Principles of Microsurgery

Microsurgical reconstruction is used for complex reconstructive surgery problems when other options such as primary closure, healing by secondary intention, skin grafting, local flap transfer, and distant flap transfer are not adequate. Microsurgery may not be the best solution for all reconstructive dilemmas and certainly is not the first choice in the reconstructive ladder. However, it can offer the reconstructive surgeon a wide range of possibilities for complex reconstruction. In specific cases, such as mandibular reconstruction, free tissue transfer may be the best option. The purpose of this article is to outline the principles of microsurgery, specifically the principles of surgical planning and operative technique that will optimize success.