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What is Microsurgery of the Hand?

Hand microsurgery is a specialized form of surgery used to treat conditions and injuries that affect the hands, wrists, and fingers. It is a minimally invasive technique involving the use of specialized tools and techniques to repair damaged tissues in the hand. 

Indications for Microsurgery of the Hand

Hand microsurgery can treat a wide range of conditions, including nerve compression injuries, tendon injuries, fractures, and arthritis. This type of surgery can also be used to reconstruct damaged tendons or nerves in the hand.

Preparation for Microsurgery of the Hand

Preparation for surgery includes understanding the risks, benefits, and alternatives to the procedure; getting the right tests done; discussing any allergies or medications with your doctor; making sure you have all necessary information on hand; and following any instructions given by your doctor such as avoiding certain medications and not eating or drinking for specified amount of time before the surgery. By taking these steps before entering the operating room, you can ensure that you receive the best possible care during your surgery.

Hand Microsurgery Procedure

The procedure may involve the use of an operating room microscope, specialized instruments, tiny needles, and ultra-fine sutures to repair the damaged blood vessels.

The various types of hand microsurgeries that may be performed include: 

  • Blood Vessel Repair (Vascular Anastomosis): It is done to connect the separate blood vessels to form a single channel. 
  • Vein Grafting: It is done if the cut ends of the blood vessels cannot be attached. The veins that are similar in diameter are removed from hand, arm or foot and are reconstructed through end to end anastomosis procedure.
  • Nerve Repair: It involves connecting the two cut ends of the nerve (nerve anastomosis). In this technique, either the epineurium layer or perineurium layer or both the layers of the nerve are sutured.
  • Nerve Grafting: In this technique, a piece of nerve from one part of the body is transferred to the damaged area using anastomosis techniques.
  • Free Tissue Transfer: This technique is usually performed for soft tissue defects caused by tumor surgery or following a trauma. It involves the removal of muscle along with its blood vessels which are transferred to another part of the body. The artery and veins are reconnected to the blood vessels to restore blood circulation.
  • Free-Bone Transfer: It is the same process as the free-tissue transfer, but in this technique, the bone along with its blood vessels are removed and transferred. It is done for reconstructing non-healing bones that are damaged by tumor surgery or traumatic injury.

Recovery after Microsurgery of the Hand

Prescription pain medicines or NSAIDs (non-steroidal anti-inflammatory drugs) are used to manage pain. You will be encouraged to work with occupational therapists to perform passive physical therapy exercises initially to optimize mobility. As the tissues heal and your hand becomes stronger, you will be allowed to gradually start active occupational therapy.

Risks of Hand Microsurgery

As with any surgery, there are associated risks and complications that may occur. Those related to microsurgical flap procedure of the hand may include:

  • Anesthetic complications
  • Infection
  • Loss of sensation
  • Stiffness
  • Delayed healing or failure to heal

Benefits of Hand Microsurgery

Most patients that have undergone microsurgical procedures of the hand report significant improvement in hand strength, function, and aesthetics.