(i) Skin cover in hand injuries

SummaryPrompt coverage of skin loss associated with major hand injuries ensures primary healing, protects the reconstruction of the underlying structures and facilitates early rehabilitation. Radical debridement prior to the provision of skin cover is important. Flap cover is chosen according to the functional requirements of the site to be covered, need for access for further procedures and donor site morbidity. Combined defects can be reconstructed with composite flaps. Coverage of large defects can be made simpler by providing flap cover only to critical areas which definitely need flap cover and the rest with skin grafts. With the wide choice of flaps available to cover a particular defect, the surgeon's experience with the particular flap and donor site morbidity, on which depends the long-term satisfaction of the patient, become the main considerations in the choice of the flap.