their knowledge to heal and support patients through comprehensive techniques, including surgery.

69) Chedya:
Chedya means 'excising' or 'removing.' It refers to one of the surgical interventions detailed in Ayurveda, demonstrating the understanding ancient surgeons possessed regarding the need for precise removal in managing injuries and conditions effectively.

70) Eranda (Eramda):
Eranda refers to the castor plant, known for its medicinal properties in Ayurveda. Its application in surgical procedures signifies the importance of utilizing natural resources in healing and recovery, emphasizing the integration of herbal remedies in surgical practices.

71) Aharya:
Aharya translates to 'extraction,' a process described in Ayurvedic surgery. Its significance demonstrates the diverse surgical methodologies employed in ancient practices, emphasizing the comprehensive comprehension of various surgical interventions.

72) Eshya:
Eshya refers to 'exploration' within the surgical context, highlighting the diagnostic and procedural role in understanding and treating medical conditions. This term underscores the thoughtful and investigative nature of Ayurvedic surgical practices.

73) Patra:
Patra means 'leaf' or 'a particular kind of tree.' It often refers to natural materials used in planning for surgical interventions. The emphasis on natural elements illustrates Ayurveda's deep connection to nature and its role in healing.

74) Gupta:
Gupta, in this context, refers to Rajesh Gupta, a co-author of the research article. His expertise contributes to the understanding and validation of ancient practices in modern contexts, emphasizing collaborative efforts in advancing Ayurvedic surgical knowledge.

75) Sivya:
Sivya refers to 'suturing,' an essential technique in surgical procedures. This term emphasizes the critical role of suturing in the healing process within Ayurveda, affirming the sophisticated understanding of surgical techniques among ancient practitioners.

[Note: The above list is limited to 75. Total glossary definitions available: 85]

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Discover the significance of concepts within the article: ‘Sandhana Karma: The Ayurvedic Roots of Plastic Surgery by Sushruta’. Further sources in the context of Science might help you critically compare this page with similair documents:

Ayurveda, Sushruta-samhita, Shalyatantra, Paschat-karma, Vedic Time, Poorvakarma, Acharya Sushruta, Reconstructive surgery, Plastic surgery, Shashti Upakrama, Post-operative care, Sandhana Karma, Karna Sandhana, Pradhan Karma, Oshta-Sandhana, Recipient site.

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