Soft Tissue Reconstruction
Skin grafts are commonly used in the hand for soft tissue loss. This involves the loss of skin most commonly at the end of the finger and/or mid palm area. If there is good fatty tissue underneath the loss of skin, then the injured area will support a skin graft. This is often harvested from the hypothenar area of the hand and involves the transfer of full thickness skin. The donor site can be closed primarily and the skin offers a very nice color match to the respective area of injury. If, however, there is significant soft tissue loss more than the skin, including fat and/or bone, then local flaps are indicated in order to cover the wound deficit. These are can be harvested from an adjacent finger or from the thenar eminence area. This is especially important if there is an exposed tendon that requires coverage. Postoperative, the patient would be immobilized in a cast for approximately 2 to 3 weeks to allow for vascular growth into the flap and then the flap is divided at a secondary procedure at that time. Subsequent to the division of the flap, initiation of a therapy program and mobilization of the affected injured site is initiated.