title: Refinements in hand coverage with microvascular free flaps.
abstract: The specialized tissue requirements or dorsal and palmar skin are analyzed and options for full-thickness replacement outlined in detail. Thoughtful and accurate preoperative planning is the key to success. Dorsal coverage with a variety of pedicled and free fasciocutaneous flaps are quite satisfactory. Palmar coverage is more difficult and the need for sensation more critical. Free vascularized temporoparietal fascial flaps covered with full-thickness skin grafts are currently the treatment of choice for most complex wounds.
authors.affiliation: Department of Surgery (Plastic), Beth Israel Hospital, Boston, Massachusetts.
authors.forename: J
authors.initials: J
authors.lastname: Upton
authors.forename: R J
authors.initials: RJ
authors.lastname: Havlik
authors.forename: R K
authors.initials: RK
authors.lastname: Khouri
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005260:Female; D006225:Hand / Q000601:surgery*; D006230:Hand Injuries / Q000601:surgery; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000379:methods*; D011300:Preoperative Care; D013524:Surgical Flaps / Q000379:methods*