Microsurgery Complications in Plastic And Reconstructive Surgery, A Review

Abstract

Microsurgery has revolutionized the field of plastic and reconstructive surgery by enabling precise manipulation of small vessels and nerves, allowing for complex reconstructions that restore both form and function. Its principal applications include free tissue transfer, nerve repair, replantation, and lymphatic surgery. Recent developments such as perforator and supermicrosurgical flaps have minimized donor-site morbidity and expanded reconstructive possibilities, particularly in oncologic and post-traumatic settings. Technological advancements—including robotic-assisted microsurgery and advanced imaging modalities like near-infrared fluorescence and MR lymphography—have enhanced surgical accuracy and intraoperative decision-making. Despite these advances, microsurgery remains technically demanding, with complications such as vascular thrombosis, flap failure, and systemic medical events requiring vigilant perioperative management. Continuous innovation, careful patient selection, and adherence to microsurgical principles are essential to achieve optimal outcomes and further refine the field’s safety and effectiveness.