Current trends in local flaps of the hand

Abstract

Soft-tissue coverage of the hand remains a difficult surgical challenge. Local flaps provide thin, pliable, durable options for coverage of defects. Functional and aesthetic outcomes are optimized by restoring defects with similar tissue. Local flaps have been used for coverage of soft-tissue defects of the hand for decades; however, recent advances in detailed anatomic neurovascular knowledge and microsurgical techniques allow for accurate vascular pedicle and nerve dissection. This has prompted the emergence of new flaps and modifications to previously described operations. Research evaluating and comparing outcomes and complications between reconstructive alternatives have become essential to enabling surgeons to offer the most suitable options to patients. The purpose of this article is to briefly describe the most important advances in the recent literature regarding local flaps in the hand. Current trends include efforts to decrease donor site morbidity, improve functional outcomes (often through the reestablishment of sensation through nerve coaptation), optimize aesthetic outcomes, and minimize complications.