Homodigital flaps--especially for treatment of the burned hand

Burn deformities involving the hand can cause a devastating impairment that often requires ingenious solutions to improve function. Fortunately, a skin shortage usually can be expeditiously replaced by autogenous skin grafts; otherwise, a vascularized flap may be imperative. If that is so, use of a donor site from the digit itself would always be preferable, because normal sensation potentially could be maintained with similar thin, extensile, and durable tissue. The sides of the finger often have been protected from the thermal injury and are available for use as homodigital flaps. Although technically this form of homodigital flap is an axial flap because it incorporates dorsal digital artery branches, the proper digital artery is always spared. The immediate transfer of a homodigital flap completes the desired reconstruction in a single stage, which allows early initiation of hand mobilization and rehabilitation.