Microvascular Surgery

Microvascular reconstruction, or microsurgery, is one of the most advanced and highly technical procedures in modern surgery. Dr. Brian T. Andrews performs microvascular reconstruction for a number of reasons that involve the surgical reconnection of living tissue, including:
  • Limb reconstruction
  • Burn repair
  • Congenital birth defects
  • Malignant tumor removal
  • Amputation

Who should undergo microvascular reconstruction?

This procedure may be appropriate for patients of almost any age who require the surgical reattachment of living tissue. However, not all patients and conditions are appropriate for the use of microvascular reconstruction. Prior to the procedure, Dr. Andrews will complete a thorough physical examination of the surgical area to determine if reconstruction is possible using this method.

What happens during surgery?

The surgical process of microvascular reconstruction varies greatly depending on the specifics of the procedure, though most procedures begin with general anesthetic. Incisions are made, and a number of different treatments may be used during the process, including skin grafting, soft tissue covers, callus distraction, tendon transfer, and local or musculocutaneous flaps. Each segment of your personal procedure may be discussed in detail with Dr. Andrews prior to beginning surgery.

Depending on the specific situation of the procedure, often multiple long surgeries will be necessary to complete the intricate, careful surgical work necessary for microvascular reconstruction. As with any case involving the surgical attachment of living tissue, it may not be possible to achieve the same level of connection that previously existed.
    

Microvascular surgeons advance replantation possibilities

Advances in microsurgery make successful replantation of lost body parts with reasonable functional recovery more possible than ever before. No longer should amputation be broadly viewed as the first or only option following traumatic separation of a limb or body part.

To optimize the potential for successful replantation of a severed body part:
  • Moisten and wring out sterile gauze. Gently wrap the body part and place in a plastic bag.

  • Keep the wrapped body part cool, but do not allow it to freeze. Set the bag on ice and place it in a cooler, but do not immerse it in ice. Frozen tissue will die.

  • Never use dry ice.

  • Give the body part immediately to the care team. It may be possible to begin preparing the part for surgery while evaluating the patient, allowing for the best use of available time.
Read Steve Pelegrin's story of his woodworking accident and successful replantation surgery.
  

What should I expect after surgery?

Immediately after the procedure, a bandage will be applied to the area and drains may be used to release the pressure of fluid accumulation. A splint or brace may be necessary in cases of limb attachment to provide complete immobilization. There may be some discomfort, which can be managed by the use of prescription medication.

Sutures may be removed in about a week, at which point some activity may be resumed, with the treatment area favored and protected from accidental impacts for about 2-5 weeks. Some patients may experience bruising following the procedure, which should dissipate in 5-10 days, with swelling dissipating in 3-5 weeks.

The microvascular reconstruction procedure carries a few unlikely complications, including changes in sensitivity, atypical appearance, asymmetry and infection.

Those interested in the possibility of microvascular reconstruction for their own condition may contact Dr. Brian T. Andrews, and he will be glad to answer any of your questions regarding the procedure and its personal application.