The fascial radial flap

Six patients with full-thickness skin loss complicating traumatic problems of the hand each had a retrograde forearm fascia flap transfer. Fascial pedicle flaps were used, because more conventional means of coverage had failed or were deemed inappropriate. Four patients had an uncomplicated one-stage flap transfer. Two patients had postoperative hematoma, but no further procedures were required. One patient had superficial necrosis of more than one fourth of the flap. Hematoma and necrosis were considered to be a result of a reversed flow occurring in the radial artery and its vena comitant and to the increased vascular pressure of the flap. This technique provides soft tissue reconstruction of the hand in one stage, with the advantage of early rehabilitation.