MICROSURGERY
Dr. De Jesus maintains a special interest in reconstruction of hands and fingers in children and adults that have been involved in accidents or were born with defects. These are reconstructed by transferring the patient�s own tissues from one part of the body to another. The goal is to re-establish hand function. This is generally known as microsurgical tissue transfer. In reconstructive surgery missing parts of the body are replaced with other similar body parts. For example, the tissue that most resembles a finger is that of the great and second toes. If a patient is missing a finger, one of his toes is removed and implanted into the area. This surgery is known as Toe-to-hand transfer when the toe is transplanted to the index, middle, ring or small fingers. When the toe is transferred to the thumb, it is known as Toe-to-thumb transfer. Loosing a toe may not sound like a great idea, but one must take into account the great amount of function that can be gained by replacing a missing finger. While removal of a toe does not affect foot balance, a missing finger can greatly affect a person�s life. Full understanding is important for the patient and family to make sensible decisions about surgery.

In severe finger injuries, replantation or revascularization is often successful in salvaging injured digits, but when not possible, toe transfer can be performed. This scenario happens occasionally with crush injuries, industrial machinery, snow blowers, saws, etc. This surgery is also commonly done in burned hands.

The primary goal of toe-to-thumb surgery is to restore function, but it also improves the appearance the hand. The thumb is responsible for 50% of the function of the hand. Therefore, when missing, it drastically reduces the whole function of the hand and the quality of life of the individual.

When tissue units are required for reconstruction the quality of the tissue as well as the resultant appearance from that donor area are taken into account. Among the preferred flaps for the hand are:

1) Free-Groin Flap
2) Anterolateral Thigh Flap
3) Rectus Abdominis Flap
4) Gracilis Muscle Flap


Other Flaps utilized for reconstruction are:

TRAM or Deep Inferior Epigastric Perforator Flap
The Lateral Arm Flap
The Scapular & Parascapular Flap
The Osteocutaneous Scapular Flap
The Radial Forearm Flap
Fibular Free Flaps
Deep Circumflex Iliac Osteocutaneous Flap " Deep"
Free Serratus Anterior Flap
Latissimus Dorsi Muscle Flap
Posterior Interossei Flap
CLICK  HERE  TO  SEE  BEFORE AND AFTER SURGERY PHOTOS
CLICK HERE FOR ADDITIONAL INFORMATION ON MIICROSURGERY
CLICK HERE  FOR INFORMATION ON WHERE I COMPLETED MY MICROSURGERY TRAINING AND FOR ACCESS TO A MICROSURGERY TEXTBOOK
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