Burns-Local and Regional Flaps for Hand Coverage

Local and Regional Flaps for Hand Coverage

Pdf Summary

Hand surgeons often face the challenge of covering soft tissue defects in the hand that involve bone, tendon, or joint. While smaller defects without deep structure involvement can often heal on their own or be treated with skin grafts, larger defects may require vascularized coverage to promote rapid healing and prevent wound contraction. This review provides an overview of local and regional flaps commonly used for soft tissue reconstruction in the hand. The simplest coverage technique is direct primary closure, followed by skin grafting and local and regional flaps. In some cases, free vascularized tissue transfer may be necessary. The clinical indications and outcomes of these flap reconstructions are discussed, along with evaluation and wound preparation techniques. The review also covers specific types of defects and the appropriate flap techniques for each, including fingertip defects, digital defects proximal to the fingertips, thumb defects, and defects proximal to the metacarpophalangeal joint. The article concludes by mentioning distant flaps and free tissue transfer as more advanced techniques that can be considered when local or regional flaps are not feasible or likely to succeed. Overall, this review provides a comprehensive overview of the various flap techniques that hand surgeons can use to achieve optimal soft tissue coverage and promote healing in the hand.

Keywords

hand surgeons

soft tissue defects

bone

tendon

joint

vascularized coverage

rapid healing

wound contraction

local flaps

regional flaps