Microsurgery is a surgical technique that applies fine instruments to perform precise operations on tiny tissues and organs under optical magnification devices. Digital and intelligent technologies, such as digital imaging, virtual reality (VR), augmented reality (AR), mixed reality (MR), 3D design and reconstruction, 3D printing, digital navigation, mixed perception of multi-source heterogeneous information, automatic control, digital twins, Internet of Things, cloud computing, machine learning, deep learning, large-scale AI models, generative artificial intelligence and so on, have been enabling the innovative development in microsurgery. It will make significant changes in disease diagnosis and monitoring, treatment decision-making and surgical planning, precise and individualised surgery, doctor-patient interaction and healthcare, team collaboration and professional education, and will drive the innovative development in microsurgery.

As early as in 1900, Nicoladoni performed a staged pedicled toe transfer for thumb reconstruction. In 1966, Yang Dongyue achieved the first successful single-staged thumb reconstruction using free second toe transfer through microvascular anastomosis. In the same year, Buncke reported a successful hallux-to-hand transfer utilising the microvascular anastomosis on the Rhesus monkey. Cobbett successfully performed the first free hallux transfer for thumb reconstruction in human in 1968. Having been invited by the Chinese Medical Association, North American Replantation Mission visited to China in 1973 and then the Chinese technique of free second toe transfer for reconstruction of thumb gained recognition by the international community. In years of 1978 and 1980, Morrison introduced the wrap-around flap technique. In 1980, Foucher reported the twisted-toe technique. In 1979, Yu Zhongjia reported a "reconstructed hand" by transfer of bilateral free second toes to the forearm stump. Further in 1981, he achieved simultaneous transfer of 5 toes for a total hand reconstruction. In 1982, the hand reconstruction technique was internationally recognised and referred as the "Chinese Hand". In 1985, the "Technique for reconstruction after hand loss or complete loss of total digits" was awarded the First Prize of National Invention in China.

Hand degloving injury represents one of the most severe forms of hand trauma, characterised by challenging treatment and a complex prognostic outcome. It is crucial to effectively utilise the degloved tissues in emergency or primary repair of a hand degloving injury. This consensus provides a comprehensive review of the existing literature on definition, classification, emergency assessment, debridement, judgment of skin viability, in situ repair of the degloved skin, and adjunctive treatment for degloving injury of hand. Based on conclusion of both domestic and international experiences, this expert consensus on the classification of hand degloving injury and the emergency repair with the avulsed skin is established, aiming to provide a guidance to surgeons on standardised treatment strategy and improve the management of hand degloving injury.

On November 23, 1964, Huang Chengda and members of his surgical team successfully performed the world's first replantation of an traumatically amputated leg above ankle. After a 7-month follow-up, the leg function was restored. In October 1965, this case was reported in the Chinese Medical Journal. In April 1966, the British Medical Journal highly praised it. In May 1973, the American Replantation Mission visited China. The advanced Chinese limb (digit) replantation techniques and principles, which had been practiced for nearly a decade, were well recognised by international peers. Among which, Huang Chengda achieved the world-first successful experience in leg replantation. "Recovery of protective sensation from immediate nerve repairs has made possible worthwhile lower extremity replants." This inspired scholars at home and abroad to continuously practice and explore the application of microsurgical reconstruction techniques, improving the survival rate in replantation of lower limbs and promoting the development of reconstructive microsurgery.

Cervical perivascular sympathectomy (CPVS) involves an excision of the sympathetic nerve plexus surrounding the carotid arteries to improve cerebral blood supply and achieves the therapeutic purposes. CPVS has been applied in neurosurgery for treatment of cerebral ischemic diseases such as moyamoya disease (MMD) and cerebral palsy (CP). The mechanism of CPVS is not yet clear, even the efficacy of it has been clinically recognised. This paper summarises comprehensive reviews of the anatomy of cervical sympathetic nerves, historical evolution, current status in application and possible mechanisms of CPVS.

