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. This flap relies only on perforating branches (5 to 11 in number) arising from the radial artery and located proximal to the radial styloid (2 to 7 cm). The main advantages of this method are that it is a single-stage operative technique, it is applicable in emergency conditions, and the main artery is spared. The cosmetic effect of the donor site could be considered a disadvantage of this approach.