Pedicle flaps for coverage of the wrist and hand

The coverage of wounds about the hand and wrist may be accomplished by numerous pedicled flaps. Attention must be given to preservation of the perforating arteries that supply these fasciocutaneous flaps. Difficulties with wound healing over the area of flap harvest may occur and care must be given to preservation of the peritenon in the distal forearm. The use of fascial flaps may allow coverage that is quite pliable and the radial forearm fascial flap may be performed with preservation of the radial artery. In some cases, the use of a groin flap may be required for coverage of large wounds that do not have arteries available for sacrifice.