Summary 1. Incisions in the hand must be planned to provide adequate exposure without the risk that contracture in healing will restrict function. This is less of a problem in the loose dorsal skin than in the relatively fixed palmar tissues. 2. Amputations are treated with consideration of the individual case, generally preserving length and striving for pain-free wound closure, but recognizing that extensive measures to salvage a part of limited potential can seriously jeopardize the function of the whole hand. 3. Skin grafts are usually chosen to replace skin losses in the hand when the recipient bed is suitable and there is not a need for replacement of subcutaneous tissues. Thick skin grafts are more normal and serviceable, but their successful transplantation depends on ideal circumstances. Careful hemostasis and effective immobilization are the most important technical factors in successful skin grafting.