Standardised emergency management protocols for hand injury in microsurgery is critical, as it directly determines ultimate clinical outcomes. This consensus consolidates expert insights regarding diagnostic and treatment procedure for hand injury in microsurgery, emergency support protocols and key points of emergency workflow optimisation. It summarises the opinions of experts and puts forward standardised recommendations to guide clinical practice in microsurgical treatment process, so as to further improve the quality of treatment for hand injury in microsurgery and maximise the protection of limb function and quality of life of patients.

Hand degloving injury represents one of the most severe forms of hand trauma, characterised by challenging treatment and a complex prognostic outcome. It is crucial to effectively utilise the degloved tissues in emergency or primary repair of a hand degloving injury. This consensus provides a comprehensive review of the existing literature on definition, classification, emergency assessment, debridement, judgment of skin viability, in situ repair of the degloved skin, and adjunctive treatment for degloving injury of hand. Based on conclusion of both domestic and international experiences, this expert consensus on the classification of hand degloving injury and the emergency repair with the avulsed skin is established, aiming to provide a guidance to surgeons on standardised treatment strategy and improve the management of hand degloving injury.

Microsurgery is a surgical technique that applies fine instruments to perform precise operations on tiny tissues and organs under optical magnification devices. Digital and intelligent technologies, such as digital imaging, virtual reality (VR), augmented reality (AR), mixed reality (MR), 3D design and reconstruction, 3D printing, digital navigation, mixed perception of multi-source heterogeneous information, automatic control, digital twins, Internet of Things, cloud computing, machine learning, deep learning, large-scale AI models, generative artificial intelligence and so on, have been enabling the innovative development in microsurgery. It will make significant changes in disease diagnosis and monitoring, treatment decision-making and surgical planning, precise and individualised surgery, doctor-patient interaction and healthcare, team collaboration and professional education, and will drive the innovative development in microsurgery.

As early as in 1900, Nicoladoni performed a staged pedicled toe transfer for thumb reconstruction. In 1966, Yang Dongyue achieved the first successful single-staged thumb reconstruction using free second toe transfer through microvascular anastomosis. In the same year, Buncke reported a successful hallux-to-hand transfer utilising the microvascular anastomosis on the Rhesus monkey. Cobbett successfully performed the first free hallux transfer for thumb reconstruction in human in 1968. Having been invited by the Chinese Medical Association, North American Replantation Mission visited to China in 1973 and then the Chinese technique of free second toe transfer for reconstruction of thumb gained recognition by the international community. In years of 1978 and 1980, Morrison introduced the wrap-around flap technique. In 1980, Foucher reported the twisted-toe technique. In 1979, Yu Zhongjia reported a "reconstructed hand" by transfer of bilateral free second toes to the forearm stump. Further in 1981, he achieved simultaneous transfer of 5 toes for a total hand reconstruction. In 1982, the hand reconstruction technique was internationally recognised and referred as the "Chinese Hand". In 1985, the "Technique for reconstruction after hand loss or complete loss of total digits" was awarded the First Prize of National Invention in China.

On November 23, 1964, Huang Chengda and members of his surgical team successfully performed the world's first replantation of an traumatically amputated leg above ankle. After a 7-month follow-up, the leg function was restored. In October 1965, this case was reported in the Chinese Medical Journal. In April 1966, the British Medical Journal highly praised it. In May 1973, the American Replantation Mission visited China. The advanced Chinese limb (digit) replantation techniques and principles, which had been practiced for nearly a decade, were well recognised by international peers. Among which, Huang Chengda achieved the world-first successful experience in leg replantation. "Recovery of protective sensation from immediate nerve repairs has made possible worthwhile lower extremity replants." This inspired scholars at home and abroad to continuously practice and explore the application of microsurgical reconstruction techniques, improving the survival rate in replantation of lower limbs and promoting the development of reconstructive microsurgery.