Versatility of Dorsal Metacarpal Artery Flaps for Hand Burns

Burns to the hands can be devastating injuries and early debridement and coverage can prevent these chronic problems. Reconstructive options for these defects include skin grafts; local, regional, and distant flaps; and free flaps. In this series, they set out to demonstrate the versatility, durability, and effectiveness of dorsal metacarpal artery (DMCA) flaps for primary soft tissue coverage. This study involves a review of all consecutive patients who underwent acute soft tissue coverage using DMCA flaps at their institution from December 2014 to December 2017. Four patients were identified, two underwent reverse DMCA flaps, and two others underwent first DMCA flaps. Three patients were males and one female whose age ranged from 33 to 74 (mean 48 years old). Follow-up ranged from 6 to 43 days. One of the four flaps had de-epithelialization of the distal flap with loss of the most distal tip left to heal by secondary intention. The remainder of the flaps survived without incident, and a full thickness skin graft had 100% take onto the index finger donor site. At the final follow-up, all flaps had healed completely and patients had return of almost complete active range of motion. Flaps based on the DMCA have been proven to be versatile and reliable methods for primary hand burn reconstruction.