In hand surgery; microsurgery is essential; with super microsurgery particularly necessary for fingertip replantation; lymphaticovenular anastomosis; and perforator flap procedures. Recently in Japan; proximal finger amputations have decreased; while fingertip amputations have increased. As vascular anatomy understanding improves; many thin perforator flaps have been developed; which are particularly useful in hand surgery. Since donor vessels for perforator flaps can be very small; super microsurgery experience is precious.
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