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Microsurgical Flap Procedure of the Hand
What is a Microsurgical Flap Procedure of the Hand?
A microsurgical flap procedure of the hand is a surgery performed to cover a defect in an injured hand using skin along with the underlying healthy tissue of varying thickness harvested from adjacent tissue or another part of the body. The surgery is performed under microscopic visualization to ensure torn blood vessels and nerves are properly sutured back together again.
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Types of Flaps
According to their location in relation to the defect in the hand, flaps can be classified as:
- Local flaps: These flaps are harvested from tissue surrounding the site of injury.
- Regional flaps: These flaps are harvested from a non-injured part of the hand.
- Distant flaps: These flaps are harvested from a distant site away from the injured hand.
Indications for Microsurgical Flap Procedure of the Hand
Microsurgical flap procedures of the hand may be indicated in cases of:
- Severe traumatic hand injuries which damage the delicate blood vessels and nerves in the hand
- Finger reimplantation surgery
Preparation for Microsurgical Flap Procedure of the Hand
Your doctor will assess your symptoms and perform an examination. Imaging tests such as X-ray, MRI, or CT-scanning may be ordered. Inform your doctor about the medicines you are taking prior to the procedure, and if you are allergic to any medicines or anesthesia. Arrange for someone to drive you home after the surgery.
Microsurgical Flap Procedure of the Hand
- Either general or regional anesthesia can be used for the surgery.
- Necrotic tissue and debris are removed from the site of injury.
- The flap is harvested from the donor site and placed appropriately to cover the defect.
- Using magnification technology and special microsurgical instruments, the delicate blood vessels and nerves are repaired.
- The incision is then closed with sutures.
- If the hand injury is very severe, multiple surgeries may be necessary to optimize hand function.
Recovery after Microsurgical Flap Procedure 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 Microsurgical Flap Procedure of the Hand
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 Microsurgical Flap Procedure of the Hand
Most patients that have undergone microsurgical flap procedures of the hand report significant improvement in hand strength and function.
Frequently Asked Questions
What is a microsurgical flap procedure of the hand?
It is a surgery that covers a defect in an injured hand using skin and healthy underlying tissue harvested from nearby tissue or another part of the body. The procedure is performed under microscopic visualization so that torn blood vessels and nerves can be precisely sutured back together.
When is a microsurgical flap procedure needed?
This procedure is indicated for severe traumatic hand injuries that damage the delicate blood vessels and nerves, as well as for finger reimplantation surgery. Imaging such as X-ray, MRI, or CT may be used to plan the procedure.
What types of flaps are used?
Flaps are classified by where the tissue comes from: local flaps are taken from tissue surrounding the injury, regional flaps from a non-injured part of the hand, and distant flaps from a site away from the hand. Dr. Luo selects the type based on the size and location of the defect.
What does the procedure involve?
Under general or regional anesthesia, dead tissue and debris are removed, the flap is harvested and positioned to cover the defect, and the blood vessels and nerves are repaired using magnification and specialized instruments. If the injury is very severe, multiple surgeries may be needed to optimize hand function.
What is recovery like, and what are the benefits?
Pain is managed with prescription medication or NSAIDs, and you’ll work with occupational therapists—starting with passive exercises and progressing to active therapy as the hand heals. Most patients who undergo this procedure report significant improvement in hand strength and function.
What are the risks of a microsurgical flap procedure?
As with any surgery, possible risks include anesthetic complications, infection, loss of sensation, stiffness, and delayed healing or failure to heal.
Randy Y. Luo, MD, MBA
Board Certified Orthopedic Surgeon
Hand & Upper Extremity Specialist