Workhorse Flaps for Soft Tissue Coverage in the Hand

Soft tissue defects of the hand are frequent and can be due to a variety of causes, including trauma, infection, and tumor. Numerous flaps have been described for the coverage of these defects but in our hands we have found 3 flaps capable of providing coverage for the majority of hand defects; these flaps include the first dorsal metacarpal artery island flap, the heterodigital island flap, and the radial forearm flap (with its variations, including perforator-based and fascia-only flaps). This article will provide an overview of the surgical technique required for successful usage of these 3 flaps.