Health Watch: Microsurgery saving limbs


Microsurgery, which was first developed in the 1970’s by Dr. Harry Buncke in San Francisco, has revolutionized the plastic surgery field with its ability to repair intricate structures, returning form and function to individuals affected by trauma, cancer and/or congenital defects.

Two of SLUCare’s renowned plastic surgeons, Dr. Bruce Kraemer and Dr. Kyle Xu at SSM Health Saint Louis University Hospital, trained directly under Dr. Buncke and his son, respectively. They learned the fine art of this technique from the doctor who pioneered it to bring to the St. Louis area.

Microsurgery is used by plastic surgeons to perform 1) transfer of tissue from one part of the body to another (free tissue transfer), 2) reattachment of severed parts (replantation) and composite tissue transplantation.

Microsurgical reconstruction is typically reserved for complex reconstructive surgery problems when other options such as primary closure, skin grafting, local or regional flap transfer are inadequate.

Microsurgery uses operating microscopes and precision instrumentation to repair intricate structures such as blood vessels and nerves less than a few millimeters in diameter. This field has made a major impact to restore form and function to individuals impaired by trauma, cancer and congenital anomalies.

Dr. Xu says, “In the past, someone could have such a bad injury to their leg that they would require an amputation. Now, we have options where we’re able to try to save the leg.”

Veteran plastic surgeon, Dr. Bruce Kraemer says these advancements empowered Dr. Xu to help a woman who beat cancer, but then suffered a block lymphatic system causing debilitating swelling in her foot.  “He hooked up her lymphatics, and now her foot is going down in sizes and it’s shrinking down. So, it’s exciting that we can do those kinds of operations now in a more reliable fashion.”

Common microsurgery procedures, include breast reconstruction; head and neck reconstruction; functioning free muscle transfer for muscle paralysis; vascularized bone flap transfer; complex wound reconstruction; toe transplantation; digit replantation; nerve repair and grafting; and lymphatic reconstruction.

To learn more about microsurgery options with SLUCare plastic surgeons, click here.


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