(vii) Considerations and principles of soft tissue cover for the hand

There are a number of considerations to be accounted for when planning soft tissue cover for the hand. We not only have to think about skin closure but also other issues such as appearance, tendon cover and sensibility.One way to approach this challenge is to prioritise the requirements for reconstruction. In the hand, function is paramount but even within this encompassing term there are different modalities to function, which need to be ordered in priority. The aesthetic appearance of the hand must also be a consideration as the hand is the second most cosmetically sensitive part of the body after the face. In reconstruction, the nature of the defect will also need to be defined as this can change the options available.