Free hypothenar full-thickness grafts for distal digital defects

The application of free full-thickness grafts of palmar skin from the hypothenar area is advocated for full thickness digital tip defects too large for open treatment. The traditional objection to this site as a donor for full-thickness skin on the basis of sensitivity and pain has not been confirmed. Strict, meticulous attention to detail is required for success in utilizing this technique. Other methods of treatment are reviewed and indications, advantages, and disadvantages of the free full-thickness graft of hypothenar skin are discussed.