Microsurgery: The biggest advance in plastic surgery in 60 years

Microsurgery describes the surgical process of joining together very small arteries and veins to restore the vital blood supply to a piece of living tissue. This technique has been the single biggest advance in plastic surgery in the last 60 years because it allows a surgeon faced with a defect in the body to move tissue from another part of the same body and restore life to the transplanted tissue, so that healing begins immediately. An example might be seen after removal of a large cancer from the face, leaving a deep hole that a simple skin graft cannot fill, but which can be repaired by transplanting muscle and skin from the back.

However, microsurgery has moved on to apply this concept widely, so that whole bones may be transplanted to replace diseased structures such as the jawbone, or toes may be moved to the hand to replace absent digits, whether from birth or through injury.  The secondary effect of microsurgery as a powerful tool for reconstruction is that tumours that might previously been irremovable (because the resulting defect would have been too large or left exposed vital organs such as the brain) can now be treated and the defect closed immediately.  In the same way many injuries and tumours of the limbs that previously required amputation can now be repaired by microsurgical transplants from the same body.

Finally, microsurgery allows the replacement of an accidentally amputated body part provided it has been kept cool and clean and the patient is fit for surgery. Many thousands of such replantations have saved thumbs, hands or even arms severed in accidents, to the lasting benefit of the patients.