[Microsurgery: indications and organization].

Microsurgery is an important, but purely technical advancement. It would be a serious error for medicine and patient care to accept the concept of a "microsurgeon" rather than recognizing the necessity for surgical specialists working in many anatomical regions to learn microsurgery techniques as related to comprehensive care of their area. In hand surgery it is already clear that the duration of procedures and the exhaustion associated especially with reattachment surgery demands care by a team rather than by a single individual. Decision making and over all responsibility for performance of that team must, however, rest clearly with a primary surgeon. The institution of an emergency service for microsurgical cases represents a heavy burden to the infrastructure of a hospital. Therefore it seems reasonable to institute in each country an appropriate number of replantation centers to which the cases can be referred. The indications for reattachment surgery must be carefully evaluated and well balanced against traditional possibilities of treatment. The dramatic achievements of reattachment surgery and composite tissue transfers are illustrated by a few examples.