Reconstruction of Dorsum of Hand

Basic Principles

The dorsum of the hand has numerous extensor tendons and can be easily exposed. It is possible to use an artificial dermis to raise granulation tissue and then conduct a skin graft, however this tends to lead to adhesion of the tendons and contracture of the MP joints. Covering this area using a skin flap requires a thin skin flap, however it is not necessary to reconstruct sensory function. A flap is chosen that can become a tendon gliding surface.

Both pedicled and free abdominal flaps are practical because they can be thinned.

If the thinner skin flap is required, the temporal fascia flap can be used.

Thinning of the groin flap is difficult, and they are difficult to use except covering amputation stumps. The blood flow of the reverse flow posterior interosseous flap is unstable.

Use of negative pressure wound therapy is indicated for a skin graft.

The difficulty level of each surgical procedure is shown subsequent to the procedure title (e.g., Level of Difficulty: 2). The levels range from 1 to 5, with level 1 indicating a preliminary level and level 5 indicating a very advanced level.