Soft Tissue Coverage

Abstract

Over the years, there have been a number of new techniques developed for soft tissue coverage of wounds of the hand. There is a smaller number of procedures that, are generally accepted as reliable and have a high success rate. There are some that are particularly useful in certain areas of the hand. When there is soft tissue loss of up to 2.5 cm over the volar distal thumb tip, a volar advancement flap is often the procedure of choice (Fig. 4–1). When there is soft tissue loss over the volar aspect of the fingers, a cross finger flap is the procedure of choice (Fig. 4–2). A split-thickness skin graft, which includes the epidermis and partial thickness of the dermis, is used to cover the donor site resulting from the cross finger flap. When there is a sufficiently large soft tissue loss over the dorsum of the hand that cannot be addressed by primary closure, a radial volar forearm flap is one method for soft tissue coverage in that area (Fig. 4–3).