Microsurgery: reconnecting what's smaller than a millimeter
Microsurgery uses an operating microscope to reconnect vessels and nerves as small as 0.5mm — the technique behind reattaching severed fingers, transferring tissue (free flaps) from one body part to reconstruct another, and repairing fine nerve injuries. It is one of reconstructive surgery's most demanding skill sets, and outcomes depend heavily on surgeon experience and speed to treatment.
What microsurgery makes possible
Operating under a microscope allows surgeons to precisely reconnect structures far too small to work with using the naked eye — blood vessels and nerves down to roughly half a millimetre. This is the technical foundation behind reattaching a completely severed finger or limb (replantation), moving living tissue with its own blood supply from one part of the body to reconstruct a defect elsewhere (a free flap — see flap surgery), and repairing fine nerve injuries with a level of precision that wasn't possible before microsurgical technique became standard.
Replantation: the critical time window after an amputation injury
If a finger, hand, or limb is completely severed, the tissue can potentially survive reattachment, but the window is time-critical — generally the sooner surgery happens, the better the chance of success, and viability drops as time passes, especially for tissue with significant muscle content. Correct first aid genuinely changes outcomes: wrap the severed part in clean, slightly damp gauze, place it in a sealed plastic bag, then place that bag on ice (never put the part directly on ice or in water) and get to a microsurgery-capable hospital immediately.
Free flaps: moving tissue to solve reconstruction problems
A free flap is a piece of tissue — skin, muscle, bone, or a combination — removed from one part of the body along with its supplying blood vessels, then transferred to reconstruct a defect elsewhere, with those vessels microsurgically reconnected to blood vessels at the new site to restore circulation. This makes it possible to reconstruct defects that are too large, too deep, or in too poor a blood-supply environment for a simple skin graft to survive on — common uses include reconstruction after cancer removal, severe trauma, and complex diabetic foot or pressure sore wounds discussed elsewhere on this site.
Frequently asked questions
What should I do if a finger or body part is severed?
Wrap the part in clean gauze, place it in a sealed bag, put that bag on ice (never directly on the part), and get to a microsurgery-capable hospital immediately — viable replantation windows are measured in hours.
What is a free flap?
Tissue (skin, muscle, or bone with its blood vessels) moved from one part of the body to reconstruct a defect elsewhere, with the vessels reconnected under microscope to restore blood supply at the new site.
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