[Defect coverage on the hand : A reconstructive challenge]

Soft tissue defect coverage of the hand represents a particular challenge in reconstructive surgery due to its complex anatomy, high functional demands and exposed location. The aim is to achieve a robust, durable and, whenever possible, sensitive soft tissue coverage that enables early functional rehabilitation while preserving the hand function and esthetic appearance. The choice of the reconstructive technique follows the principles of the reconstructive ladder but always requires individual adaptation to defect size, depth and location, taking patient-specific factors into account. Depending on the defect location and the involvement of the thumb, fingers or the dorsal or palmar aspect of the hand, different reconstructive options are available, ranging from local and pedicled flaps to microsurgical reconstruction techniques.