Negative-pressure wound therapy (NPWT) is used to promote wound closure or to prepare a wound for definite coverage. However, the anatomy of the hand makes it difficult to apply dressings that require an airtight seal. In this report, the authors describe the case of a patient with an extensive defect of his right hand and forearm who was treated with a free fibula osteocutaneous flap transfer. The remaining defect was covered with a split-thickness skin graft following NPWT. An airtight seal was achieved by placing the whole extremity in a sterile bag and sealing it proximal to the defect. The authors present a simple and innovative way of treating defects on upper extremities with NPWT with excellent results.
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