Dear Editor,

First of all, we do need the presence of a skilled surgical team in microsurgical repairing procedures. Second, there must be conditions for a possible long-lasting surgical procedure and of course antiseptic surgical conditions. Maybe it is better to perform surgery in a second attention hospital.

Our procedures (most of them) were performed in a huge neurosurgical clinic of the largest university hospital in São Paulo, and we had all the supporting conditions (time including…).

In conclusion, we advise performing surgery in a second attention hospital in the rearguard near the front (in a war setting), early after trauma, with available conditions for performing a good microsurgical repair.