The Development and Future of Reconstructive and Microvascular Surgery of the Hand
Marco Malahias 1, Daniel J Jordan 2, Sandip Hindocha*, 2, Wasim Khan 3, Ali Juma 4
Identifiers and Pagination:Year: 2014
Issue: Suppl 2: M4
First Page: 415
Last Page: 422
Publisher Id: TOORTHJ-8-415
Article History:Received Date: 22/2/2014
Revision Received Date: 3/5/2014
Acceptance Date: 27/5/2014
Electronic publication date: 31 /10/2014
Collection year: 2014
open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.5/) which permits unrestrictive use, distribution, and reproduction in any medium, provided the original work is properly cited.
The hand is often thought of as a key discriminator in what makes humans human. The hand is both intricate and fascinating in its design and function, allowing humans to interact with their surroundings, and each other. Due to its use in manipulation of the person’s environment, injury to the hand is common.
Devastating hand injuries have a profound, physical, psychological, ﬁnancial and socially crippling effect on patients.
Advances in operative techniques and improvements in microscopes and instruments allowed Malt &McKhann to perform the first successful arm replantation in 1962 .
This was followed by a myriad of autologous free flaps of varying composition, that were discovered after the mapping of the cutaneous blood circulation by Taylor and Palmer  and Mathes &amp; Nahai’s classification of muscle flaps  providing us with countless options to harvest and transfer healthy, well vascularised tissues into areas of injury.
Since the late sixties, with the emerging subspecialty of microvascular reconstruction, surgeons have had the technical ability to salvage many amputated parts, even entire limbs.
The measure of functional outcomemust incorporate the evaluation and severity ofthe initial injury and the subsequent reconstructive surgeries .