Abstract
Since even minor soft tissue injuries can cause relevant functional deficits, reconstruction must meet high demands. This is especially true for complex defects after major injuries. The hand is a tactile organ and requires not only an intact and mechanically resistant surface, but also sensibility. Generally these aims are to be achieved using the simplest methods. At the latest in the presence of combined tissue defects, however, complex reconstructions based on microsurgical procedures are required. Therefore, it may be reasonable to leave these reconstructions to specialized hand surgery centers. In addition to reconstructive quality also the need for early mobilization should be kept in mind. Even during healing of skin flaps physiotherapy of the injured hand is of great importance. This concept is in analogy to early guided motion without load in osteosynthesis and should influence the choice of the reconstructive option.
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