Injured hands may now be divided into two categories: those in which revascularisation by suture or bypass is necessary as an acute emergency and those in which classical reparative surgery suffices. As far as the first category is concerned, those who first see such patients should undertake the vascular repair but also all the others, if this is possible and desirable, or refer the injured individuals to a specialised centre. The prodigious development of microsurgery and its teaching to hand surgeons should soon make it possible for all injured patients to derive full benefit from this revolution. However, the indications must be perfectly defined in order to avoid the creation of handicapped patients and useless increase in surgical expenditure.