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Local Flaps of the Hand: Quick Tips
Soft-tissue defects of the hand resulting from trauma or tumor resection are common challenges for the hand surgeon, and can lead to an undesirable appearance or disability for patients if not managed appropriately. Multiple reconstructive options have evolved over the past decades to provide ideal soft-tissue coverage of the hand, including primary closure, skin grafting, local flaps and distant skin flaps, and free tissue transfer. Local hand flaps have been shown to be reliable sources of soft-tissue replacement when a defect cannot be managed by primary closure or skin grafting. Several types of flaps have been developed based on their composition, method of transfer, flap design, and blood supply. This surgical technique guide reviews the indications, contraindications, design principles, and surgical steps for performing several types of local hand flaps. With minimal donor-site morbidity, using similar tissue from nearby the defect, these flaps can be used to reconstruct most soft-tissue defects with successful functional and cosmetic outcomes.