Microsurgery: Current and Future Challenges

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Guest Editor
1. Department of Plastic Surgery, University Hospital Muenster, 48149 Muenster, Germany
2. Department for Plastic, Aesthetic, Hand- and Reconstructive Surgery, Klinikum Passau, University Campus Lower Bavaria, 94032 Passau, Germany
Interests: breast surgery; breast reconstruction; facial plastic surgery
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Special Issue Information

Dear Colleagues,

Currently, no subfield in plastic surgery is undergoing as many changes as the field of microsurgery. Technical innovations have driven and allowed for a surgical evolution with novel treatment options and simultaneous improvement of outcome.

Innovations such as robotic-assisted microsurgery or Artificial Intelligence, have the potential to change the whole field of microsurgery. But when transferring from bench to bedside, all of these innovations are facing the same obstacles: initially prolonged surgery time, concerns regarding patient safety, high costs or problems in patient selection- just to mention some of them. Some innovations are overcoming these hurdles, but many are failing to make the step into everyday clinical practice.

This Special Issue focuses on challenges in microsurgery—because it is not about having a solution and creating a problem, but about having a problem and finding a solution.

We are looking forward to receiving papers about your problems and solutions in microsurgery.

Dr. Matthias Aitzetmüller-Klietz
Guest Editor

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Keywords

  • microsurgery
  • reconstruction
  • reconstructive surgery
  • breast reconstruction
  • extremity reconstruction

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Published Papers (1 paper)

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Research

9 pages, 2433 KiB  
Article
Lessons Learned from Reconstructing Severe Hand Injuries During the COVID-19 Pandemic
by Christina Glisic, Tonatiuh Flores, Erol Konul, Hugo Sabitzer, Giovanni Bartellas, Alexander Rohrbacher, Berfin Sakar, Sascha Klee, Uwe Graichen, Patrick Platzer, Klaus F. Schrögendorfer and Konstantin Bergmeister
J. Clin. Med. 2025, 14(7), 2169; https://doi.org/10.3390/jcm14072169 - 22 Mar 2025
Viewed by 301
Abstract
Background: COVID-19 presented many challenges for our health system, one being a suspected change in the epidemiology of severe hand trauma modalities. These complex injuries are traditionally treated at specialized hand trauma centers, but COVID-19 has in many ways disturbed these established [...] Read more.
Background: COVID-19 presented many challenges for our health system, one being a suspected change in the epidemiology of severe hand trauma modalities. These complex injuries are traditionally treated at specialized hand trauma centers, but COVID-19 has in many ways disturbed these established pathways and presented new challenges. Methods: We retrospectively analyzed finger amputation injuries treated at the University Hospital of St. Poelten between 2018 and 2022 to examine differences in the management of micro amputation injuries before and during the COVID-19 pandemic. Further challenges in the treatment of hand trauma patients were analyzed and solutions were developed. Results: Overall, the number of occupational finger amputation injuries in Lower Austria declined during the COVID-19 pandemic. Contrarily, more private accidents were treated in the same period, suggesting a lockdown specific change in injury characteristics. Throughout the entire examined period, a total of 130 injured fingers, including 29 thumbs, were treated. In 67 cases, a reconstruction attempt was feasible and successful in 59 cases. Specific challenges were fewer active hand trauma centers, subsequent long transport times, specific COVID-19 prevention measures, and limited postoperative rehabilitation resources. Conclusions: Despite many challenges overall affecting the time to revascularization, good results were achieved by small but meaningful modifications. These included well-established principles such as back table preparation and strengthening novel concepts such as tele-medicine for patient selection. Overall, the reconstruction of severe hand injuries is often challenging, especially during a world-wide health crisis, but with adequate solutions, good results can be readily achieved. Full article
(This article belongs to the Special Issue Microsurgery: Current and Future Challenges)
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