Upper Extremity Coverage

The need for a free tissue transfer to cover a tissue defect is not as common in the upper extremity as it is in the lower. There are many other options available, including local flaps and distant pedicle flaps from the chest, abdomen and groin. Nevertheless, many complex injuries and reconstructions to the upper extremity require postoperative hand elevation, and early digit mobilization, and are not suited to two-stage dependent flap procedures. Since free tissue transfers are done in one stage, benefit from elevation and heal rapidly, they are particularly well suited to many complex hand injuries and reconstructions which require flap coverage. There are many free tissue transfers which are available, including skin only, muscle only, skin and muscle (myocutaneous), and fascial free tissue transfers.