Perforator-based forearm island flap.

Reconstruction of soft tissue defects of the hand with exposed tendons, nerves, joints and bones could be quite a challenge for the surgeon. Only adequate coverage can save their functions. In our case we present a patient with adduction contracture of the right thumb after II degree burns, treated with perforator-based forearm flap.

Neurocutaneous metacarpal flaps.

The article describes the possibility of covering large skin defects of the fingers by the use of fasciocutaneous flap from the back of the hand. It is pedicled on a sensory nerve branch and its paraneural tissue. The flap relies on blood supply from the constant para- and intraneural vascular network which gives perforator branches towards the overlying skin as well as on the constant anastomoses between the dorsal and volar arterial pool.