Beyond replantation: microsurgical salvage of complex hand injuries

The authors believe that certain complex hand injuries so severe as to be considered for amputation or simple proximal revision, may under some circumstances be salvaged with the use of appropriate microsurgical techniques. They present three examples of severely injured hands to illustrate the reconstructive potential of microsurgery. Salvage techniques are considered in some detail including debridement, evaluation and planning, fixation, restoration of circulation, reconstruction of tendons, joints and nerves, and provision of coverage. The importance of vein grafts for successful salvage of complex hand injuries is emphasized.