Fascial Flaps for Hand Reconstruction

Free or pedicled fascial flaps to the hand provide an excellent reconstructive option in cases of exposed tendon, joint, or bone where soft tissue coverage is needed. They provide thin, broad, well-vascularized coverage and a gliding surface for tendons and joints. A fascial flap also avoids an unsightly donor site that results from a fasciocutaneous flap. Because of these characteristics, mobilization can be started early to avoid or minimize tendon adhesions and joint and soft tissue contractures. In this report, we discuss the technique for harvesting and insetting a pedicled reverse radial forearm adipofascial flap for a dorsal thumb defect.