Coverage of soft tissue defects in the thumb: Essential flaps in daily practice

Area of Science:

• Reconstructive surgery
• Hand surgery
• Plastic surgery

Background:

• Thumb soft tissue defects require diverse reconstructive solutions.
• Existing literature offers a wide array of techniques, from simple healing to complex transfers.
• A focused approach on clinically relevant methods is needed.

Purpose of the Study:

• To present a curated selection of thumb defect coverage techniques used in daily practice.
• To detail the anatomical principles, surgical procedures, and indications for these selected methods.
• To provide a practical guide for reconstructive surgeons managing thumb injuries.

Main Methods:

• Review and selection of commonly used techniques for thumb soft tissue reconstruction.
• Detailed description of anatomical considerations for each technique.
• Step-by-step surgical technique explanation.
• Topographical indication mapping based on defect location and characteristics.

Main Results:

• Established a practical framework for thumb soft tissue defect coverage.
• Detailed guidelines for implementing local flaps (homodigital and heterodigital) and skin grafts.
• Provided specific anatomical and topographical guidance for technique selection.
• Highlighted the importance of tailored reconstructive strategies based on individual patient needs.

Conclusions:

• A focused approach on specific, practiced techniques simplifies decision-making for thumb defect coverage.
• Understanding anatomical bases and precise surgical techniques is crucial for successful reconstruction.
• Tailoring the choice of flap or graft to the defect's location and characteristics optimizes outcomes.