[The role of vascular microsurgery in trauma of the hand]

The author presents the current scope of microvascular techniques in hand surgery. In a first stage, basic techniques are presented: sutures under microscope. Then, the indications are made, stressing emergency procedures, with emphasis on: limb (or segments) reimplantation, revascularization. Indications for reimplantation, operative technique and additional treatments are presented, emphasizing the failure rates (40%) and the contraindications. We are insisting on the fact that the indications for revascularization in simple or complicated wounds of the hand are the most frequent and the most positive for these patient's future. Finally, secondary reconstruction techniques are presented, always compared with classical techniques (free 2nd toe transfer versus pollicization).