Dr. Kemal Karaca

Microsurgery is a surgical method in which structures that are difficult to see with the naked eye, such as vessels and nerves, are repaired under a microscope. The stitches used are thinner than a hair and the procedure is performed under magnification.

Its most well-known use is the reattachment of severed fingers or limb parts. Apart from this, moving the tissue taken from one area to another area with its vessels (free tissue transfer) is also done with microsurgery. This method is used to repair extensive tissue losses.

The determinant of success is monitoring the circulation in the postoperative period. The blood flow of the transferred tissue is evaluated regularly. When problems occur, early intervention may be required.

Loss of sensation or loss of strength in the hand or arm after a cutting injury suggests nerve injury. Whether the nerve has been cut or not is evaluated by examination. Electrophysiological examinations are used when necessary.

The aim of the repair is to bring the cut nerve endings together without creating tension. If there is a distance, a nerve graft taken from the patient's own body can be used. The sooner the repair is made, the better the outcome is usually.

Nerve recovery is slow; fibers grow at the rate of millimeters per day, so it may take months for sensation to return. During this period, hand therapy and exercise program are integral parts of recovery.

Whether a severed finger or hand part can be reattached depends on what is done in the first hours. Therefore, the correct preparation at the scene is as decisive as the surgery.

The severed piece should be wrapped in a clean, damp cloth and then placed in a waterproof bag. The bag is placed in a bowl containing an ice-water mixture. The part should not come into direct contact with ice or water. Direct contact damages tissue.

The injured area is wrapped with a clean cloth and elevated, and the patient is immediately directed to a center where microsurgery can be performed. Whether it is appropriate to reattach. It is determined by evaluating the shape, duration and condition of the tissue.