One of most challanging developments in reconstructive surgery, in the last 25 years, has been microsurgery of small vessels and nerves.
The initial experimental and clinical successes in microvascular surgery, in the sixties, have been followed by rapid progress in the seventies.
Each year new clinical fields have appeared and now, in addiction to transplantation and replantation surgery by the direct anastomosis of vessels less than one mm. in external diameter, the "Microvascular free flap", which may be defined as the transfer, in a single operation, of a composite segment of skin and subcutaneous tissue, nerve, muscle, tendon, bone, omentum, to a distant site, using microvascular surgery has been established.
The microvascular free flap has been applied to extensive skin losses with exposure of vital structures following trauma, including burns, cancer surgery, irradiation necrosis, disfiguring contracting burn scars, congenital disfigurement, adduction contracture of the thumb, both congenital and acquired.
There are many peoples with digital injuries and deformities, especially from industrial accident or any other causes.
Most of them desire the severed or deformed part restored and return to his original figurement for occupational, functional and cosmetical problems.
Replantation of an amputated digit and transplantation of free flap for restored deformity is impossible without primary microvascular anastomosis.
"The primary aim in replantation or transplantation are to obtain survival. The other equally important aim is to achieve satisfactory function."
I write this paper about my 3 successful clinical cases report which 2 cases of replantation of amputated digits following trauma and I case of free flap surgery for correction of postburn adduction scar contracture of the thumb with microvascular surgery.
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